Traditional medicine

Lymphadenopathy: types, manifestations, localizations and possible causes, approach to treatment. Reactive lymphadenopathy: description of the disease, causes, symptoms, treatment methods, reviews Reactive lymphadenopathy

Lymphadenopathy is a change in the size of lymph nodes of various locations. In most cases, this condition is only a manifestation of the underlying disease. In the absence of the necessary help, uncontrolled enlargement of lymph nodes can lead to serious complications that threaten the health and even life of the patient.

Why are lymph nodes needed?

So, lymphadenopathy. What is it and how to deal with it? Before asking such a question, you should understand what function lymph performs. This colorless liquid penetrates all organs, returning all nutrients from the tissues to the blood. Along the path of lymph flow there are control points - lymph nodes, which receive vessels from various places in the human body.

Anyone who has ever visited a therapist knows about the presence of these organs. Lymph nodes are of great importance for the normal functioning of the entire body. In essence, they are biological filters that do not allow harmful agents to penetrate organs and tissues. The lymph passing through them is cleared of bacteria and other foreign substances and enriched with antibodies, thereby providing adequate protection for the entire body.

Lymph nodes work around the clock, without “breaks and weekends.” Collecting lymph from every corner of the human body, these organs constantly guard our health. Trying to find out if everything is okay with the patient, the doctor first palpates the lymph nodes of various locations. Based on the state of these organs, one can draw conclusions about the functioning of the entire body, as well as timely notice the development of many dangerous diseases.

Lymphadenopathy: what is it? Reasons for development

Acting as a collector, the lymph node is forced to collect all harmful substances that enter the body. Sooner or later, this well-established mechanism may fail, causing a condition called lymphadenopathy of the lymph nodes. What can cause this pathology? There are several similar factors:

infectious diseases (influenza, stomatitis, rubella, tuberculosis and many others);
human immunodeficiency virus (HIV);
oncological diseases;
mechanical injuries;
allergic reaction;
diseases of internal organs.

Classification

Depending on the degree of damage to the lymph nodes, the following types of lymphadenopathy are distinguished:

localized (local enlargement of one lymph node);
regional (damage to lymph nodes in two adjacent areas);
generalized (changes in lymph nodes in more than three groups)

The localized form occurs in 70% of cases and is usually associated with localized infection or trauma. Lymphadenopathy of the cervical lymph nodes is characterized by their regional damage, and generalized inflammation indicates a serious disturbance in the immune status of a person.

Symptoms

Regardless of the location, this pathology has a number of similar signs that make it possible to recognize it among other diseases. The affected lymph nodes are enlarged, hot and painful to the touch. There may be unpleasant sensations in the area where the process is localized, especially when changing body position.

General symptoms include fever, weakness, chills. In the acute period, enlargement of the liver and spleen is possible. In case of an infectious lesion, the signs of a particular disease that provoked an enlargement of the lymph nodes come to the fore.

An experienced doctor will be able to make a diagnosis during the initial examination and determine the tactics for further treatment of the patient. Knowing exactly how lymph moves through the body, you can find out not only the location, but also the cause of the pathological process. Let's take a closer look at each particular case of lymph node enlargement.

Enlarged cervical lymph nodes

Cervical lymphadenopathy is quite common. Lymphadenitis localized in this area is dangerous due to its proximity to brain structures. If the immune system cannot cope with the problem that has arisen, the consequences for a person can be very sad.

Lymphadenopathy of the cervical lymph nodes can be caused by a variety of reasons. Most often, this condition develops when a viral or bacterial infection enters the body (influenza or other acute respiratory infections). Cervical lymphadenitis is most typical for children whose immune system has not yet fully formed. At an early age, even ordinary stomatitis or gingivitis can cause a sharp increase in the submandibular lymph nodes, which is accompanied by high fever and chills.

Cervical lymphadenopathy can be associated with various malignant neoplasms, which forces doctors to be especially careful about this symptom. In this case, the patient requires consultation not only with a therapist, but also with an oncologist. With syphilis and tuberculosis, enlarged lymph nodes are also one of the most common signs.

Enlarged lymph nodes in the chest area

Mediastinal lymphadenopathy is considered among doctors to be one of the most dangerous symptoms. In most cases, this condition develops in patients after 40 years of age and indicates the presence of a malignant neoplasm. This can be a tumor of the lungs or heart, or metastases from the abdominal cavity or pelvis. In any case, such a pathology requires prompt diagnosis, including ultrasound examination of internal organs, magnetic resonance imaging and biopsy of affected tissues.

Mediastinal lymphadenopathy can occur in various diseases of the internal organs. Most often we are talking about pathology of the thyroid gland, dysfunction of which leads to changes in the flow of lymph. Some connective tissue diseases (systemic lupus erythematosus, scleroderma and others) can also be a direct cause of lymphadenitis.

Inflammation of the pulmonary lymph nodes

This situation is a fairly common finding during radiography. Pulmonary lymphadenopathy is a special case of damage to the mediastinal lymph nodes. Such a symptom may indicate the development of a dangerous disease such as lung cancer. Typically, this pathology occurs in older people who smoke or work in hazardous enterprises. The development of tuberculosis or sarcoidosis is possible - in both cases, pulmonary lymphadenopathy is one of the very first symptoms. With simple pneumonia and bronchitis, changes in the lymph nodes also occur. For a more accurate diagnosis, you should take a photograph of the affected organ in two projections, and also be sure to visit a phthisiatrician or oncologist.

Enlarged axillary lymph nodes

Lymph nodes of this localization are very sensitive to the slightest changes in the immune status and can enlarge even with ordinary flu or ARVI. In this case, axillary lymphadenopathy does not require special treatment and goes away on its own upon recovery from the underlying disease. With any serious injury to the upper extremities, the lymph nodes of this location are also involved in the pathological process.

A similar symptom in women of any age deserves close attention. Axillary lymphadenopathy may be one of the first signs of breast cancer. If a woman discovers this type of abnormality, she should immediately make an appointment with a mammologist.

Generalized lymphadenopathy

This medical term refers to an enlargement of three or more groups of lymph nodes that lasts more than one month. In children and adolescents, the most common cause of this condition is infectious mononucleosis, a disease caused by the Epstein-Barr virus. In some situations, the symptoms are smoothed out, and the pathological process occurs under the guise of a common cold. Occasionally, an increase in a large number of lymph nodes occurs with rubella and measles.

