Every third appeal to an oncologist on social networks or on remote consultation portals is formulated something like this: “save, help, I have enlarged lymph nodes.”
As a rule, young people write, usually from 18 to 25 years old, and I don’t remember a case when it eventually turned out that the situation required treatment from an oncologist. Most often, enlarged lymph nodes were caused by a sore tooth, sore throat, conjunctivitis, and so on.
It is clear that fear and fears for one’s health in such cases force one to immediately run to an oncologist.
However, is everything so simple, and is it worth rolling your eyes about any treatment with an enlarged lymph node?
My personal statistics show: if a person comes for a face-to-face consultation, he is already one of those few whose situation was not limited to the banal “it got sick and went away.”
Let's take a closer look at how the lymphatic system works and understand the nature of enlarged lymph nodes.
Fact #2
Lymphatic vessels are not something abstract.
It is worth crossing or ligating them, for example, during surgery on the axillary lymph nodes for breast cancer, and lymphostasis is likely to develop - swelling of the limb, which, again, most likely will not go away.
The most visible to us from the point of view of examination - the so-called peripheral lymph nodes (in the neck, supraclavicular, axillary and inguinal) can increase, and this is in most cases a manifestation of reactive lymphadenopathy - an inflammatory reaction indicating the fight against infection.
Survey
Enlargement of the cervical lymph nodes, which is not accompanied by other symptoms, is an indication for consultation with a hematologist. When lymphadenopathy is combined with signs of damage to the respiratory and digestive systems, consultation with other specialists may be required. Diagnosis involves assessing the condition of pathologically changed lymph nodes and identifying the cause of the condition. The most valuable are:
- Ultrasonography
. Ultrasound of the lymph node is performed to study the morphological structure of the affected tissue; the method allows you to detect hyperechoic and hypoechoic zones. Additionally, ultrasound of the thyroid gland and sonography of the thymus are recommended to determine the root cause of lymphadenopathy. - Blood tests
. Infectious and hematological diseases, in which enlargement of the cervical lymph nodes is possible, are characterized by changes in blood counts. Patients are prescribed a standard general analysis, biochemical study, and determination of the level of acute phase indicators. - Lymph node biopsy.
Collection of cytological material from the affected organ followed by histological examination is recommended to verify the diagnosis. The method is primarily used for differential diagnosis of malignant tumors of lymphoid tissue and metastases with other diseases. - Lymphography
. A radionuclide study of the lymphatic system using the introduction of a special radiopharmaceutical is prescribed to study the pathways of lymphatic drainage and exclude oncopathology. The method is widely used for the neck area, since standard radiography is difficult.
A further list of studies is formed taking into account the patient’s complaints. Often an examination of the upper respiratory tract is required - pharyngoscopy, rhinoscopy, laryngoscopy. To confirm the infectious etiology of the process, specific serological reactions are performed (RIF, ELISA, PCR). If a connection between lesions of the cervical lymphatic structures and pathology of the thyroid gland is suspected, a blood test for triiodothyronine and thyroxine and scintigraphy with radioactive iodine are performed.
Fact #3
Most often, the cervical and submandibular lymph nodes become inflamed, because in the facial part of the skull there are many open mucous membranes and associated infections.
A sore throat, carious or rotten teeth, and ear and eye bacterial and viral infections are the most common causes of cervical lymphadenopathy. The axillary and inguinal nodes react according to the same principle.
Therefore, if a lymph node is bothering you, first of all you need to go to a therapist, dentist, or ENT doctor.
If the genesis of lymphadenopathy is unclear, the doctor will prescribe an ultrasound, and during this study, attention will be directed mainly not to the size of the lymph node, but to its shape and differentiation of the structure.
Causes of inflammation of the cervical lymph nodes
There are many factors that can trigger the appearance of inflammation in the body. There are several groups of lymph nodes in the neck area: superficial and deep. The action of the former is aimed at protecting the external integument, while the latter prevents the penetration of infection into the internal organs. Bacterial or viral infection of the pharynx, larynx, trachea, upper esophagus, as well as the oral cavity, nose and ear are the most common causes of inflammation of the cervical lymph nodes.
