Systemic lymphadenopathy. Lymphadenopathy of the lymph node: treatment, causes, signs, symptoms, diagnosis, diagnosis

Lymphadenopathy of the axillary lymph nodes usually indicates various diseases of nearby organs. It is an overgrowth of lymphoid tissue. Often there is a unilateral change in the size of formations.

Axillary lymphadenopathy is divided into the following types:

• localized;
• regional;
• generalized;
• acute;
• chronic;
• one- and two-sided;
• right- and left-sided;
• specific and non-specific;
• purulent;
• reactive;
• axillary;
• malignant.

Let's analyze each type of axillary lymphadenopathy in more detail.

By area and course of the lesion

According to the area of ​​the lesion, the following types of axillary lymphadenopathy are distinguished:

• localized, in which only one immune link becomes inflamed;
• regional, accompanied by an increase in several formations at once in one or two neighboring areas;
• generalized. Characterized by the defeat of 3 or more nodes in isolated areas of the body.

The localized form of pathology is more common than others. It accounts for more than 70% of cases. The most dangerous type of lymphadenopathy is generalized.

Along the course, acute and chronic forms of lymphadenopathy are isolated. In the first case, specific symptoms are observed. The chronic form proceeds for a long time without manifestations.

double sided

According to the features of localization, pathology is divided into unilateral and bilateral. The latter type is often found in women suffering from malfunctioning of the ovaries, since the immune links of these organs are interconnected with their axillary "brothers". Unilateral localization of axillary lymphadenopathy sometimes indicates:

• breast carcinoma;
• lymphoma;
• brucellosis.

Bilateral axillary lymphadenopathy often indicates a sexually transmitted disease and, as a rule, is eliminated after treatment.

right hand

Right-sided lesion of the axillary lymph nodes is distinguished into a separate category. Pathology is accompanied by pulling pain in the right armpit, poor health and increased fatigue. In this case, the following stages of the process are distinguished:

• at the initial stage, there is pain in the affected area, as well as weakness throughout the body, the formations retain a normal consistency and move during palpation;
• after 3-4 days, tissue infiltration occurs, the glands merge with each other, as a result of which a bunch of grapes is formed on the affected area, visible visually.

Specific

Based on the characteristics of the causative agent of the disease, there are specific and nonspecific axillary lymphadenopathy. The latter type is a secondary deviation from the norm, developing against the background of other disorders. Specific lymphadenopathy of the armpit area is caused by pathogenic microorganisms.

Purulent

The purulent form of axillary lymphadenopathy indicates a serious pathology, in which the glands increase in size, hurt during palpation. All this is accompanied by swelling of neighboring tissues, discomfort during movement of the limb, fever. Groups of adjacent lymph nodes are often affected.

The purulent process is characterized by signs of intoxication (headache, weakness, weakness). In this case, the lymph nodes involved in the pathology are visible to the naked eye. These symptoms require immediate medical attention and diagnostic procedures.

Reactive axillary lymphadenopathy

Reactive axillary lymphadenopathy on the right or left occurs in response to the invasion of an infectious agent, an allergic reaction, or an autoimmune disorder. Symptoms are mild or absent. Generalized forms are very rare.

Axillary

Pathological damage to the axillary lymph node of the axillary region, accompanied by inflammation, can be caused by the introduction into the body of microorganisms that provoke viral diseases, tuberculosis, as well as the activation of staphylococci, streptococci, etc.

With an increase in education outside of inflammation, the presence of a tumor localized in the affected area is possible. This phenomenon occurs with pain and fever.

Causes of axillary lymphadenopathy:

Malignant axillary lymphadenopathy

With oncological lesions of the lymph nodes, the following symptoms are observed:

• formations become hard to the touch and increase in size;
• the chest takes on a different shape, dents, irregularities and stretching appear on it;
• discharge from the nipples appears (light or mixed with blood);
• the skin in the nipple area becomes a different color, its sensitivity changes, sometimes external manifestations similar to eczema appear;
• night sweats and weight loss.

Causes of armpit lymphadenopathy

The most common causes of violations of the lymph nodes of the axillary region are:

Signs of axillary lymphadenopathy

With adenopathy of the axillary lymph nodes on the right or left, the following symptoms are observed:

• an increase in formations in size, the acquisition of the form of "cones";
• general malaise;
• excessive sweating, mainly at night;
• rapid weight loss for no apparent reason;
• fever;
• skin rash;
• hepato- and splenomegaly;
• redness of the skin in the area of ​​​​the glands;
• swelling of the immune links and their soreness.

