Lymphadenopathy is a condition in which the lymph nodes increase in size. Such pathological changes indicate serious illness, which progresses in the body (often of an oncological nature). To make an accurate diagnosis, several laboratory and instrumental analyzes. Lymphadenopathy can form in any part of the body and even affects internal organs.
Etiology
It is possible to find out the exact cause of lymphadenopathy only after conducting appropriate studies. Most common reasons enlarged lymph nodes may be the following:
- viral diseases;
- lymph node infection;
- connective tissue injuries and diseases;
- serum sickness (action medications);
- fungus;
- infectious diseases that suppress the immune system.
The child most often develops lymphadenopathy abdominal cavity. The reason for this is bacterial and viral infection of the body. Lymphadenopathy in children requires immediate examination by a physician, as symptoms may indicate a severe infectious disease.
Symptoms
In addition to pathological changes in the lymph nodes, one can observe additional symptoms. The nature of their manifestation depends on what caused the development of such pathology. In general, the following symptoms can be identified:
- skin rashes;
- elevated temperature;
- increased sweating (especially at night);
- attacks of fever;
- increased splenomegaly and hepatomegaly;
- sudden weight loss for no apparent reason.
In most cases, enlarged lymph nodes are a marker of other complex diseases.
Classification
Depending on the nature of the manifestation and localization of the disease, the following forms of lymphadenopathy are distinguished:
- local;
- reactive;
- generalized.
Generalized lymphadenopathy
Generalized lymphadenopathy is considered the most complex form of the disease. Unlike local lymphadenopathy, which affects only one group of lymph nodes, generalized lymphadenopathy can affect any area human body.
Generalized lymphadenopathy has the following etiology:
- allergic disease;
- autoimmune processes;
- acute inflammatory and infectious diseases.
If the increase lymph nodes observed in a chronic infectious disease, then persistent generalized lymphadenopathy is implied.
Most often, the pathological process affects nodes in non-overlapping areas - in the anterior and posterior cervical chain, in the axillary and retroperitoneal region. In some cases, enlarged lymph nodes are possible in the groin and supraclavicular areas.
The most common diagnosis is neck lymphadenopathy. Cervical lymphadenopathy may indicate illnesses caused by insufficient or excessive production of hormones or cancer.
Reactive lymphadenopathy
Reactive lymphadenopathy is the body's response to infectious diseases. Any number of lymph nodes can be affected. Symptoms are not expressed, painful sensations No.
Stages of disease development
According to the statute of limitations, lymphadenopathy can be divided into the following groups:
- acute;
- chronic;
- recurrent.
In addition, any form of lymphadenopathy can take both tumor and non-tumor forms. However, any of them is dangerous to human life.
Characteristic localization of lesions
There are more than 600 lymph nodes in the human body, so the pathological process can develop in almost any system of the human body. But most often lesions are diagnosed in the following places:
- abdomen;
- mammary gland;
- mediastinal area;
- groin area;
- lungs;
- submandibular region;
- armpit area;
Each of these types of pathology indicates an underlying disease. Often this is an oncological disease. Establish the exact reasons for the formation of such pathological process possible only after a complete diagnosis.
Abdominal lymphadenopathy
An increase in nodes in the abdominal cavity indicates an infectious or inflammatory disease. Less often, such a pathological process acts as a marker of an oncological or immunological disease. The symptoms, in this case, correspond to the points described above. In a child, the list can be added with the following symptoms:
- increased temperature at night;
- weakness and malaise;
- nausea.
Diagnosis, if damage to the abdominal cavity is suspected, begins with laboratory tests:
When diagnosing, special attention is paid to the patient’s medical history and age, since some ailments are unique to children.
Treatment
The main course of treatment for lesions of the abdominal cavity is aimed at localizing the pathological process and stopping the growth of the tumor. Therefore, chemotherapy and radiotherapy are used. At the end of the course, restorative therapy is prescribed for recovery. immune system. If treatment of such a plan does not bring the desired results or a pathology of unknown pathogenesis develops, then surgical intervention- the affected lymph node is completely removed.
Lymphadenopathy of the breast
Enlarged breast lymph nodes may indicate a dangerous cancer, including . Therefore, if you have such symptoms, you should immediately consult a doctor.
In this case, it is worth noting the nature of the tumor manifestation. If an increase in nodes is observed in the upper part of the mammary gland, then it can be assumed benign education. However, almost any benign process may develop into a malignant tumor.
Enlarged nodes in the lower area of the mammary gland may indicate the formation of a malignant process. You should consult a doctor immediately.
Enlarged lymph nodes in the area of the mammary glands can be easily noticed visually. As a rule, the formation is noticed by the woman herself. No painful sensations are observed.
Any extraneous formation in the area of the mammary glands of both women and men requires immediate examination by a specialized doctor to clarify the diagnosis and correct, timely treatment. The earlier the disease is detected, the greater the chance of a positive result. Especially with regard to intrathoracic pathological changes.
Mediastinal lymphadenopathy
Mediastinal lymphadenopathy, according to statistics, is diagnosed in 45% of patients. To understand what pathology is, it is necessary to clarify what the mediastinum is.