They can call him:
Fact #5
Lymph nodes enlarge during cancer because cancer cells enter the lymphatic vessels draining a certain area, which then settle in the “filters” (lymph nodes) in the form of metastases and begin to grow there.
Such lymph nodes do not shrink after treatment of infectious diseases, but only increase, merging with other lymph nodes into conglomerates, extending beyond the lymph node and fixing it in the surrounding tissues. Such lymph nodes are rarely painful, they are dense, very dense.
Often in cancer, lymph nodes are affected by a “chain” that is clearly visible on palpation. With lymphomas, conglomerates are often visible from the outside. Of course, with such manifestations you need to go to an oncologist and hematologist.
For suspicious nodes, a biopsy will be performed in the absence of other causes. This is either a puncture with a needle and collection of material, or an operation to completely remove the lymph node for histological examination.
Inflammation of the lymph nodes
Reactive lymphadenitis is the most common cause of palpable swelling of the neck or lymph nodes in children, adolescents, and adults of any age.
Lymph nodes are located throughout the body as part of the lymphatic system, which also includes lymph capillaries, vessels, and ducts. In healthy people, in the area of the lower jaw, neck, groin, etc., it is possible to palpate under the skin several small, less than 1 cm, seals that are visually invisible. Lymphadenopathy is a noticeable enlargement of a lymph node greater than 1 cm.
Patients of different ages come to see specialists at the Miracle Doctor clinic with symptoms of lymphadenitis, who either themselves discovered enlarged lymph nodes, or were referred by another specialist who discovered characteristic signs:
- painful subcutaneous thickening over 1 cm, located in the anatomical areas of the lymph nodes: under the jaw, on the neck, in the groin, under the armpit, etc.
- limited mobility and tight fit of the nodes to the surrounding tissues,
- the appearance of a lump is accompanied by headache, malaise, weakness, and changes in body temperature.
Causes of enlarged lymph nodes
Lymph nodes are “filtration stations” in the lymphatic system and are involved in activating the immune system when infectious pathogens enter the lymph flow.
Some components of blood plasma and foreign cells (for example, cancer cells, microorganisms) penetrate into the lymphatic vessels along with cellular material, antigens, etc.
Thanks to the filtration process, antigens also interact with lymphocytes contained in the lymph nodes. The immune response of these lymphocytes involves cell proliferation, which can cause enlarged nodes—reactive lymphadenopathy. Pathogenic microorganisms that enter the lymphatic fluid can directly infect nodes, causing lymphadenitis.
Thus, lymph node inflammation is primarily found in the context of inflammation and malignant diseases. If a patient has swollen lymph nodes, there are primarily two types of causes: benign causes, which are much more common, and malignant causes, which must be taken into account due to their serious consequences.
Depending on the duration of the course and manifestations, acute and chronic lymphadenitis are distinguished. Acute lymphadenitis can end in a purulent stage, with the formation of an abscess and the possible entry of purulent infected contents into adjacent tissues. Chronic develops after acute inflammation subsides and can be wavy in nature.
Diagnostics
The main goal is to establish the primary cause of the development of lymphadenopathy and differential diagnosis of other diseases with similar symptoms - phlegmon, purulent atheroma, etc.
Clinical examination and history taking are essential. Palpation is carried out to determine the number and degree of pain of the superficial inflamed lymph nodes, especially in the neck (including the occipital and supraclavicular regions), armpits and groin. The size of the nodes, sensitivity and degree of elasticity, mobility of the lymph nodes in the adjacent tissues are determined.
The duration of inflammation is established, the following are noted:
- possible skin injuries, especially cat scratches, rat bites;
- the presence of infections in the areas drained by the affected nodes: infectious and inflammatory diseases of the upper respiratory tract, lesions or discharge from the genitals, joint pain, swelling, local soft tissue infections, dental infection;
- information on recent travel to countries with endemic infections (eg, Middle East, Africa);
- history of taking medications that contain trigger components.
Doppler ultrasound allows you to determine the length, width, shape, echogenicity of blood vessels, and therefore the degree of damage to the lymphatic system and determine the causes of the pathology.