Diagnosis of pathology

First of all, palpation is performed to assess the size of the node. If an inflammatory process is suspected, other examinations and analyzes are indicated:

• taking KLA and OAM;
• blood test for tumor markers;
• conducting a biochemical blood test, serological tests for infections;
• radiography, ultrasound.

Self-examination technique

To identify any changes in the lymph nodes of the axillary region, you need to take your hand about 30 degrees. Further, if the right axillary cavity is being examined, press with the straight fingers of the left hand on the axillary fossa, and then perform a soft sliding shoveling movement.

Normally, the formations are either not palpable, or are palpated as small rounded glands 5-10 mm in size, while pain does not occur. Finding an increase, soreness, induration or any other discomfort, you need to see a doctor. It is impossible to warm the affected area. This can lead to the spread of the pathological process.

Treatment of the disease

Axillary immune links react to diseases of neighboring organs. Adenopathy of these lymph nodes is treated based on the cause that led to its occurrence. If the pathology is infectious in nature, then the doctor recommends antiviral drugs or antibiotics. Malignant tumors are eliminated by radiotherapy, chemotherapy, and surgery.

At the discretion of the specialist, physiotherapeutic methods are used:

1. Laser therapy, in which the body is affected by light waves, as a result of which the pain syndrome is stopped, the intensity of the inflammatory process decreases.
2. Galvanization, which consists in exposing soft tissues to a small electric current. The procedure is aimed at relieving pain, restoring tissues and nerve fibers.

In exceptional cases (usually with a purulent process), surgical intervention is performed, after which antibiotics are prescribed for prophylactic purposes.

Prevention

To prevent armpit lymphadenopathy, you need to:

• observe the rules of personal hygiene;
• maintain a normal level of immunity;
• treat diseases in time;
• Treat damaged skin immediately with antiseptics.

Lymphadenopathy is a condition characterized by an increase in lymph nodes, regardless of the cause that caused this increase. At its core, this is not a diagnosis, but a clinical term that implies further examination of the patient to determine the cause of such changes, making a diagnosis.

Among the reasons that cause changes in the size of the lymphatic apparatus are:

1. An increase in lymph nodes due to an inflammatory reaction - lymphadenitis. Such a reaction is due to the direct entry of the infectious agent into the lymph node or an autoimmune mechanism.
2. Reactive enlargement of the lymph node - hyperplasia. This is a reaction of the lymphatic apparatus to a distant focus of infection or an autoimmune process.
3. An increase in lymph nodes of non-inflammatory origin is a tumor lesion.

The term "lymphadenopathy" implies the unclear nature of the pathological process, requiring clarification of its nature.

According to the prevalence of detected changes, there are:

• Local lymphadenopathy - an increase in one group of lymph nodes.
• Generalized - an increase in two or more unrelated groups.

Mediastinal lymphadenopathy (mediastinal lymphadenopathy) is a collective term for local enlargement of lymph nodes of any nature located within the chest.

Dimensions

The concept of the norm, in relation to the size of the lymph node, is very relative. The size depends on the age, location, professional affiliation of the patient, geography of residence.

When describing the size, the clinician usually indicates the greatest length and width. Estimate the size by the smallest value. The size of the mediastinal lymph node up to 1.0-1.5 cm in an adult patient is considered normal.

All indicators exceeding the indicated values ​​are classified as manifestations of lymphadenopathy.

General symptoms

Quite often, an increase in the regional lymphatic apparatus in the mediastinum does not cause any subjective changes in patients.

Regardless of the cause, mediastinal lymphadenopathy has the same clinical manifestations. The characteristic clinical picture is due to the peculiarities of the anatomical structure of this area. The severity of the clinical manifestations of symptoms depends on the size of the altered lymph nodes and their localization.

• Discomfort, pain in the chest, a feeling of heaviness.
• Symptoms due to compression of structures located in the mediastinum: impaired passage of food through the esophagus, severe shortness of breath, coughing with compression of the trachea and main bronchi, expansion of the venous subcutaneous mesh of the anterior chest wall with compression of the superior vena cava, drooping of the upper eyelid and constriction of the pupil with pressure on the sympathetic trunk.
• The symptoms associated with the etiological factor are diverse. They are caused by the underlying disease that caused the appearance of enlarged lymph nodes: fever, severe weakness, headache, skin rashes, itching, excessive sweating, etc.