The mediastinum is an anatomical space that forms in the cavity chest. The mediastinum is closed in front by the chest, and in the back by the spine. On both sides of this formation there are pleural cavities.
Pathological enlargement of nodes in this area is divided into the following groups:
- primary enlarged lymph nodes;
- malignant tumors;
- damage to organs located in the mediastinum;
- pseudotumor formations.
The latter may be due to defects in the development of large vessels, severe viral and infectious diseases.
Symptoms
Mediastinal lymphadenopathy has a well-defined clinical picture. During the development of such a pathological process, the following symptoms are observed:
- sharp, intense pain in the chest area that radiates to the neck and shoulder;
- dilated pupils or sunken eyes eyeball;
- hoarseness (more often observed during the chronic stage of development);
- headaches, noise in the head;
- heavy passage of food.
In some cases, bluishness of the face and swelling of the veins in the neck may be observed. If the disease has chronic stage development, then the clinical picture is more detailed:
- elevated temperature;
- weakness;
- swelling of the limbs;
- heart rhythm disturbance.
The child may experience shortness of breath and increased sweating, especially at night. If such symptoms appear, the child must be hospitalized immediately.
Pulmonary lymphadenopathy
Enlarged lymph nodes of the lungs signal a current underlying disease. In this case, the formation of metastases () is not excluded. But under no circumstances should you make such a diagnosis yourself, based on primary signs alone.
Simultaneously with the enlargement of the lymph nodes of the lungs, the same pathological process may form in the neck and mediastinum. The clinical picture is as follows:
- cough;
- pain when swallowing;
- labored breathing;
- increased temperature, especially at night;
- pain in the chest area.
Lung damage can be caused by severe infectious diseases and previous injuries. Smoking and excessive alcohol intake should also not be excluded.
Submandibular pathology
Submandibular lymphadenopathy is most often diagnosed in children preschool age and teenagers. As shown medical practice, in most cases, such changes are temporary and do not pose a threat to the child’s life. But this does not mean that such symptoms should not be paid attention to. The cause of enlarged lymph nodes may be a dangerous oncological formation. Therefore, you should not postpone a visit to the therapist.
Axillary lymphadenopathy
The axillary type of pathology (axillary lymphadenopathy) can even develop due to a hand injury or an infectious disease. But inflammation of the axillary lymph nodes may indicate inflammation of the mammary gland. Therefore, you should not postpone a visit to the therapist.
As statistics show, it is the enlargement of lymph nodes in the axillary region and in the mammary glands that is the first sign of the appearance of metastases in the body of the mammary gland. If the disease is detected in a timely manner, then the chances of complete cure from breast cancer increase significantly.
Diagnostics
Diagnostic methods depend on the location of the pathology. To prescribe the correct course of treatment, you need not only to accurate diagnosis, but also to identify the cause of the progression of the pathological process.
The standard procedure includes:
- UAC and OAM;
- tumor markers;
- radiography.
Since PAP is a kind of marker of another disease, the cause of the development of the disease should first be diagnosed.
Treatment
The choice of treatment method depends on the diagnosis. In addition, when prescribing a treatment plan, the doctor takes into account the following factors:
- individual characteristics of the patient;
- anamnesis;
- survey results.
Treatment folk remedies may be appropriate with physician approval and only in tandem with drug therapy. Self-medication for such pathological processes is unacceptable.
Prevention
Unfortunately, there is no prevention of such manifestations as such. But, if you lead a healthy lifestyle, monitor your health and consult a doctor in a timely manner, you can minimize the risk of progression of dangerous illnesses.
Lymph nodes are integral part of the immune system.
Their inflammation may indicate a disease of any organ or the body as a whole.
In this case, you need to seek help from a specialist, since axillary lymphadenopathy may be only the first sign of any disease.
What is lymphadenopathy?
Lymphadenopathy is a condition in which the size of lymphatic vessels of various origins increases.
In 75% of cases, with this disease, inflammation Only one lymph node is affected.
Most often, lymphadenopathy occurs in the axillary or .
Sometimes ordinary inflammation of the lymph nodes is confused with a disease called lymphadenitis. They are similar, but have one difference. With lymphadenitis, in places where lymphatic vessels are enlarged, accumulations of pus form, which is more dangerous to human health.
Features of the disease in the axillary region
There are several forms of the disease depending on severity:
- Localized(inflammation occurs in only one lymph node);
- Regional(several lymphatic vessels increase in one or two adjacent zones);
- Generalized(affects three or more nodes in several different areas).
The localized form is the most common(more than 70% of the population). Generalized lymphadenopathy is considered the most dangerous type.
Also varies spicy and chronic form diseases. In the acute form, sites of inflammation of the lymph nodes are accompanied by pain, swelling and increased body temperature. Chronic lymphadenopathy long time is asymptomatic.
Inflammation lymphatic system- This the first sign of a serious illness. Thus, unilateral (right or left) enlargement of lymph nodes may indicate diseases such as:
- Breast carcinoma;
- Bodice;
- Brucellosis.
The appearance of so-called “bumps” in the axillary region on the left and right simultaneously (bilateral lymphadenopathy) indicates about the presence of sexually transmitted diseases.
Causes
Other causes of lymphadenopathy in the axillary area include:
Symptoms
The main signs of lymphadenopathy include:
Almost the same symptoms may indicate.