Histological examination after diagnostic biopsy of the lymph node is usually prescribed for the differential diagnosis of malignant tumors and destructive changes in tissues.
A complete blood count may reveal an abnormal number of white blood cells, which is a reason to prescribe a tuberculin skin test and serological tests for mononucleosis, toxoplasmosis, sexually transmitted diseases, and a test for antibodies to SLE.
As a rule, the treatment of lymphadenopathy is carried out by the attending physician, who can refer the patient for consultation with a specialist.
Depending on the true cause of lymphadenopathy, antiviral and antibacterial drugs and physical therapy sessions may be prescribed. For purulent formations, surgical sanitation, installation of drainage and drug treatment are performed.
Treatment
Since adenopathy itself is not curable, treatment is aimed at eliminating the cause that provokes the development of lymphadenopathy. Patients with generalized lymphadenopathy—numerous swollen lymph nodes—usually have a systemic disease causing the inflammation, while patients with localized adenopathy usually have a local disease.
3. Diseases leading to inflammation of the lymph nodes
If the lymph nodes become inflamed and enlarged in more than one area of the body, it is called generalized lymphadenopathy.
This inflammation of the lymph nodes is caused by:
- Viral diseases such as measles, rubella, chickenpox or mumps;
- Mononucleosis, the symptoms of which are fever, sore throat, fatigue, as well as the viral infection cytomegalovirus that causes similar symptoms;
- Bacterial diseases such as strep throat (caused by streptococcus bacteria) or Lyme disease (a bacterial infection spread by certain types of ticks);
- Side effects from taking phenytoin, a medicine used to prevent seizures;
- Side effects from the measles-mumps-rubella vaccine;
- Cancer - leukemia, Hodgkin's disease and lymphoma;
- AIDS, acquired immunodeficiency syndrome;
- Syphilis is a sexually transmitted disease.
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Why does inflammation of the lymph nodes in the neck occur?
So why does inflammation of the lymph nodes in the neck occur? Lymph nodes are an integral part of the human immune system, part of its defense, a kind of biofilter that helps prevent the development of many diseases. If the filter becomes clogged and simply cannot cope with pathogenic microorganisms, inflammation occurs. Thus, if your lymph nodes hurt, it means there is an infection in your body that threatens your health. In total, nine pairs can be classified as cervical lymph nodes, one way or another connected with the area of the face or neck. They are located near the ears, jaw, above the collarbones and even under the tongue, so the occurrence of pain in these areas may indicate inflammation of the lymph nodes.
Most often, the cervical lymph nodes become inflamed due to a sore throat or ear infection. Also, the cause of the painful condition can be ARVI, which peaks in the autumn and spring periods, influenza, any diseases of the oral cavity, from stomatitis to caries. The lymph nodes located next to the ears become inflamed with otitis media. The location of the lymph nodes plays an important role in determining the source of infection, since they usually signal disease in nearby organs.
Much less often, pain in the lymph nodes occurs due to metabolic disorders, alcoholism, thyroid disease or simple allergies, however, it would be wrong to completely exclude these options.
In addition, inflammation of the lymph nodes, unfortunately, can be associated with serious problems, for example, mechanical damage (trauma) to the lymph node itself or nearby tissues, as well as cancerous degeneration of lymph tissue cells.
Be that as it may, inflamed lymph nodes are a sign of dysfunction of the immune system. In this regard, there is a common misconception that pain in individual nodes, their enlargement, may indicate the presence of AIDS in a person. This is not an entirely correct statement, since HIV-infected people suffer from enlargement of entire groups of lymph nodes.
4.Treatment of lymph nodes
Treatment of swollen lymph nodes involves treating the cause of their enlargement, swelling and pain. For example, a bacterial infection is usually treated with antibiotics, but a viral infection often goes away on its own. A more serious case is cancer. If there is reason to suspect that enlarged lymph nodes are associated with oncology, a biopsy may be performed and, of course, a full examination by a good doctor is necessary.
In any case, if the enlarged lymph nodes do not go away in about a month and their size does not decrease, you should consult a doctor. In general, lymph nodes may remain swollen long after the infection has passed. This is especially common in children.