Generalized lymphadenopathy in adults may indicate the development of HIV infection. In this case, the process affects three or more groups of lymph nodes and lasts at least three months. ELISA, an analysis to determine immunodeficiency virus antibodies in peripheral blood, will help confirm the diagnosis.

Diagnostics

During the initial examination, the affected lymph nodes are palpated. The doctor determines the localization of the process, the consistency and pain of the changed organ. In most cases, such a simple technique allows you to determine the vector of further examination and make a preliminary diagnosis.

After collecting anamnesis and identifying risk factors, the doctor will prescribe laboratory tests, which will certainly include general blood and urine tests. If necessary, ultrasound of internal organs, chest X-ray, and magnetic resonance imaging are performed. All these manipulations make it possible to find out the cause of lymphadenitis and determine treatment tactics.

In some cases, puncture of the affected lymph node followed by a biopsy may be required. This method allows you to find out exactly the reason for which lymphadenopathy developed. What is it? Under local anesthesia, a puncture is made with a thin needle, after which a piece of the desired tissue is taken. This procedure allows you to identify metastases in an enlarged lymph node, detect a purulent process or other pathological changes.

Treatment of lymphadenopathy

It is worth considering the fact that enlarged lymph nodes in themselves are not a separate disease. This is why it is so important to find the reason why lymphadenopathy developed. Treatment will depend on the underlying diagnosis and identification of the factors that gave rise to the occurrence of such a problem.

In the case when lymphadenitis is caused by any infectious agent, the patient is sent under the supervision of a therapist. For most viral and bacterial diseases, no special treatment is required: after recovery, the lymph nodes will return to their normal state on their own.

Quite often, oncological diseases lead to a phenomenon such as lymphadenopathy. Treatment in this case will depend on the severity of the underlying disease. The treatment regimen is approved by the oncologist and may include both surgery and other available methods.

In some cases, an enlarged lymph node may be caused by direct trauma. In this case, the patient also ends up on the surgeon’s table. Opening the affected organ with removal of purulent contents allows you to completely solve the problem of lymphadenopathy.

Any unreasonable enlargement of lymph nodes requires a thorough examination by a specialist. Even if lymphadenopathy is not a sign of a serious illness, it can cause some discomfort and lead to a deterioration in overall health. Timely diagnosis allows not only to prevent the development of the pathological process, but also to help the patient cope with his own fears regarding the current situation.

The lymphatic system, which protects the body from pathogenic microflora, consists of lymphatic vessels, capillaries, lymphoid organs and nodes. Lymph nodes, in turn, are the main element of the lymphatic system, which undergoes significant stress and, accordingly, is susceptible to various pathological conditions. Lymphadenopathy is one of them.

Lymphadenopathy (ICD-10 International Classification code R59) is a condition accompanied by enlargement of lymph nodes caused by certain diseases or external influences. The pathology occurs in both adults and children, can be life-threatening and requires immediate medical intervention.

Classification

Lymphadenopathy can form in any part of the body and even affects internal nodes

Depending on the extent of the pathological process, the following forms of lymphadenopathy are distinguished:

local, affecting one group of lymph nodes;
generalized, involving several groups of lymph nodes in the pathological process at once

Attention! Generalized lymphadenopathy is a serious condition that requires immediate medical attention.

Depending on the reasons that led to the development of pathology, lymphadenopathy is divided into:

nonspecific (reactive), which is the body’s reaction to certain irritants - infectious diseases, allergic reactions, inflammation;
specific, resulting from diseases that directly affect the lymph nodes - tuberculosis, HIV infection, mononucleosis, cancer;
idiopathic, developing in the absence of health problems (lymphadenopathy of unknown origin is rare).

According to the nature of the course, lymphadenopathy of the lymph nodes is divided into:

spicy;
chronic;
recurrent.

Depending on the form, the pathology is divided into:

tumor;
non-tumor.

In addition, lymphadenopathy is divided into:

primary;
secondary.

Primary lymphadenopathy is an enlargement of the lymph nodes caused by inflammatory processes in the lymphatic system. There is no generalized lymphadenopathy.

Secondary lymphadenopathy is an enlargement of the lymph nodes that develops as a result of the penetration of pathogenic microflora into them from other foci of infection.

Reasons

In some cases, taking the drug Carbamazepine can cause the development of reactive lymphadenopathy

In the vast majority of cases, lymphadenopathy is a consequence of:

Reactive lymphadenopathy can develop due to the use of the following drugs:

Captopril;
Quinidine;
Hydralazine;
Phenytoin;
Allopurinol;
Pyrimethamine;
Carbamazepine;
Penicillin;
Atenolol;
gold preparations;
cephalosporins;
sulfonamides, etc.

Depending on the location, lymphadenopathy is divided into:

submandibular;
inguinal;
cervical nodes;
mediastinal;
supraclavicular, etc.

Submandibular lymphadenopathy is the most common pathology and is usually diagnosed in children and adolescents. This is explained by the fact that the lymph nodes included in this group most often react to various infections transmitted by airborne droplets.

Interesting. According to many experts, inflammation of the submandibular lymph nodes in children is one of the normal variants.

Inguinal lymphadenopathy occurs in both children and adults and develops against the background of diseases of the genitourinary system.

Lymphadenopathy of the cervical lymph nodes, as a rule, is a consequence of diseases of the oral cavity, salivary glands, larynx, childhood infections (rubella, mumps), tumors of the parotid gland, diffuse cervical lipomatosis. When the root cause is eliminated, the pathology goes away on its own.

Mediastinal lymphadenopathy (enlarged mediastinal lymph nodes) is observed with inflammation and lung cancer, tuberculosis.

Retroperitoneal lymphadenopathy may be one of the signs of lymphoma or other cancer.

Enlarged lymph nodes in the groin develop against the background of diseases of the genitourinary system

The parotid lymph nodes can become inflamed due to diseases of the organs of vision, adenovirus infection, and “cat scratch disease.”

Enlargement of intrathoracic lymph nodes (IHLN) usually accompanies the formation and growth of malignant tumors and metastases in the chest area.