Surveys

Quite often, lymphadenopathy is established by conventional x-rays of the lungs, chest organs during a routine examination. Such patients often do not present any complaints.

The situation is completely different with patients who suddenly have complaints and symptoms characteristic of lesions of the chest organs.

Mandatory examinations in the detection of mediastinal lymphadenopathy or the suspicion of the possibility of establishing such a diagnosis are:

1. X-ray examination of the chest in two projections, with the performance of a tomogram of the mediastinum, contrasting the esophagus.
2. Computed tomography of the chest, if necessary - with bolus amplification. It allows not only to clarify the localization of the lesion, to assess the size of the formations, but also to suggest the nature of the identified changes in the mediastinum.
3. Perform fibrobronchoscopy, fibrogastroscopy for differential diagnosis with diseases of the bronchial tree, esophagus and stomach.
4. Diagnostic video-assisted operations - videothoracoscopy, the main task of which is to perform a biopsy of enlarged lymph nodes for histological, microbiological, and other studies in order to establish a clinical diagnosis.

An important role during the examination, in addition to instrumental methods, have:

• Careful collection of anamnesis, study of the epidemiological situation, assessment of the prescription of the existing pathological process.
• General clinical laboratory research.
• Blood test for hepatitis, syphilis.
• An HIV blood test is indicated for all patients diagnosed with lymphadenopathy for more than two months.

Additionally, taking into account the received instrumental data, anamnesis data, appoint:

• PCR study for the presence of specific pathogens of infectious, viral diseases.
• ELISA for the presence of antibodies to tuberculosis.
• Specific tests for the presence of systemic lupus erythematosus, rheumatoid factors.
• Molecular-histochemical studies, etc.

Causes of mediastinal lymphadenopathy

Mediastinal lymphadenopathy can be divided into:

• tumor nature.
• non-tumor nature.

Enlarged mediastinal lymph nodes of a tumor nature can be divided into:

• Increased due to the primary process that affects the lymphatic apparatus - lymphomas (Hodgkin's, non-Hodgkin's), lymphocytic leukemia.
• Changes in the lymph nodes due to metastatic lesions - metastases of cancer of the lung, breast, esophagus, stomach, etc.

Lymphadenopathy due to a non-tumor process:

• Lymphadenitis of infectious origin.
• Reactive changes in the lymph nodes due to manifestations of an autoimmune nature.
• Drug-induced lymphadenopathy caused by long-term use of certain groups of drugs.

Tumor lesion

The enlarged lymph nodes of the mediastinum revealed as a result of the examination are the reason for the diagnostic oncosearch.

• Lymphoma is a collective concept that includes a fairly wide group of systemic oncological diseases. The defeat of the mediastinal lymph nodes is quite common. It is manifested by severe weakness, a periodic increase in body temperature to subfebrile and febrile values, shortness of breath, symptoms of compression of neighboring organs. More than 80 types of systemic lymphoproliferative diseases are known today, differing in course, prognosis, and approaches to treatment. The diagnosis is established by examining biopsy material obtained during video-assisted thoracoscopy.
• Lymphocytic leukemia - also refers to lymphoproliferative tumor lesions of the lymphatic tissue, in contrast to lymphomas, it occurs from the precursor cell of lymphopoiesis. Accompanied by characteristic changes in the structure of the bone marrow, peripheral blood. The diagnosis is established on the basis of a study of bone marrow cells, biopsy material.
• Metastatic lesion is a sign of the spread of a malignant tumor process. Metastases in the lymph nodes of the mediastinum can occur with any oncological disease, the most common localizations are: lung cancer, cancer of the esophagus, stomach, colon. Quite often, sarcomas and breast cancer metastasize in this way. A detailed examination of patients, the results of a histological examination of biopsy material, help to establish the diagnosis.

Tuberculosis

A tuberculous lesion of the intrathoracic lymph nodes is accompanied by a cough, an increase in body temperature, and a history of contact with a patient with tuberculosis may be noted. A sharply positive reaction to specific tuberculin tests is characteristic. The disease can begin without clear symptoms, proceed as pulmonary lymphadenopathy.

Infectious diseases

The most common cause of an increase in the lymph nodes of the mediastinum are conditions after a bacterial infection - pneumonia. Hyperplasia can persist up to 2 months after antibiotic treatment. A distinctive feature is a slight increase in the size of the lymph nodes while maintaining their correct elongated shape and internal structure.