Diagnostics
In order to make an accurate diagnosis and prescribe an effective course of treatment, you will need determine the cause of lymph node inflammation. Since lymphadenopathy may be just a symptom of another serious disease.
Typically, the following series of standard studies are performed for diagnosis:
- UAC and OAM;
- Ultrasound examination of the abdominal cavity;
- Tumor markers;
- Radiography;
- Blood chemistry;
- Serological tests for EBV, CMV, toxoplasmosis and HIV;
- Taking a sample for tuberculosis.
Sometimes additional lymph node biopsy.
Look ultrasound procedure video for lymphadenopathy of the axillary region:
Differences between adult and childhood illnesses
Currently the disease Children under 12 years of age are more susceptible. This is because the lymphatic system is considered immature. Although the development of lymph nodes begins when the child is still in the womb.
The first year of a child’s life is considered critical as the rapid enlargement of the lymph nodes begins, which are difficult to palpate.
IN mature age lymphadenopathy is easier to detect than in adolescence or at birth.
The only difference is difficulty of detection, everything else depends on the location, severity and cause of occurrence.
Treatment
The method of treatment is determined after receiving the results of examinations, interviewing the patient and making a diagnosis.
Treatment depends only on the identified cause of the disease:
- If this is the reason infectious nature , then a course of drugs aimed at combating the virus (for example, Acyclovir; Rimantadine) or antibacterial drugs (Amoxiclav; Ceftriaxone; Clindamycin) is prescribed.
- If the cause of inflammation of the lymph nodes is oncological diseases, then a course of radiotherapy and chemotherapy is prescribed.
They also conduct a course of physiotherapy:
Sometimes treatment of lymphadenopathy requires surgical intervention.
Some have a preference folk medicine, in which for recovery they use:
- Herbal decoctions;
- Echinacea tincture;
- Warming the lymph nodes.
Attention! Warming is strictly prohibited if adenophlegmon develops, the presence of tuberculosis and a tumor in an enlarged lymph node or signs of intoxication of the body (fever, headaches).
Traditional methods of treatment can be used only after a final diagnosis has been made, in therapy with antibacterial drugs and with the permission of a doctor.
Prevention
To prevent the onset of disease several rules should be followed:
Axillary lymphadenopathy is inflammatory process in the lymph nodes. In most cases, swollen lymph nodes are just a symptom of a more serious disease. Timely treatment started, as well as preventive measures will help you maintain your health.
Lymph nodes are present in all areas of the body, but separate groups are located in the neck, axillary areas, groin areas; several small ones (<1 см) лимфатических узлов обычно пальпируются в этих областях у здоровых людей. Лимфаденопатия - это пальпируемое увеличение (>1 cm) one or more lymph nodes; is divided into localized, when present in only one area of the body, and generalized, when observed in 2 or more areas of the body. The combination of lymphadenopathy with pain in the area of an enlarged lymph node and/or signs of inflammation (skin hyperemia, soreness) is interpreted as lymphadenitis. Depending on the underlying disease, other symptoms may be present.
Pathophysiology of lymphadenopathy of the lymph node
Some plasma and cells (eg cancer cells, infectious microorganisms) in the interstitial space, along with cellular material, antigens and foreign particles, enters lymphatic vessels, becoming lymphatic fluid. Lymph nodes filter lymph, removing cells and other particles from it on its way to the central venous bed. The filtration process also ensures that antigens are presented to the lymphocytes contained in the lymph node. These lymphocytes trigger an immune response that includes cell proliferation, which can lead to an enlarged lymph node (reactive lymphadenopathy). Pathogenic microorganisms that have entered lymph fluid, can directly infect lymph nodes, causing lymphadenitis, and tumor cells can linger and proliferate in the lymph node.