Supraclavicular lymphadenopathy is mainly caused by cancer. Thus, right-sided enlargement of lymph nodes in the supraclavicular region develops against the background of the growth of malignant tumors in the lungs, esophagus, and mediastinum. A change in the size of the lymph nodes above the collarbone on the left can accompany damage to the kidneys, testes, ovaries, prostate and pancreas, gall bladder, and stomach. The bilateral form of this pathology, as a rule, does not occur.

Enlarged iliac lymph nodes may indicate a viral, bacterial, fungal infection, syphilis, tuberculosis, or cancer.

Lymphadenopathy of paraumbilical (peri-umbilical) lymph nodes indicates the presence of malignant processes in the abdominal cavity or pelvis.

Enlargement of the visceral nodes of the mediastinum may indicate the presence of a tumor in the lungs or esophagus.

Lymphadenopathy of the axillary lymph nodes (both unilateral and bilateral) occurs as often as submandibular lymph nodes - nodes located in the armpits react to the slightest health problems. An increase in this group of lymph nodes may also indicate the presence of malignant processes in the mammary gland.

Pulmonary lymphadenopathy is, as a rule, a reaction of lymphoid tissues to various stimuli - inflammatory processes, etc.

Changes in the size of the lymph nodes of the abdominal cavity may indicate leukemia, metastases of malignant neoplasms of the intestine, and intestinal infections.

Symptoms

With lymphadenopathy, a sharp enlargement of the liver may occur

The main symptom of lymphadenopathy is an increase in the size of the lymph nodes. In addition, patients may experience:

weight loss;
sweating;
increased body temperature;
rashes on the skin;

There are about six hundred lymph nodes in the adult human body. However, you can palpate only those of them that are located in places accessible to palpation - on the neck, armpits, groin, on the head.

Which doctor should I contact?

The answer to the question which doctor will cure is ambiguous. Diagnosis of lymphadenopathy begins with examination and questioning of the patient. The initial appointment is carried out by a general practitioner. He is usually interested in:

the patient's medical history, medications he is taking;
the size of the lymph nodes (normally their diameter is 1-1.5 centimeters);
severity of pain - pain may indicate the onset of inflammatory processes, the development of an abscess or necrosis of the lymph node;
density of lymph nodes - soft and elastic lymph nodes indicate the presence of infectious and inflammatory processes, and compaction indicates metastasis of malignant neoplasms;
adherence of nodes to each other - “packets” of lymph nodes may indicate the presence of malignant tumors or tuberculosis;
localization of pathology.

In addition to examination, patients may be prescribed:

general and biochemical blood tests;
tests for tumor markers, markers of HIV and viral hepatitis;
Ultrasound of the pelvic region and abdominal cavity;
chest x-ray.

In the future, after a diagnosis has been made, consultations with specialized specialists may be required: a surgeon, an infectious disease specialist, an oncologist, an endocrinologist, a phthisiatrician, a urologist, as well as additional diagnostic methods.

Treatment

The treatment regimen for lymphadenopathy depends on the disease that caused it. Enlarged lymph nodes in themselves cannot be treated, as they are a symptom of a particular pathology.

Let's look at how diseases accompanied by lymphadenopathy manifest themselves and are treated, and what needs to be done in a particular case.

Tuberculosis of the lymph nodes

The lesion may affect any of the groups of lymph nodes in the neck

It usually develops in children and adolescents (it practically never occurs in adults and older people). Most often the disease affects the cervical and submandibular lymph nodes, less often - the axillary, and very rarely - the elbow and inguinal.

The onset is characterized by a significant increase in body temperature, intoxication, and involvement of the skin and subcutaneous tissue in the pathological process. Lymph nodes increase in size and form large, almost motionless bags.

Lymphadenopathy in tuberculosis quickly turns into lymphadenitis - inflammation of the lymph nodes.

Depending on the nature of the course, tuberculous lymphadenitis is divided into:

infiltrative, accompanied by an increase in one group of nodes and their compaction;
caseous, spreading to several groups of lymph nodes and accompanied by cheesy necrosis, suppuration, formation of ulcers and fistulas;
indurative, characterized by compaction of the lymph nodes with petrification, scarring of the skin at the site of healed fistulas.

Treatment of pathology can be carried out in two ways:

conservative;
operational.

The type of medication, as well as its dosage, is selected by the attending physician depending on the nature of the course of the disease.

Surgical treatment is used when conservative treatment is ineffective. In this case, the affected lymph nodes are opened, their contents are removed, the cavity is disinfected and drained.

Occasionally, lymph nodes are excised, but this can lead to relapse of the disease or its spread to other organs and systems of the body.

Infectious mononucleosis

It is a viral disease that develops as a result of infection with the Epstein-Barr virus. The disease is characterized by an acute onset and is accompanied by fever, weakness, headaches, muscle and joint pain, tonsillitis and lymphadenopathy, spreading to the submandibular and posterior cervical lymph nodes (in some cases, the inguinal, axillary and cubital lymph nodes are affected).

Occasionally, acute mesadenitis develops. A quarter of patients develop skin rashes. The liver and spleen usually become enlarged.

Treatment of patients with mild and moderate forms is carried out at home (in this case they are isolated). In more severe cases, they are hospitalized.

In case of liver inflammation, a restorative diet is prescribed - table No. 5.

No specific therapy for the disease has been developed. People suffering from this pathology are given symptomatic, detoxification, desensitizing and restorative treatment.

Antibacterial agents are prescribed only in the presence of bacterial complications. In the presence of hypertoxic lesions and signs of asphyxia, which has developed against the background of enlarged tonsils and swelling of the oropharynx, glucocorticoids are used.

The oropharynx is sanitized with antiseptic solutions.

Protracted and chronic forms of pathology are treated with the use of immunocorrectors - agents that restore the functioning of the immune system.

Rubella

Take 1 tablet 2-3 times a day

The disease begins with a slight increase in body temperature, a feeling of general malaise, fatigue, drowsiness, and headache. Some patients experience a runny nose, sore throat, dry cough, redness of the throat, and rashes on the soft palate. The posterior cervical and occipital lymph nodes increase moderately in size, and slight pain appears (in some cases, the disease spreads to the parotid, popliteal, anterior cervical and axillary lymph nodes). After a few days, these symptoms are accompanied by a pale pink, small, profuse rash covering the face, chest, limbs and abdomen.