Infectious mononucleosis is an acute viral disease caused by the Epstein-Barr virus. Along with the emerging lymphadenopathy in the mediastinum, it is accompanied by an increase in other groups of lymph nodes, tonsillitis, an increase in the size of the liver, spleen. The diagnosis is helped to establish blood PCR studies, characteristic changes in the general analysis of peripheral blood.

HIV is a viral disease in which manifestations of lymphadenopathy are a stage in the development of the disease. (HIV-associated lymphadenopathy).

Patients suffering from prolonged lymphadenopathy (more than 2 months) should be examined to rule out HIV infection.

Rubella, brucellosis, toxoplasmosis, herpes infection, cytomegalovirus infection are diseases accompanied by local or generalized enlargement of the lymph nodes. Diagnosis is made with specific tests.

Sarcoidosis

The cause of this disease is still unknown. It is believed that there is a certain relationship between the disease and the type of professional activity of the patient. Workers of jewelry workshops, galvanic production, miners get sick more often. The lungs and mediastinal lymph nodes are predominantly affected. The pulmonary-mediastinal form of sarcoidosis is up to 90%.

It should be differentiated from lymphomas, metastatic lesions of the lymphatic apparatus, tuberculosis. The diagnosis is established on the basis of histological examination.

Drug-induced lymphadenopathy

Some groups of drugs, when taken for a long time, can provoke the occurrence of immune reactions, manifested by an increase in certain groups of lymph nodes, including mediastinal ones.

There are the following groups of drugs that affect the possibility of mediastinal lymphadenopathy:

1. Antibacterial drugs - penicillin, cephalosporins, sulfa drugs.
2. Antihypertensive drugs - atenolol, captopril.
3. Antimetabolites - allopurinol.
4. Anticonvulsants - carbamazepine.

As a rule, after discontinuation of the drug, the manifestations of lymphadenopathy disappear.

There are many reasons for the enlargement of the mediastinal lymph nodes. Lymphadenopathy is a problem for doctors of various specialties: hematologists, oncologists, infectious disease specialists, pulmonologists, and surgeons. A correct and timely diagnosis is a real chance for recovery.

Many well-known diseases of a person at different age periods of his life are accompanied by an increase in lymph nodes or an inflammatory reaction of the lymphatic system. Such a reaction is often the body's response to the introduction of infection and is protective.

But there is a group of diseases when an increase or hyperplasia of the lymphoid tissue does not have a protective function, but is a reflection of the lymphoproliferative process, which has completely different pathomorphological signs and symptoms that distinguish these diseases from the banal bacterial lymphadenitis. This article will highlight the topic of lymphadenopathy, combining both of these concepts.

Lymph nodes are morphological formations that perform a variety of functions, primarily immune. Lymph nodes are part of the lymphatic system, which, in addition to these formations, includes lymphatic vessels and parenchymal organs involved in the implementation of immune reactions.

Lymph nodes are a kind of collectors of lymph outflow pathways from the corresponding areas of the body. Often, with various diseases of an infectious or other origin (for example, tumor), an increase in lymph nodes or their groups is observed in combination with other signs and symptoms.

An increase in the lymph nodes of an inflammatory nature is called "lymphadenitis". In this case, as a rule, it is possible to find a connection between inflammation of the lymph node and a recent infectious disease or an exacerbation of a chronic process.

Unlike lymphadenitis, lymphadenopathy - a concept that includes any pathology of the lymph nodes, and is often used as a term reflecting a preliminary diagnosis that requires further clarification.

Lymph nodes are located along the outflow of lymph from organs and tissues and are often anatomically located in groups. In various diseases, an isolated lesion of one lymph node can be observed, or lymphadenopathy occurs, which captures a certain number of lymphatic formations of one or more anatomical regions.

Classification of lymphadenopathies

There are several classifications of lymphadenopathy based on different principles. The main one is the following:

If one lymph node (or several adjacent ones) is enlarged, lymphadenopathy is called regional. Accordingly, this lymphadenopathy is localized in nature.

Localized lymphadenopathy may be non-tumor(more often) and tumor genesis (lymphomas, leukemias and other lymphoproliferative blood diseases).

If a simultaneous increase in lymphatic formations and nodes located in different and distant anatomical regions (two or more) is diagnosed, they speak of generalized lymphadenopathy.