Causes of lymphadenopathy of the lymph node
Infections:
| State | Inspection data | Diagnostic tests |
|---|---|---|
| Upper respiratory tract infections | Cervical lymphadenopathy with little or no tenderness. Hyperemia of the pharynx, rhinitis, cough | Inspection |
| Oropharyngeal infections (pharyngitis, stomatitis, tooth abscess) | Cervical lymphadenopathy only (often painful). Clinically diagnosed oropharyngeal infection | Inspection |
| Infectious mononucleosis | Symmetrical lymphadenopathy, most typically in the neck, less often in the axillary and inguinal areas. Fever, hyperemia of the throat, severe weakness. Often - splenomegaly. Common in teenagers and young adults | Heterophilic antibody test. Sometimes - serological test for Epstein-Barr virus |
| Tuberculosis (extrapulmonary - tuberculous lymphadenitis) | Usually - cervical or supraclavicular lymphadenopathy, sometimes with signs of inflammation or the presence of discharge. Common in patients with HIV infection | Tuberculin test or IGRA (interferon gamma release test). Lymph node aspiration or biopsy is usually required |
| HIV infection (primary) | Generalized lymphadenopathy. Usually - fever, general malaise, skin rash, arthralgia. Often - HIV-positive status according to medical history or lifestyle associated with high risk HIV infection | HIV antibody test. Sometimes - HIV RNA test (if an early stage of infection is suspected) |
| Sexually transmitted diseases | With the exception of secondary syphilis, only inguinal lymphadenopathy (a softened lymph node or the presence of discharge allows one to suspect syphilitic lymphogranuloma). Often - dysuric symptoms, discharge from the urethra. Sometimes - changes in the genital area. With secondary syphilis - often widespread changes in the skin and mucous membranes, generalized lymphadenopathy | Herpes simplex - cultural studies. Chlamydial infections- tests based on the detection of nucleic acids Syphilis - serological studies |
| Skin and soft tissue infections, including primary lymph node infection | Usually - visible local damage (or historically established fact of recent trauma) distal to the site of lymphadenopathy. Sometimes - only erythema, tenderness of an isolated lymph node (usually the cervical one) without obvious signs lymph node damage | Usually - inspection. Cat scratch disease - serum antibody titer test |
| Toxoplasmosis | Bilateral, painless cervical or axillary lymphadenopathy. Sometimes - flu-like syndrome, hepatosplenomegaly. Frequent contact with cat feces | Serological tests |
| Other infections (brucellosis, cytomegalovirus infection, histoplasmosis, paracoccidioidomycosis, plague, rat bite fever, tularemia) | Various. Risk factors (geographical region, exposure) | Various |
Neoplasms:
| State | Inspection data | Diagnostic tests |
|---|---|---|
| Leukemia (usually chronic and sometimes acute lymphoblastic leukemia) | Weakness, fever, weight loss, splenomegaly. At acute leukemia- often spontaneous hematomas, bleeding | Clinical blood test, peripheral blood smear microscopy Bone marrow examination |
| Lymphomas | Painless adenopathy (local or generalized), lymph nodes of dense elastic consistency, sometimes lumpy. Common: fever, night sweats, weight loss, splenomegaly | Lymph node biopsy |
| Tumor metastases (often head and neck, thyroid gland, breast, lungs) | One or more painless, locally located lymph nodes. The nodes are often dense, sometimes fixed to nearby tissues | Investigations to find the primary tumor |
Systemic connective tissue diseases:
| State | Inspection data | Diagnostic tests |
|---|---|---|
| Systemic lupus erythematosus (SLE) | Generalized lymphadenopathy. Arthritis and arthralgia are typical. Sometimes - rash on the cheekbones, other skin changes | Clinical criteria, antibody tests |
| Sarcoidosis | Painless adenopathy (local or generalized). Often - cough and/or shortness of breath, fever, malaise, muscle weakness, weight loss, arthralgia |
X-ray or CT scan of the chest cavity If changes in the lungs are detected, a lymph node biopsy is performed |
| Kawasaki disease | Painful cervical lymphadenopathy in children. Fever (often >39 °C), rash on the skin of the trunk, crimson tongue, peeling of the skin of the feet, palms, around the nails | Clinical criteria |
| Other systemic diseases connective tissue | Various | Various |
Other states:
The participation of the lymphatic system in the body’s immune response is the reason for its involvement in the pathological process with a large number of infectious and inflammatory diseases, as well as for neoplasms. The causes of lymphatic system involvement most likely vary depending on the patient's age, associated conditions, and risk factors, but the most common etiological factors are:
- Idiopathic lesions of the lymphatic system.
- Upper respiratory tract infections.
- Localized soft tissue infections.
Oncological disease, HIV infection, tuberculosis are causes of damage to the lymphatic system that are life-threatening to the patient. However, most cases of lymphatic system involvement occur due to benign conditions or clinically detectable localized infection. Probably, less than 1% of all cases of lymphatic system involvement undifferentiated at initial treatment are due to the presence of a neoplasm.
Symptoms and signs of lymph node lymphadenopathy
Enlarged lymph nodes may be important feature hematological disease, but lymphadenopathy is often only a manifestation of the body’s reaction to inflammation of an infectious or non-infectious nature. Reactive nodes usually enlarge quickly and are painful. On the contrary, in hematological diseases the nodes are usually painless. In the case of a localized lesion, it is necessary to direct efforts to search for a source of inflammation in the area from which lymph flows to this group of nodes. Thus, if the cervical group is affected, the skin of the scalp, ears, face, oral cavity and teeth are subject to careful examination; axillary - corresponding mammary gland; inguinal - the area of the perineum and genitals. Generalized lymphadenopathy can be a consequence of infectious processes, connective tissue diseases or extensive skin lesions, but most often it indicates hematological oncology. A decrease in body weight, severe sweating at night, requiring a change of underwear, gives reason to suspect malignant tumors of hematopoietic tissue, primarily lymphoma.
Diagnosis of lymphadenopathy of the lymph node
Lymphadenopathy may be a reason to see a doctor or be discovered during testing for another condition.
Examination for lymphadenopathy begins with a clinical blood test (to detect neutrophilia, characteristic of infections, or obvious signs of hematological pathology), including ESR, and chest x-ray (to identify or exclude mediastinal lymphadenopathy). If the data obtained indicates tumor process, a puncture biopsy or excision of one of the affected lymph nodes for histological examination is indicated.
Anamnesis
The history of the present illness should include data on the location and duration of lymphadenopathy, and whether it was ever accompanied by pain. Recent skin lesions (especially cat scratches and rat bites), as well as infections in the areas of the affected lymph nodes.