There is no specific treatment for the pathology. Patients are recommended:

bed rest for three to seven days;
quality food;
antiviral agents (Arbidol, Isoprinosine);
immunomodulators (Anaferon, Cycloferon, Viferon, Interferon, etc.);
detoxification therapy, including drinking plenty of fluids;
vitamin therapy – Ascorutin;
symptomatic therapy - mucolytics, antipyretics, analgesics, antispasmodics and anti-inflammatory drugs.

Hodgkin's lymphoma ()

It takes development from one lymph node and spreads to others. The affected lymph nodes (usually supraclavicular and mediastinal) increase in size, become densely elastic, and in some cases painful after drinking alcohol (there are no adhesions with the skin).

In addition to lymphadenopathy, patients experience the following symptoms:

sudden weight loss;
unexplained rises in body temperature;
profuse night sweats.

Treatment of pathology is carried out comprehensively and may include:

radiation therapy;
chemotherapy;
bone marrow transplant (in severe cases).

Much attention is paid to preventing relapses of the disease through maintenance therapy.

After recovery and during the remission stage, patients are prohibited from undergoing physiotherapeutic procedures, working in hazardous conditions, or staying in places with high radiation levels.

lymphomas

They are part of a heterogeneous group of malignant lymphoproliferative neoplasms, differing in biological properties, morphological manifestations, clinical picture, response to treatment, and prognosis.

At the first stage of development, the disease affects one lymph node, then spreads through metastases. The primary tumor focus can be located both in the lymph nodes and in other organs and tissues.

The affected lymph nodes become denser and form conglomerates (adhesion to the skin and underlying tissues, no pain). Enlarged lymph nodes, in turn, compress blood vessels and nearby organs, which is accompanied by the following symptoms:

superior vena cava syndrome;
portal hypertension;
dynamic intestinal obstruction;
obstructive jaundice.

The main method of treating pathology is chemotherapy using combinations of cytostatic agents. Therapy is carried out in short courses with intervals between them of two to three weeks. If there is no effect, another, high-dose course of chemotherapy is prescribed, followed by hematopoietic stem cell transplantation.

Still's disease

The dosage regimen is individual and depends on the indications, the patient’s condition and his response to therapy.

It is a systemic disease of connective tissue, accompanied by enlarged lymph nodes and spleen, fever, skin rashes, joint pain, and rarely arthritis.

There is no specific treatment for the pathology. Patients are prescribed symptomatic therapy, including:

non-steroidal anti-inflammatory drugs in the acute period;
systemic corticosteroids (Prednisolone or Dexamethasone) in the presence of pathological processes in the lungs or the absence of positive dynamics during treatment with non-steroidal anti-inflammatory drugs;
Cyclophosphamide or Cyclosporin A, which have immunosuppressive, antitumor and cytostatic effects.

Viral hepatitis

In addition to liver symptoms, they are accompanied by lymphadenopathy, fever, lung damage, hemorrhagic vasculitis, Sjögren's syndrome, and polyserositis.

Treatment of viral hepatitis is carried out comprehensively and includes:

antiviral agents;
interferons;
hepatoprotectors;
antihistamines and hormonal agents;
antibacterial drugs (rarely, according to indications).

Sarcoidosis

It is a granulomatous inflammation, accompanied by inflammation of the bronchopulmonary (less commonly peripheral) lymph nodes, damage to the lungs and other organs, and suppression of cellular immunity.

Treatment for sarcoidosis is symptomatic and includes:

hormonal drugs;
antiviral agents;
vitamin and mineral complexes.

Tularemia

Tularemia can only be treated in a hospital setting

It is characterized by an acute onset - a significant increase in body temperature, headaches and muscle pain, weakness, lack of appetite, vomiting, regional lymphadenitis. In addition, you may experience:

delirium, agitation, lethargy (rarely);
pain in the eye, in the throat when swallowing, behind the sternum, in the abdomen (in the area of the developing bubo).

By the end of the first week of the disease, the liver and spleen enlarge.

Treatment of tularemia is carried out in a hospital setting. Patients are prescribed:

antibacterial drugs;
detoxification agents;
anti-inflammatory and antipyretic drugs;
antihistamines;
cardiovascular medications (if necessary).

The ulcerations are covered with sterile bandages, the festering buboes are opened and drained.

Cat scratch disease (benign lymphoreticulosis)

It is an infectious disease that develops after being bitten, scratched or salivated by infected cats. Accompanied by regional lymphadenopathy, quickly turning into lymphadenitis, fever, enlarged liver and spleen.

The disease begins with the appearance of an ulcer or pustule at the site of penetration of the pathogen. 15-30 days after infection, the axillary, cervical or elbow lymph nodes enlarge. They reach three to five centimeters in diameter, become painful, and suppurate (there are no adhesions with surrounding tissues). At the same time, the following appear:

signs of general intoxication;
fever;
enlarged liver and spleen.

Lymphadenitis can persist for several months.

Treatment of pathology is carried out comprehensively and includes:

antibacterial drugs;
non-steroidal anti-inflammatory drugs;
painkillers.

When the lymph nodes become suppurated, their contents are sucked out and the cavity is washed with an antiseptic solution.

HIV infection

It develops against the background of infection with the human immunodeficiency virus (HIV), is characterized by a slow progression and is accompanied by damage to the nervous and immune systems, the addition of opportunistic infections, the appearance of tumors, and persistent generalized lymphadenopathy (PGL). When progressing to the AIDS stage, it most often ends in death.

The only treatment for HIV is the use of highly active antiretroviral therapy (HAART), which slows the progression of the disease and stops its transition to the AIDS stage.

Lymphadenopathy of the breast

If any deviations in the vital functions of the body appear, and even more so if visible pathology of the mammary glands is detected, you should immediately seek help from a specialist

The female breast is an anatomically complex organ. Located under the pectoralis major muscle, it has mobility that influences the structure of the lymphatic system in this area.

The main group of lymph nodes in the mammary gland is the paramammary system, consisting of nodes located in the pectoralis major muscle and connecting to the axillary (axillary) lymph nodes.

Breast lymphadenopathy: what is it? This is a condition accompanied by an increase in size of the lymph nodes of these groups. Most often it is caused by mastitis or a breast tumor (benign or malignant).

