common in infants and children less than years of age, is a neuroendocrine tumor arising in the adrenal glands, but can originate in the high thoracic and cervical sympathetic ganglia or metastasize to cervical and supraclavicular lymph nodes Again, prompt imaging with chest radiograph, as well as abdominal imaging with computed tomography (CT) or magnetic resonance imaging (MRI) should be initiated in cases of suspected neuroblastoma Rare noninfectious causes of chronic cervical lymphadenopathy deserve consideration in the appropriate clinical context Sarcoidosis is a multisystem granulomatous disorder that affects young adults, particularly African Americans, causing systemic symptoms such as weight loss, cough, fatigue, and joint pain Patients often have chronic bilateral cervical adenopathy, and chest radiograph in such patients may reveal hilar adenopathy as well Autoimmune lymphoproliferative syndrome (ALPS), also known as Canale–Smith syndrome, is a genetic disorder of lymphocyte apoptosis leading to lymphadenopathy, splenomegaly, and pancytopenia Children with ALPS present in the first year of life with massive cervical adenopathy and splenomegaly Histiocytic disorders, another uncommon group of diseases that cause prominent cervical adenopathy, occur when there is an overproduction of dendritic cells or macrophages which cause organ damage and tumor formation Langerhans cell histiocytosis (LCH) affects children less than years of age, causing lytic bone lesions and unilateral or bilateral soft and matted cervical lymphadenopathy Sinus histiocytosis with massive lymphadenopathy (Rosai–Dorfman disease) presents in children as massively enlarged, nontender cervical lymphadenopathy, along with involvement of the nasal cavity, lytic bone lesions, pulmonary nodules, or rash Finally, the syndrome of periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) is an autoinflammatory disease presenting in young children that cycles every to weeks Children with PFAPA experience tender cervical lymphadenopathy with flares There is no specific diagnostic test, and though corticosteroids and nonsteroidal anti-inflammatory drugs alleviate symptoms, the condition resolves spontaneously by 10 years of age Other Lymphadenopathy of the Head and Neck Beyond cervical lymphadenopathy, acute localized adenopathy of the head and facial regions has a more narrow differential diagnosis, and the location of lymphadenopathy often suggests a cause, based on the location of focal infections and drainage patterns of nodes Submandibular and submental nodes, draining the lips, buccal mucosa, and floor of the oropharynx, enlarge with infection within the oral cavity This includes dental caries and abscesses, as well as gingivostomatitis Herpetic gingivostomatitis generally affects the anterior tongue, buccal mucosa, or lips, while Coxsackievirus gingivostomatitis affects the posterior oropharynx, sparing the gingiva and lips, and causes characteristic lesions on palmar and plantar surfaces Lymphadenopathy in the