术语淋巴结病是指一个或多个淋巴结的大小、稠度或形态方面的异常。尽管淋巴结病在日常临床实践中很常见，但区分良性和恶性疾病的困难可能会延迟治疗方法。本综述旨在根据现有文献更新不同临床情况下的诊断算法。进行文献综述以评估当前的知识并更新诊断方法。使用一个简短的临床小插图作为典型临床表现的示例。这例患者病史不完整的转移性淋巴结肿大病例表明，这种淋巴结肿大可能具有误导性，导致诊断延迟，甚至致命。任何淋巴结肿大持续超过 2 周都应被视为可疑并值得进一步检查。精确的临床检查、细致的病史采集和相关症状的搜索仍然是诊断疾病起源的基石。下一步的诊断步骤取决于解剖区域和具体患者的情况。成像从超声波开始，而计算机断层扫描 (CT) 和磁共振成像 (MRI) 可以评估周围的结构。如果诊断仍不确定，则应进行组织取样和组织学分析。除头颈部局部淋巴结肿大外，对于持续性淋巴结肿大尚无系统性指南。本审查澄清了一些令人困惑和复杂的情况。通过使用免疫细胞学和流式细胞术方法的芯针活检可以提高细针抽吸细胞学的准确性。值得注意的是，除了头颈部以外，当怀疑淋巴瘤或之前的细针抽吸细胞学或空芯针活检获得不确定结果时，开放活检仍然是最佳选择。恶性淋巴结肿大的发病率因其部位和不同的诊断策略而异。对于原发性不明的转移性淋巴结病，欧洲肿瘤内科学会 (ESMO) 指南和下一代测序 (NGS) 等现代方法可能有助于处理此类复杂病例。

The term lymphadenopathy refers to an abnormality in size, consistency or morphological aspect of one or several lymph nodes. Although lymphadenopathies are commonly observed in everyday clinical practice, the difficulty of differentiating benign and malignant disease may delay therapeutic approaches. The present review aims to update diagnostic algorithms in different clinical situations based on the currently available literature. A literature review was performed to assess current knowledge of and to update the diagnostic approach. A short clinical vignette was used as an example of a typical clinical presentation. This case of metastatic lymphadenopathy with incomplete patient history demonstrates how misleading such lymphadenopathy may be, leading to a delayed diagnosis and even a fatal outcome. Any lymphadenopathy persisting for more than 2 weeks should be considered suspicious and deserves further investigation. Precise clinical examination, meticulous history-taking and a search for associated symptomatology are still cornerstones for diagnosing the origin of the condition. The next diagnostic step depends on the anatomical region and the specific patient's situation. Imaging starts with ultrasound, while computed tomography (CT) and magnetic resonance imaging (MRI) allow assessment of the surrounding structures. If the diagnosis remains uncertain, tissue sampling and histological analyses should be performed. Except for head and neck loco-regional lymphadenopathy, there are no methodical guidelines for persistent lymphadenopathy. The present review clarifies several confusing and complex situations. The accuracy of fine needle aspiration cytology could be increased by using core needle biopsy with immunocytologic and flow cytometric methods. Notably, except in the head and neck area, open biopsy remains the best option when lymphoma is suspected or when inconclusive results of previous fine needle aspiration cytology or core needle biopsy are obtained. The incidence of malignant lymphadenopathy varies with its location and the various diagnostic strategies. In metastatic lymphadenopathy of unknown primary origin, European Society for Medical Oncology (ESMO) guidelines and modern methods like next-generation sequencing (NGS) may help to manage such complex cases.