Since lymphadenopathy is not an independent disease, but only a symptom of a particular disease, its treatment consists of treating the underlying disease.

Traditional medicine (usually medicinal herbs) in the treatment of lymphadenopathy is used exclusively as an addition to the main therapy in order to alleviate existing symptoms.

All types of treatment are used only as prescribed by a doctor.

The main role of the lymphatic system in the body is to cleanse foreign particles and neutralize pathogenic microorganisms. For this reason, enlarged lymph nodes may indicate various disruptions in the immune system. This is how lymphadenopathy occurs in humans.

What is cervical lymphadenopathy

The structural unit of immunity in the body is the lymph nodes, which act as a filter. They contain macrophages and lymphocytes that kill foreign microorganisms that have entered the body. An increase in the size of lymph nodes under the influence of certain factors is called lymphadenopathy.

The proliferation of lymph nodes is associated with their increased production of antibodies, which is the body’s response to pathogenic cells. Lymphadenopathy can appear in several areas at once or in one place. Often there may be an increase in the nodes in the neck. Other types of hyperplasia:

inguinal;
femoral;
supraclavicular;
popliteal;
visceral;
axillary;
mediastinum;
intrathoracic.

Difference from lymphadenitis

Lymphadenitis refers to inflammation of the lymph nodes, often of an infectious nature. Characteristic differences between this disease and lymphadenopathy:

Pathology	Development mechanism	Signs
Lymphadenitis	An infection enters the lymph nodes, which they may not be able to cope with. As a result, they increase.	pain and mobility of the nodes; tension and redness of the skin over the nodes; pain in the lymph nodes when moving; fever.
Lymphadenopathy	It can also be painless. Lymphadenopathy is unilateral or bilateral hyperplasia (enlargement) of nodes. The pathology occurs due to weakening of the control of T-suppressors against the background of simultaneous enhanced transformation of B lymphocytes.	“cold” but slightly enlarged nodes; slight soreness.

Reasons

Lymphadenopathy of the cervical region in childhood often occurs due to acute or chronic infections of the oral cavity or nasopharynx, for example, sinusitis, tonsillitis, rhinitis. This is due to the immaturity of the immune system, which does not always respond correctly to various stimuli. Unvaccinated children are often exposed to diphtheria, mumps, rubella, and measles. In adults, lymphadenopathy can be caused by the following diseases:

In most patients, the cause of hyperplasia of the cervical lymph nodes is opportunistic microflora. Bacteria living on the skin and in the upper respiratory tract begin to multiply when the immune system is weakened. Such microorganisms include streptococci, staphylococci, Escherichia coli and Pseudomonas aeruginosa. Lymphadenopathy when affected by these bacteria occurs in three stages:

Acute serous (catarrhal) lymphadenitis. At an early stage, mild inflammation is observed, which does not threaten complications.
Acute destructive (purulent) lymphadenitis of the cervical lymph nodes. At this stage, fever and pain already appear, which are a reason to consult a doctor.
Adenophlegmon. Irreversible changes form in the lymph node, which is why it cannot be fully restored.

Specific

The group of specific causes of pathological enlargement of the cervical nodes includes infections caused by pathogenic bacteria. Diseases that cause lymph node hyperplasia:

Autoimmune and cancer diseases

In case of cancer pathologies, malignant cells settle inside the lymph nodes and begin to divide. As a result, metastases grow. Because of this, the nodes enlarge, but no inflammatory process is observed. The same can happen with autoimmune processes. Specific causes of pathology:

Autoimmune lymphoproliferative syndrome. With a sharp increase in the process of death of lymphocytes, a painful enlargement of the lymph nodes is observed.
Oncology of lymphoid tissue (lymphoma or lymphogranulomatosis) or metastasis of tumors located in other organs. For example, with a malignant lesion of the stomach, the next tumor may appear on the left side of the neck above the collarbone.

The term “lymph node adenopathy” refers to a pathological condition characterized by a change in shape and an increase in size of one or an entire group of accumulations that are part of the vascular system. In most cases, the disease does not occur independently, but develops against the background of an illness that is a provoking factor. With timely treatment, the prognosis is usually favorable. Ignoring the problem can lead to complications that pose a danger to the patient’s life.

Development mechanism

The lymphatic system is similar in structure to the nervous and circulatory systems. Outwardly, it resembles tree roots. The peculiarity of the lymphatic system is that it unites disparate organs into one whole. In addition, it is responsible for removing excess fluid, toxic compounds, and pathogens from tissues. It also takes part in transporting vital substances and strengthening the immune system.

Located throughout the body. Separate groups of accumulations are localized in the axillary areas, neck, and groin. At the same time, a slight increase in lymph nodes (less than 1 cm in diameter) is not an alarming sign. A similar situation can occur in a healthy person, which is associated with the occurrence of physiological processes in the body.

Under the influence of various unfavorable factors, a significant increase in lymph nodes (1 cm in diameter or more) can occur. Moreover, during palpation it is possible to detect accumulations that have changed in size only in one zone or several at once. In the first case, it is customary to talk about localized adenopathy of the lymph nodes, in the second - about generalized one.

The disease develops as follows: a small amount of plasma and pathogens that enter the body penetrate the biological fluid circulating through the accumulations. At the same time, it must be cleared of harmful compounds before it enters the central venous bed. Pathogens can infect clusters (as a rule, this occurs when the body’s defenses are weakened) and remain in them, carrying out their vital functions. At this time, the lymph nodes begin to increase in size, forming an immune response and trying to cope with foreign agents. Often the accumulations become painful. The clinical picture directly depends on which area of the body is affected.

According to lymphadenopathy, code R59 was assigned.

Reasons

Pathology is rarely independent. Lymphadenopathy is a disease that most often develops against the background of other ailments that serve as provoking factors.