The organ system survey should include data on symptoms of possible causes of lymphadenopathy, including nasal discharge (urinary tract infections), sore throat and sore throat (pharyngitis, Infectious mononucleosis), pain in the mouth, gums or teeth (oral and dental infections), cough and/or shortness of breath (sarcoidosis, lung cancer, tuberculosis, some fungal infections), changes in the genital area or discharge from the genital tract, urethra (herpes simplex, chlamydia, syphilis), joint pain and/or swelling of the joint area, spontaneous bleeding, bruising (leukemia), dry, inflamed eye (Schöngren's syndrome).
The life history should reveal risk factors or the presence of tuberculosis, HIV infection, as well as cancer (especially alcohol and/or tobacco use). It is necessary to ask the patient whether he has traveled to regions of endemic infections (Middle East - brucellosis, Southwest USA - plague), as well as about possible contact (with cat feces - toxoplasmosis, farm animals - brucellosis, wild animals - tularemia). The previous drug therapy to identify agents that cause lymphadenopathy.
Physical examination
Aimed at detecting fever. Areas of group location of superficial lymph nodes in the neck (including the occipital and supraclavicular areas), axillary and inguinal areas are palpated. The size of the lymph node, pain, consistency, as well as free mobility or fixation to surrounding tissues are noted.
The skin should be examined to identify rashes and lesions, and special attention should be paid to areas draining into the altered lymph node. The oropharynx is examined and palpated to identify signs of infection and changes suspicious for a neoplasm. Palpated thyroid gland for enlargement and presence of nodes. Palpation of the mammary glands (including men) is carried out to search for formations. Auscultate the lungs to detect wheezing (suspicious for sarcoidosis or infection). Palpation of the abdomen to exclude hepatomegaly and splenomegaly. Examination of the genitals to identify chancre, vesicles, other changes, and discharge from the urethra. Examination of joints for signs of inflammation.
- Lymph node >2 cm.
- Lymph node with discharge, dense or fixed to surrounding tissues.
- Supraclavicular lymph node.
- Risk factors for tuberculosis, HIV infection.
- Fever and/or weight loss.
- Splenomegaly.
Interpretation of identified symptoms
Patients with generalized lymphadenopathy usually have systemic disease. However, patients with localized lymphadenopathy may have both local and systemic disease (including those that typically cause generalized lymphadenopathy).
Sometimes, based on the history and physical examination, the cause of lymphadenopathy can be suspected and a diagnosis can be made in patients with obvious viral infection UDP or with local infection of soft tissues, odontogenic infection. In other cases (such as in the “notes” section), these data are taken into account, but do not allow the determination of a single cause of lymphadenopathy. Dense, significantly enlarged lymph nodes (>2-2.5 cm), and/or fixed to surrounding tissues, especially lymph nodes in the supraclavicular region or in patients with a long history of tobacco and/or alcohol use, suggest the presence of a neoplasm. Significant pain, erythema, local hyperthermia in the area of a single enlarged lymph node can be caused by a purulent infection of the lymph node (caused by staphylococcus or streptococcus). Fever is accompanied by many infections, malignant diseases and systemic connective tissue diseases. Splenomegaly can occur with infectious mononucleosis, toxoplasmosis, leukemia and lymphoma. Weight loss is observed with tuberculosis and malignant neoplasms. Analysis of the patient's risk factors and travel history is the best way to suspect the cause of lymphadenopathy. Finally, lymphadenopathy can sometimes have a serious cause in a patient without any other evidence of disease.
Instrumental studies
If a specific disease is suspected (for example, infectious mononucleosis in a young patient with fever, sore throat and splenomegaly), tests are carried out in accordance with the standard of examination for this pathology.
If the history and physical examination do not reveal possible reason lymphadenopathy, further examination depends on the lymph nodes involved in the pathological process and other research data.
Patients who have identified changes from the “pay attention” section, as well as patients with generalized lymphadenopathy, are shown a clinical blood test and chest x-ray. For generalized lymphadenopathy, tuberculin therapy is indicated skin test(or IGRA), serological testing for HIV, infectious mononucleosis, and possibly toxoplasmosis and syphilis. Patients with joint symptoms or skin rash should have an antinuclear antibody test performed to rule out SLE. According to most experts, patients with localized lymphadenopathy without any other abnormalities identified during the examination can be safely observed for 3-4 weeks, except in cases of suspected malignancy. If cancer is suspected, it is most often necessary to perform a lymph node biopsy. A biopsy should also be performed if localized or generalized lymphadenopathy does not resolve within 3 to 4 weeks.
Treatment of lymphadenopathy of the lymph node
Primary therapy is aimed at eliminating the cause of the disease; lymphadenopathy itself does not require treatment. Treatment with glucocorticosteroids is not attempted in cases of lymphadenopathy unknown etiology, because glucocorticosteroids can reduce lymphadenopathy in lymphoma, leukemia, which will delay diagnosis. In addition, the course of tuberculosis may worsen due to the administration of glucocorticosteroids. An attempt at antibiotic therapy is also not indicated, except in cases of suspected purulent infection of the lymph node.