Using another classification of diseases associated with an increase in lymph nodes, it can be distinguished that all lymphadenopathies are divided into two large groups - tumor and non-tumor.

In order to say exactly which lymph nodes are considered normal, a specialist consultation is necessary. The following signs will help to suspect the pathology of the lymph nodes.

The main signs and symptoms of enlarged lymph nodes (lymphadenopathy), regardless of the nature of the disease:

• Enlargement of the lymph node. First of all, an enlarged lymph node (or several lymphoid formations) can be palpated or palpated by the person himself, or lymphadenopathy is detected during a medical examination. The normal size of the lymph node depends primarily on the age of the person, the localization of the lymph node, the state of his lymphatic system, recent diseases.

• Soreness of the lymph node. With lymphadenitis, as a rule, the lymph node is painful to the touch, it can be warmer than the surrounding skin. In severe cases, with purulent fusion of the lymph node, a fluctuation symptom and severe pain are possible.

With lymphadenopathy, varying degrees of soreness of the nodes can also be noted. But often there is a painless (slightly painful) enlargement of the lymph nodes, even when their size is very significant and the lymph nodes are visible to the eye. Therefore, the presence or absence of pain in the lymph node does not give grounds to draw final conclusions about the severity and nature of the disease.

• Density of lymph nodes. The density of lymph nodes can be different, normal lymph nodes are palpated as formations of moderate density. With lymphadenopathy and other diseases of the lymph nodes, they can acquire pathological density.

• Displacement in relation to neighboring tissues. When palpated or palpated, the lymph nodes can easily be displaced or be immobile soldered to the surrounding tissues, formations and other lymph nodes. This symptom is very important for making a preliminary diagnosis for lymphadenopathy of various origins, but can also only be assessed by a doctor.

• The color of the skin over the lymphatic formations. The skin over the lymph nodes with lymphadenopathy and lymphadenitis can change its color (become red, or hyperemic, with a bluish tinge) or remain unchanged. Therefore, this symptom is very important and is evaluated when examining a patient with lymphadenopathy.

• Change in the shape of the lymph nodes, visible to the eye. With a significant degree of lymphadenopathy, severe inflammation with lymphadenitis, or in combination with structural features of this area of ​​the body, the lymph nodes can become visible to the eye. Sometimes the degree of increase can be very significant (conglomerates of several soldered lymph nodes in lymphomas). Often the first symptom that makes a person see a doctor is an increase in the area of ​​​​the lymph node.

Causes of swollen lymph nodes (lymphadenopathy)

Each group of lymph nodes is responsible for a specific anatomical region. Depending on which lymph node is enlarged, it is often possible to draw a definite conclusion about what was the root cause of lymphadenopathy. Consider the possible causes of an increase in different groups of lymph nodes.

Submandibular lymphadenopathy- one of the frequent companions of many diseases associated with inflammation of the lymphopharyngeal ring, ENT organs, especially manifested by purulent fusion of tissues (abscess). Diseases of the lower jaw, inflammation of the mucous membrane of the gums and oral cavity are often accompanied by submandibular lymphadenopathy.

Inguinal lymphadenitis(local lymphadenopathy) can be caused by the following diseases and processes:

• syphilitic infection caused by a specific pathogen - pale treponema;
• mycoplasma infection of the genital organs;
• defeat by staphylococcus and other bacterial flora;
• candida infection;
• genital warts when they become infected;
• chancroid;
• gonorrhea;
• HIV infection;
• genital chlamydia.

Generalized lymphadenopathy non-tumor character can be caused by the following reasons:

• HIV infection (a disease caused by the immunodeficiency virus) during the acute phase of the infectious process often occurs in the form of widespread enlargement of the lymph nodes.
• Infection with viral infections such as rubella, CMV (cytomegalovirus), toxoplasma and herpes simplex viruses often presents with generalized lymphadenopathy.
• Lymphadenopathy, which is a consequence of the reaction to the introduction of vaccines and sera.

Factors that are important in determining the cause of non-tumor lymphadenopathy:

• Presence of injury, injury of limbs, erysipelas of the skin.
• Association of enlarged lymph nodes (lymphadenopathy) with known local or generalized infections.
• Cases of the use of poorly thermally processed meat, fish, milk (infections transmitted with food).
• Professional features - work related to agriculture, animal husbandry, hunting, processing of skins and meat.
• Contact with a patient with tuberculosis and possible infection with Mycobacterium tuberculosis.
• History of blood transfusion, drug addiction using intravenous infusions.
• Frequent change of sexual partners, homosexuality.
• The use of drugs over time (some groups of antibiotics, antihypertensive and anticonvulsants).