The main causes of pathology:

Various types of infections. The most common underlying diseases in patients are stomatitis, pharyngitis, tooth abscess, HIV, tuberculosis, mononucleosis, toxoplasmosis, and STDs. Less commonly, infectious lymphadenopathy is caused by cytomegalovirus, brucellosis, histoplasmosis, plague, tularemia, rat bite fever, and paracoccidioidomycosis. In most cases, clusters located on the neck are affected, less often in the groin area, the area above the collarbones. In the presence of HIV infection, adenopathy of the lymph nodes is generalized.
Neoplasms. The disease develops against the background of leukemia, lymphoma, and also with metastasis of tumors.
Pathologies of a systemic nature: lupus erythematosus, sarcoidosis, Kawasaki disease.
Taking certain medications. An increase is often caused by the use of medications whose active substances are allopurinol, atenolol, carbamazepine, quinidine, captopril, phenytoin. The pathology also develops while taking antibiotics belonging to the following groups: penicillins, cephalosporins, sulfonamides.
In women, the cause of the disease is often the installation of silicone implants in the mammary glands.

The lymphatic system is directly involved in the formation of the immune response when various foreign agents enter the body. That is why its involvement in the pathological process can occur for many reasons, the main of which are inflammatory and infectious diseases, as well as various types of tumors.

Tuberculosis, oncological pathologies and HIV are diseases that pose a danger to the patient’s life. However, most often lymph node adenopathy is diagnosed in patients with less threatening conditions.

From the point of view of the mechanism of development of the disease, it does not matter what kind of provoking agent entered the body. This is due to the fact that the nature of changes in the structure of the node is always the same.

Symptoms

The clinical picture of the disease directly depends on its form, the individual characteristics of the human body and the underlying pathology. In some cases, damage to even one node may have a stronger intensity of manifestation than changes in an entire group of clusters.

There is such a thing as “reactive lymphadenopathy”. This is a severe form of the disease, in which there is a significant deterioration in the patient’s condition. He is worried about fever, chills, increased sweating, local hyperemia and soreness. If left untreated, the tissue integrity of the affected lymph node is damaged. In this case, inflammatory elements spread throughout the body through the bloodstream, provoking the development of generalized sepsis.

First of all, with lymphadenopathy, the nodes increase in size. It is important to understand that their normal parameters are different for different parts of the body.

The clinical picture and severity of symptoms of inflammation of the lymph nodes are different in each case. They directly depend on which accumulations in which zone are involved in the pathological process. Types of disease:

Cervical lymphadenopathy. The most common form of the disease. The node can be easily palpated. It has a lumpy surface and a dense consistency. The skin located directly above the node becomes red and tight. The patient feels unwell, and signs of an allergic reaction may occur. The nodes are painful. If they are filled with purulent contents, fever is added to the general symptoms of cervical lymphadenopathy. There are several groups of nodes in this zone. Most often inflamed: parotid, occipital, submandibular. Adenopathy of the lymph nodes in the neck most often develops against the background of infectious diseases. Less commonly, it occurs due to oncology and autoimmune pathologies.
Axillary lymphadenopathy. The disease is accompanied by an increase in nodes, which immediately take on a lump-like shape. In addition, patients experience the following symptoms: a general deterioration in health, excessive sweating (usually during night rest), a sharp decrease in body weight, fever, rashes on the skin, local redness, swelling in the area of accumulations. It is important to know that adenopathy of the axillary lymph nodes is a benign pathology in most cases. However, sometimes patients are diagnosed with cancer.
Mediastinal lymphadenopathy. Most often develops after pneumonia. General symptoms of adenopathy of the intrathoracic lymph nodes: pain, cough, shortness of breath, drooping upper eyelid, discomfort when food passes through the esophagus, elevated body temperature, general weakness, headache, itching of the skin. The disease can be either benign or malignant.
Retroperitoneal lymphadenopathy. A peculiarity of this type of disease is the fact that enlarged lymph nodes cannot be detected during a superficial examination. To diagnose the pathology, it is necessary to conduct an x-ray or ultrasound examination. Symptoms of adenopathy of the abdominal lymph nodes: excessive sweating, weakness, slight increase in body temperature, diarrhea. Upon palpation, the doctor detects an increase in the size of the spleen and liver.

If symptoms of inflammation of the lymph nodes appear, you should consult a specialist as soon as possible. This is due to the fact that pathogenic microorganisms spread very quickly with the current of biological fluid circulating in the clusters.

Diagnostics

If the first alarming signs appear that indicate lymphadenopathy (axillary, cervical, mediastinal, etc.), you should consult a physician. If necessary, he will refer you for consultation to specialized specialists (infectious disease specialist, oncologist, surgeon, phthisiatrician, endocrinologist, urologist or gynecologist).

Taking an anamnesis plays an important role in the diagnosis of lymph node adenopathy. The specialist must provide information regarding the existing symptoms and the degree of their severity, as well as talk about episodes of injury, previous infectious diseases, as well as the nature of sexual activity. After this, the doctor conducts an examination, during which he evaluates the size, shape, density, pain and location of the affected node or group of accumulations.

Based on the results of the initial diagnosis, the specialist issues a referral for a comprehensive examination, including:

Clinical and biochemical tests of blood and urine.
Wasserman test.
Serological study.
HIV test.
X-ray examination.
CT, MRI.

If there is a suspicion of a malignant nature of the disease, a sample of bone marrow biomaterial or the contents of the node is taken for cytological and histological studies.

Conservative methods of therapy

The scope of treatment directly depends on the patient’s age, the form of the disease, and the severity of the patient’s condition. The choice of treatment tactics for lymph node adenopathy is made after identifying the underlying pathology that served as a provoking factor.

If the accumulations and surrounding tissues are affected by infection, taking antibacterial drugs is indicated. Before the degree of sensitivity of pathogens to certain substances is revealed, doctors prescribe antibiotics belonging to the group of cephalosporins and fluoroquinolones. As a rule, experts recommend taking Medaxone and Levofloxacin. The duration of treatment depends on the individual health characteristics of the patient and the severity of the disease.

Pathogens spread very quickly throughout the body through the lymph nodes. In this regard, local therapy for the disease should be treated with caution. All medications must be prescribed by a doctor; only he can assess the appropriateness of their use. In almost all cases, experts recommend using Vishnevsky ointment. The product must be applied directly to the affected lymph node.

If during the biopsy it was determined that the pathological process is malignant, the patient is prescribed a course of chemotherapy. The outcome of the disease in this case directly depends on the severity of the underlying disease.

As an additional treatment, doctors prescribe immunostimulating agents. They are designed to strengthen the body's defenses during the fight against the disease. The drug “Glutoxim” has shown high effectiveness in practice.