Abdominal lymphadenopathy is an increase in the size of the nodes of the lymphatic system as a result of the inflammatory process occurring in them. As a rule, lymphadenopathy is one of the manifestations of a symptom complex of pathologies of various etiologies, and not an independent disease. But chronic inflammation in the lymph nodes can lead to the development of independent pathology, which causes severe complications.
Mechanism of occurrence
Lymphadenopathy of the abdominal cavity occurs as a result of the entry of materials with inflowing lymph that cause an inflammatory reaction in the tissues of the lymph nodes in the abdominal cavity. The causative agents may be:
- pathogenic microorganisms and their toxins;
- tissue breakdown products (plasmolemma lipids and melatonin pigment);
- foreign materials (soot, smoke particles, silicone elastomers) and cellular debris.
The introduction of an infectious agent into the lymph nodes occurs during acute, subacute, chronic local inflammatory processes (colitis, ulcer duodenum etc.), less often this occurs in general infectious pathologies. Pathogens enter the lymph node through lymphogenous, hematogenous and contact routes. If a lymph node is injured, an infectious agent may be introduced from the outside.
The inflammatory process is a defensive reaction in response to an irritant. By interacting with lymphocytes and other cells of the immune system, the infectious agent causes the formation of specific substances and triggers defense mechanism. Penetrating through the gate of infection into the lymph node, the infectious agent encounters sinus histiocytes. If it is not absorbed by resident macrophages, then a typical picture of acute inflammation is observed.
Lymphadenopathy is accompanied by an increase in the size of the lymph nodes. However, the cause of hypertrophy can also be the process of tissue hyperplasia of the node. IN acute stage lymphadenopathy in the lymph nodes localized in the intra-abdominal region, the following processes occur:
- hyperemia of the tissues of the node;
- expansion of its cavities;
- desquamation of the epithelium lining it;
- diffusion of serous discharge into the parenchyma and the formation of edema;
- processes of proliferation of lymphoid tissue;
- infiltration of node tissues with lymphocytes.
Reasons for appearance
Further progression of the pathology may be accompanied by purulent discharge. Depending on the time, strength and number of influencing factors, the process of lymphadenopathy quickly passes through all stages. The infectious agents that cause lymphadenopathy of the abdominal lymph nodes can be agents that cause:
- tuberculosis:
- toxicoplasmosis;
- brucellosis;
- helminthiasis;
- giardiasis;
- mycoses, etc.
In addition, the pathological condition can be provoked by diseases of connective tissue and serum pathology of a medicinal nature.
Lymphadenopathy in children often accompanies measles, rubella, mumps, etc. The cause of hyperplasia of intra-abdominal lymph nodes can be a malignant process or mesadenitis - inflammation of the lymph nodes in the mesentery of the small intestine. The child experiences symptoms similar to acute appendicitis.
In the abdominal cavity, the lymph nodes are located along the aorta and inferior vena cava (parietal) and near the hollow and parenchymal organs (visceral). The symptoms of the pathology correspond to the inflammatory process, and the severity corresponds to the severity of its course.
Classification of pathological condition
Depending on the number of lymph nodes involved in the process and their location, it is customary to classify lymphadenopathy into:
- local;
- regional;
- generalized.
Generalized lymphadenopathy is the most severe, since pathological changes do not affect a single node, as in the local form, but several at once. Moreover, these groups can be located in areas that are not contiguous with each other. human body. Reactive lymphadenopathy is diagnosed with the massive introduction of an infectious agent. In this case, the symptoms are not pronounced, and the enlarged lymph nodes are painless.
According to the statute of limitations, pathology is divided into acute, chronic and recurrent. In addition, each of the above forms can take the form of a tumor or non-tumor pathology. For the convenience of assessing the pathological process, some authors distinguish the following degrees of enlargement of lymph nodes in diameter:
- I degree - 50–150 mm;
- II degree - 150–250 mm;
- III degree - 250 mm or more.
Parents often do not consider enlarged lymph nodes in their child alarm signal, attributing the pathology to symptoms of viral, colds and infectious diseases. Therefore, doctors advise conducting examinations in children who often suffer from respiratory diseases, with a history of inflammation in the oropharynx, bronchitis and croup.
Symptoms and signs of pathology
The most important diagnostic sign Lymphadenopathy is an enlargement of the nodes of the lymphatic system. Additional symptoms of pathology localization in the abdominal cavity may include:
- prolonged increase in body temperature;
- night sweats;
- structural changes noted on x-ray or ultrasound;
- weight loss;
- pathological enlargement of the liver (hepatomegaly) and spleen (splenomegaly);
- nausea and vomiting;
- dyspeptic disorders;
- general weakness.
The listed symptoms are not characteristic of this pathology and may indicate other pathologies. In addition, additional symptoms differ depending on the type of infectious agent that caused the lymphadenopathy. For example, infectious mononucleosis causes not only the symptoms listed above, but is also accompanied by such signs as maculopapular rashes, which go away on their own after 2-3 days. When the infectious agent HIV is introduced into initial stage the appearance of a rash and acute respiratory infections-like symptoms are noted.