Surgical intervention

In most cases, adenopathy is treated with medications. Performing surgical intervention is advisable only when the contents of the lymph nodes are represented by purulent fluid.

In such situations, the formation is opened. It is usually carried out using a standard technique - open surgery. After gaining access, the surgeon removes the purulent contents, installs a drainage system through which the discharge will drain, and applies sutures.

Traditional methods

The use of unconventional methods does not eliminate the need to seek qualified medical help. The use of traditional methods is permissible, but only after obtaining the approval of the attending physician. This is because in some cases natural remedies can significantly worsen the course of the disease.

The most effective recipes:

Grind freshly picked dandelion grass. Moisten a cotton swab in the released juice and apply it directly to the affected lymph node. Lotions can be done up to 3 times a day.
Mix nettle and yarrow in equal proportions. Combine these components and fill them with 500 ml of water. Place the container on the fire. Boil for 20 minutes. Let the broth cool. Take the product three times a day before meals.
Mix 500 g of goose or badger fat with norichnik (medicinal plant). The latter must be taken 6 tbsp. l. Treat the affected areas with the resulting ointment.

Features of the disease in children

Until a child reaches 12 years of age, his lymphatic system is immature. At the same time, it begins to form during the period of intrauterine development. It is because of the immaturity of the system that lymph node adenopathy is very often diagnosed among children.

In a newborn baby, accumulations should not be palpable. Otherwise, it is customary to talk about their increase, and, consequently, about the presence of a pathological process.

The first 12 months of life are considered critical. In this regard, if any palpable formations are detected, you should contact your pediatrician. At this age, inflammation of the accumulations most often occurs on the back of the head, in the groin and on the neck. In a child, the cause of enlarged lymph nodes is most often infectious diseases. In addition, adenopathy often develops against the background of systemic pathologies and immunodeficiency. In isolated cases, the disease occurs due to helminthic infestation and an allergic reaction. According to statistics, 10% of young patients are diagnosed with malignant tumors.

If on the neck, the cause may also be an inflammatory process in the oral cavity, including banal teething. If after the first month of life the generalized form of the disease is combined with dermatitis, fever, diarrhea and candidiasis, the doctor assumes the presence of immunodeficiency.

Forecast

The outcome of the pathology directly depends on the timeliness of contacting a specialist. Children under 12 years of age who have palpable formations should be immediately shown to a pediatrician to rule out the presence of serious illnesses. Adults also need to seek medical help promptly.

Lymphadenopathy itself is not dangerous; the underlying disease poses a threat. It is important to know that the cause of the disease can be a malignant process, which, if ignored, leads to death.

In conclusion

Lymph node adenopathy is a pathology that is not an independent disease, but serves as a symptom of numerous ailments. If the first alarming signs occur, you should consult a doctor, who will issue a referral for a comprehensive examination and, based on its results, create the most effective treatment regimen.

As already mentioned, in the International Classification of Diseases (ICD-10), lymphadenopathy is coded R59.

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Axillary lymphadenopathy is an enlargement of the lymph nodes located in the armpits.

There are a number of causes for this condition, so a medical examination is necessary to determine the importance of lymphadenopathy.

Timely diagnosis will help identify the problem and, accordingly, begin its treatment, since lymph nodes can enlarge due to both benign formations and cancer.

At the same time, the reasons may be relatively trivial and do not require special treatment.

Reasons for the development of lymphadenopathy

In order to understand the causes and mechanisms of lymphadenopathy, it is important to know what lymph nodes are and what their role is.

A lymph node is a filter that conducts lymph coming from various organs.

Axillary and intramammary lymph node of the mammary gland - what is it?

Intramammary lymph nodes are located on the lateral edge.

The main part of the lymph drains into the axillary lymph nodes.

The axillary lymph nodes drain the shoulder area, the breast area and the chest wall.

The most common reason why regional lymph nodes of the mammary gland are enlarged is, as a rule, unilateral purulent traumatic lesions or lesions in the arm caused by infection with streptococci or staphylococci, less often tularemia or felinosis.

Axillary lymphadenopathy is caused by infection or malignant disease (malignant lymphoma, breast cancer, malignant melanoma).

Enlarged intramammary nodes may also accompany staphylococcal and streptococcal infections of the arm or sporotrichosis.

In any case, if this symptom occurs - enlarged lymph nodes, you should always consult a doctor and undergo a special examination!

Enlarged axillary lymph nodes

The lymph nodes through which lymph flows, as mentioned above, are a filter, since they, ensuring the outflow of lymph from the mammary gland, constantly monitor and filter it. They contain concentrated white blood cells.

The moment the regional nodes notice that there are some foreign particles such as bacteria in the lymph, the number of white blood cells that can fight infections increases, resulting in an increase in the local nodes in the axillary region.

Enlarged lymph nodes are considered to be those that have an average size of more than 1 - 1.5 cm. In some thin people, lymph nodes in the neck or armpits may even be palpable.

It should be remembered that the lymph nodes enlarge if they are fighting some disease.

We can talk about infection, inflammation, tumor, but enlarged nodes in the armpits also occur with leukemia and lymphoma.

Each group of nodes always signals a violation in a certain part of the body.

The lymph of the mammary gland and chest wall flows in the nodes in the axillary region. Their increase may be a signal of disease of these structures, including oncology.

Classification of axillary lymph nodes

Axillary lymph nodes are part of the lymphatic system, which, together with the venous system, provides drainage to the body.

The lymphatic system removes cell debris from tissues, prevents bacteria from entering the body and protects against a number of unwanted external influences.

Axillary lymph nodes are divided into the following groups:

apical nodes are located on the upper part of the armpit;
thoracic lymph nodes are localized in the inner (medial) axillary wall, hilar lymphadenopathy characterizes diseases of the mammary glands;
the central nodes are located, respectively, in the central axillary part;
lateral nodes are localized on the lateral (external) axillary wall;
The scapular nodes are located in the posterior axillary part.

Each group of axillary nodes protects the corresponding organ, system and/or tissue. In the event of dysfunction or disease in this organ, the nodes immediately react: they become enlarged, inflammation of the lymph nodes may occur, or they become quite painful.

In most cases, the axillary nodes undergo changes in various diseases affecting the mammary gland: when it becomes inflamed for various reasons or when cancer occurs.

Sometimes it is the enlargement of nodes that is the first signal of certain disorders in the body.

Treatment of lymphadenopathy depends on the underlying cause of its occurrence - inflammation, infection, carcinoma, etc.

If the cause is unknown, changes in the size of the lymph nodes are monitored for 3 to 4 weeks to determine the source of the disease.

Inflammatory processes in the chest

Inflammation that occurs in the mammary gland is better known as mastitis. Most often the disease develops during the first few weeks after birth.

The trigger may be lactostasis or damage to the nipples (cracks and scratches caused by improper breastfeeding).

Through microtrauma, the infectious agent penetrates into the chest tissue, causes inflammation and, as a result, changes in the nodes (right or left).

At stage 1, when the inflammatory process passes without the formation of a cavity with purulent contents. In this case, if symptoms of lymphadenopathy are present, they are minor.

In the same case, if the inflammatory process progresses and moves to stage 2 with the creation of purulent foci, the lymph nodes of the armpits increase significantly. There is pain, swelling and redness of the skin.

The reason for the enlargement of nodes is also the penetration of pathogens with the lymphatic or blood flow in breast cancer in women.

If the swelling is not very pronounced, the nodes are painless. With significant swelling, irritation of the nerve endings in the lymph nodes occurs, and, accordingly, pain occurs.

Lymphadenopathy and oncology

Symptoms of lymphadenopathy that should prompt a visit to a specialist and a thorough examination:

Enlarged and hard lymph nodes in the armpit, which are detected by palpation.
Change in breast size and shape (left or right). You should pay attention to abnormalities in the breast itself, such as dents, unevenness and stretched skin.
Discharge from the nipple: light or bloody.
Change in color or sensitivity of the skin of the breast, nipple or. The skin around the nipple may, for example, be of varying thickness, sagging in some places, and may show signs similar to eczema.
Weight loss and night sweats are common signs of diseases that eat away at the body, which include cancer or AIDS.

Due to the rapid development of metastases (sedimentation of breast tumor cells in other tissues, where they penetrate through the blood and lymphatic system, i.e., double-sided cancer can develop) to nearby lymph nodes and distant organs, it is considered a very dangerous oncology.

Measures that will ensure early detection of the disease and any changes in the mammary gland include monthly breast examinations by the woman herself and regular mammography.

If the lymph nodes for breast cancer and, accordingly, the disease itself are detected on time, then the prognostic data are quite good.

If the results of a self-examination are not conclusive, you should not delay an immediate visit to your doctor.

If breast lymphadenopathy is a sign of cancer, early diagnosis and treatment increases the chances of recovery and survival several times.

Cancer can quickly spread throughout the body without even making itself known. If, in addition to damage to the intrathoracic lymph nodes, the disease also affects other organs of the body, the chances of successful treatment are sharply reduced.

Therefore, at the slightest suspicion, you should immediately go to the doctor. Even if the suspicions turn out to be in vain, the specialist will definitely treat this with understanding.

Shame is completely inappropriate here; delay can be a huge mistake with serious consequences!

Lymphadenopathy associated with silicone implantation

A silicone implant in solid form is used to connect the fixed part of the prosthesis to the bone, in elastic form for breast augmentation.

Implantation of prostheses with attachment using solid silicone can cause enlargement of regional lymph nodes.

If used, for example, to treat rheumatic deformities of the fingers, over time a person may notice that the lymph node in the armpit has enlarged.

Similarly, inguinal lymphadenopathy may occur in some patients after implantation of silicone lower extremity prostheses.

Similarly, reactive lymphadenopathy can occur due to silicone implantation in the mammary glands, since in the case of these prostheses, silicone can leak into the surrounding tissue.

The incidence of lymphadenopathy induced by silicone implantation is estimated to be 15%.

Enlarged axillary lymph nodes in the mammary gland due to exposure to silicone are histologically proven to be reactive hyperplasia with many multinucleated giant cells, some of which contain silicon fibers.

Histologically, the lymphadenopathy induced by the elastic form of silicone used for breast augmentation is not as pronounced as the enlarged breast lymph nodes of a reactive nature when using rigid silicone for fixation of joint prostheses.

Lymphodenopathy caused by liquid silicone contains fewer multinucleated giant cells, some of which contain silicone vacuoles.

Methods for visualizing and detecting lymph nodes

Diagnostic methods aimed at detecting and examining enlarged lymph nodes in the chest include the following measures:

chest x-ray;
ultrasound examination;
computed tomography;
magnetic resonance imaging;
x-ray lymphography;
lymphoscintigraphy;
positron emission tomography.

An anteroposterior chest x-ray indicates enlarged lymph nodes if they reach a size of approximately 2 - 2.5 cm.

Ultrasound examination can detect lymphadenopathy in various locations. This test is able to detect enlargements of about 1 cm.

Indications for examination include an unclear palpable mass in the peripheral lymph nodes and monitoring the progress of the cancer patient.

Chest computed tomography (CT) is a modern and informative method of examination, especially in parts of the body that are not accessible to ultrasound.

The criteria for assessing pathological nodes are the same as for ultrasound - an increase in size above 10 mm and a change in shape.

Chest MRI (MRI) provides a different view than CT.

The greatest effort is the difference in the structure of the nodes when using a different sequence and a change in the signal after the introduction of contrast. The criteria for size and shape are approximately the same.

The greatest opportunity to show the detailed structure of lymph nodes is provided by x-ray lymphography, which highlights the nodes and their structure using an oil dye.

This makes it possible to obtain relatively accurate dimensions of the nodes, in addition, to determine whether they have a physiological structure or whether there has been a violation of the normal structure (in this case, in the image the node looks like moth-eaten fabric).

Lymphoscintigraphy - this method is more suitable for the study of lymphodema than for use in the differential diagnosis of lymphadenopathy and determination of its volume.

Positron emission tomography - with this method, pathologically infiltrated nodes are indicated. However, it is limited to a few clinics.

We recommend you find out:

Lymphadenopathy requires timely diagnosis; you should not neglect your health and allow the disease to develop. It is necessary to maintain immunity, monitor the condition of your body so that the norm of the lymph nodes does not increase.