When the body is infected with the causative agent of hepatitis B, except characteristic features, febrile symptoms, dyspeptic syndrome, and jaundice are noted. Some pathogens cause symptoms of arthritis, conjunctivitis, arthralgia, urticaria, etc. With such a diverse symptom complex, the diagnosis of lymphadenopathy is difficult, especially if the main symptom is not visualized, such as when the pathological process is localized in the abdominal cavity and retroperitoneal space. If this pathology is suspected, differential studies are carried out to exclude diseases with similar symptoms.
Methods for diagnosing pathology
To identify the cause of lymphadenopathy, anamnesis and epidemiological data are collected. The patient is asked questions about a possible blood transfusion, transplant surgery, casual sexual relations, intravenous administration narcotic drugs, contact with animals (cats) and birds, specifics professional activity(fishermen, hunters, farm and slaughterhouse workers, etc.), migration to foreign countries and etc.
Great importance is given to the age of the patient, since some forms of pathology are more common in children. Clinical examination includes a thorough palpation examination of the lymph nodes and their determination:
- localization;
- quantity and size;
- connections with each other;
- soreness;
- consistency.
The next stage of diagnosis is laboratory tests:
- biochemical and clinical tests blood;
- general urinalysis;
- tests for HIV infection and RW;
- serological blood test.
In addition, cytological and histological studies are prescribed:
- bone marrow biopsy;
- excisional lymph node biopsy.
Hardware diagnostics include:
- radiography;
- MRI and CT;
- osteoscintigraphy (if necessary).
After confirming the diagnosis and identifying the causes of the pathological process, an individual treatment regimen is developed.
Therapy of a pathological condition
Often, therapy for the pathology that causes inflammation of the lymph nodes leads to their reduction. When treating lymphadenopathy of various etiologies, drug treatment is prescribed using:
- antibiotics;
- anti-inflammatory drugs of the NSAID group;
- antiviral agents;
- immunomodulators.
In the treatment of lymphadenopathy in children, good results were observed when prescribed antibacterial drugs from the group of macrolides: Roxithromycin, Josamycin, Midecamycin. When identifying herpetic infection, the drugs Acyclovir, Arbidol, etc. are prescribed.
To boost immunity after a course of antibiotics, chemotherapy or radiotherapy, immunomodulators are prescribed: Cycloferon, Viferon, Lykopid, etc.
If drug therapy is ineffective or the cause of the pathology is a malignant process, then surgical removal of the affected lymph nodes followed by courses of chemotherapy or radiotherapy is indicated. Which method to choose is decided only by the attending physician, based on medical history, diagnostic results and individual characteristics patient. Timely detection of pathology on early stage allows you to do without radical methods of therapy.
It is a pathological condition, as a result of which the nodes of the human lymphatic system enlarge, in in this case cervical
Lymphatic system
The lymphatic system is an integral part of a set of blood vessels that performs several important functions in regulating material metabolism, cleaning the cells and tissues of the body from all kinds of bacteria, which also ensures the normal production of lymphocytes (specific cells that make up the human immune system). The lymphatic system includes blood vessels, capillaries, lymph nodes and their ducts.
The development of lymphadenopathy occurs due to the presence of any diseases in a person that have a different nature of their origin. In addition, such a pathology can take a malignant course as it progresses. Due to the fact that cervical lymphadenopathy is formed against the background of the development of many pathological processes in the human body, a patient with such a disease should undergo medical examination at different doctors. These include hematologists, infectious disease specialists, oncologists and other specialists.
A disease that provokes an enlargement of the nodes of the lymphatic system can affect not only the cervical, but also other lymph nodes located in any part of the human body.
At the same time, it often disrupts the activity of various internal organs.
What provokes the occurrence of pathology and its forms
A pathological condition, during the development of which an increase in the size of the lymph nodes occurs, has a name such as hyperplasia. This kind of reaction of the body is nonspecific and can appear as a result of various factors that negatively affect it. The most common reasons for enlarged lymph nodes are:
- Availability various diseases viral and autoimmune origin.
- Long-term use of any medications or medications. Excessive use of medications often provokes the development of serum sickness, that is, a pathology that occurs due to the abuse of various medications.
- The formation of inflammatory processes in the nodes of the lymphatic system as a result of their infection with all kinds of infectious microorganisms.
- Damage to the body's lymphoid tissue by fungal agents.
- The presence of infectious pathologies that negatively affect the state of the human immune system. Such diseases include acute respiratory viral infections.
In addition, neck lymphadenopathy can have both acute and chronic course. In case of leakage acute form development of the pathological process, its symptoms are generally well expressed, while chronic symptoms are practically not accompanied by the occurrence of any clinical signs.
Lymphadenopathy in children
Hyperplasia of the cervical lymph nodes can generally develop at any age, regardless of a person’s gender, but most often this disease affects children. This is due to the fact that in childhood, or rather up to 12 years of age, the child’s lymphatic system is immature, although its formation began during the period of intrauterine development fetus Therefore, due to the immaturity of lymphoid tissue, children are most susceptible to lymphadenopathy.
Upon reaching 1 year of age, the baby experiences regional enlargement of the cervical, inguinal and occipital lymph nodes. In this regard, such a period poses the greatest danger to the child’s health, since his body is still too weak to resist various infectious pathologies. In older children, it is considered normal to have 2 or 3 groups of lymph nodes enlarged.
But, nevertheless, inflammation in a child of at least one cervical lymph node may indicate the presence of various systemic pathologies in his body, which under no circumstances should be ignored!
Diagnosis of the disease
Confirmation of lymphadenopathy should only be done by the appropriate physician during a complete examination of the patient. If, during the examination of the patient, the doctor discovers an enlargement of the cervical lymph nodes, then to determine the factor that provoked the occurrence of such pathological condition, the patient will first need to do a detailed and general tests blood. In addition, the patient is prescribed additional blood donation to detect HIV infection and hepatitis. At the same time, to confirm the diagnosis and determine the cause of enlarged lymph nodes, a person will need to undergo a number of instrumental procedures, which include:
- Computed tomography (CT), radiography, or ultrasonography(ultrasound) cervical spine. Using one of these diagnostic techniques, it is possible to determine which particular (deep or superficial) node of the lymphatic system was affected and determine its dimensional characteristics.
- Biopsy of the inflamed node. This procedure involves puncturing a lymph node using a special syringe, after which its tissue is collected. This is done in order to study the resulting sample in the laboratory and thereby discover the cause of lymphadenopathy.
No less important role When diagnosing such a disease, the age of the patient plays a role. For example, in children, inflammation of the lymphoid tissue most often occurs as a result of any infections entering its system. Thus, it turns out that the disease is mainly infectious in nature. If the patient’s age exceeds 35 years, then most likely the cause of lymphadenopathy will be the presence of various fungal, bacterial or viral pathologies. Moreover, what older age patient, the likelihood that such a disease will have a chronic course increases significantly. The development of cervical lymphadenopathy in people over 40 years of age, in most cases, occurs against the background of progression of any oncological pathologies.
In addition, when making a diagnosis, special attention is paid to mobility, consistency and size. inflamed lymph node. For example, if the affected lymph nodes exceed 2 cm in size, then treatment of the patient must begin as quickly as possible.
Symptoms of pathological enlargement of lymph nodes
The main clinical sign of neck lymphadenopathy is an increase in the nodes of the lymphatic system, which is accompanied by the occurrence of the following:
- upon palpation, the affected nodes are severely painful;
- appears severe swelling from the side of inflamed lymphoid tissue;
- the skin in areas of swelling becomes red.
The rest of the symptoms and their manifestations depend on what causes the underlying disease and on the area where the pathological process is localized. The most common signs of lymphadenopathy include:
- Emergence skin rashes from inflamed nodes, the appearance of subcutaneous hemorrhages. Such symptoms usually indicate the presence of various infectious pathologies in the patient.
- Painful sensations in the joints and deterioration in their mobility. If, during the course of lymphadenopathy, a person experiences joint pain, this may indicate the development of some kind of connective tissue diseases, for example, such as rheumatoid arthritis and systemic lupus erythematosus.
- Hepatosplenomegaly (pathological increase in the size of the spleen and liver). Often the occurrence of such a symptom is associated with the viral nature of the origin of neck lymphadenopathy. To one of viral diseases, which can provoke inflammation of the lymph nodes include blood cancer and mononucleosis.
- Shortness of breath and paroxysmal cough. In addition, the inflammatory process often spreads to the intrathoracic lymph nodes. This phenomenon occurs if the main cause of damage to the body’s lymphoid tissue is the patient’s tuberculosis or any other malignant neoplasms in the thoracic region.
- The appearance of painful sensations in the throat, ears, and nasal congestion. The formation of such clinical signs of lymphadenopathy can be provoked by the development in a person of all kinds of ENT diseases, which include tonsillitis, sinusitis, otitis and other pathologies.
Treatment methods for lymphatic disease
Treatment of lymphadenopathy involves determining the exact cause that triggered the occurrence of the pathological process and its complete elimination. The tactics used to eliminate the underlying disease will be different for each patient and completely depend on the nature of the origin of the lymphadenopathy. For example, if such a disease arose against the background of the patient’s existing infectious ailments, then the patient will be prescribed a standard drug treatment regimen, which involves the use of various antiviral and antibacterial agents. If the lymphadenopathy is quite severe, the patient may be hospitalized, where he will be shown the use of intravenous drips.
If a pathological enlargement of the cervical lymph nodes occurs as a result of the development in the human body of various systemic pathologies that affect connective tissue, then in this case it is advisable to use hormone-containing drugs and cytostatics (a group of medications whose main task is to inhibit the pathological proliferation of connective tissue) as their treatment. . However, the use of such drugs can provoke the occurrence of severe adverse reactions and complications. That's why self-treatment Under no circumstances should cytostatic drugs be used. You can use such medications only after the doctor himself has prescribed them to the patient.
A completely different treatment regimen must be used if lymphadenopathy occurs as a result of the patient having tumors. The main method of eliminating a malignant process is the use of chemotherapy procedures and surgical removal tumor formation. Moreover, even after effective treatment The patient must be under constant medical supervision to prevent possible relapse pathological process.
Except drug treatment lymphadenopathy there are some ways traditional medicine to reduce the manifestations of the disease. However, in order to achieve a positive result, they must be used together with the main treatment and only with the permission of the attending physician!