Another large group of generalized lymphadenopathies is the defeat of the lymph nodes. tumor character:

• hemoblastosis and tumor processes of lymphoid tissue (lymphoma) of Hodgkin and others, chronic lymphocytic leukemia, myeloid leukemia;
• distant metastatic lesions of lymph nodes from tumors located in the tissues of the lung, uterus, mammary glands, prostate, stomach, intestines, as well as tumors of almost all localizations.

• What are the causes of enlargement and inflammation of the lymph nodes in the groin in men and women?
• When does an increase and inflammation of the lymph nodes under the armpits develop in women?
• What could be the causes of enlargement and inflammation of the lymph nodes in the neck?
• I am expecting a baby (fourth month of pregnancy). I recently caught a cold, there was a severe sore throat, the temperature rose. Today I noticed an increase and inflammation of the lymph nodes under the jaw. How dangerous is it during pregnancy?
• What antibiotic is prescribed for enlarged and inflamed lymph nodes?
• Are ichthyol ointment and Vishnevsky ointment used for enlarged and inflamed lymph nodes?
• The child has symptoms of enlargement and inflammation of the lymph nodes behind the ear. Which doctor should I contact? Is there any traditional treatment?

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

What does enlarged and inflamed lymph nodes mean?

The lymph nodes from the system of lymphatic capillaries receive interstitial fluid containing elements that do not enter the blood (coarse proteins, fragments of dead cells, microorganisms and their metabolic products, etc.).

In oncological diseases, tumor cells linger in the lymph nodes, which often settle there and begin to multiply, forming a tumor metastasis. In this case, it happens swollen lymph nodes usually not accompanied by inflammation.

The occurrence of this pathology, as a rule, indicates a weakening of the body's defense reactions caused by one reason or another (old age or infancy, the presence of concomitant diseases, past infections, physical or psychological trauma, hypothermia, etc.).

Inflammation and enlargement of the lymph nodes occurs both with nonspecific infections (streptococcus, staphylococcus, etc.), and with infections caused by specific microflora (tuberculosis, cat scratch disease, etc.).

It should be noted that the significance of the lymph nodes for the body is not limited to the drainage function alone. Lymph nodes contain lymphocytes that produce antibodies against foreign proteins. When a sufficient number of microorganisms enter the lymph node, its working hypertrophy occurs.

In such cases, an increase in the lymph node is not associated with inflammation of its tissue, but with an increase in the number of lymphocytes that produce antibodies against this infection, as well as macrophages that absorb microorganisms, their waste products and dead cells.

Working hypertrophy of the lymph nodes occurs both in regional infections (chronic tonsillitis, pharyngitis, etc.) and in chronic septicemia (blood poisoning), which most often develops in severe blood diseases that occur with a decrease in the level of normal leukocytes in the blood (aplastic anemia , chronic agranulocytosis, etc.).

Systemic autoimmune diseases (systemic lupus erythematosus, etc.) are also characterized by working hypertrophy of the lymph nodes that produce antibodies against the tissues of their own body. In this case, the degree of enlargement of the lymph nodes indicates the activity of the process.

And finally, like any tissue of the human body, lymph nodes can undergo tumor degeneration. In such cases (lymphogranulomatosis, lymphomas), an increase in non-inflammatory lymph nodes also occurs.

Signs of enlargement and inflammation of the lymph nodes. How to determine the increase in lymph nodes yourself?

It is believed that normally the size of the lymph nodes should not exceed 1 cm. The size of the lymph nodes depends on their location and the individual characteristics of the body. It should be noted that most of the lymph nodes in the normal state are not palpable at all.

When diagnosing a pathological increase in lymph nodes, other signs are taken into account. Normal lymph nodes:
1. Absolutely painless on palpation.
2. They have a dense elastic texture.
3. Mobile (easy to move when probing).

With enlargement and inflammation, the lymph nodes often become painful and bumpy, lose their elasticity, and in the case of a chronic process, they often combine into one conglomerate of irregular shape, and solder with the surrounding tissues.

In addition, in some cases, with inflammation and enlargement of the lymph nodes, the skin above them undergoes pathological changes: pain, swelling and hyperemia (redness) are observed.

It is quite possible to determine the described signs on your own when probing, however, an additional examination and specialist consultation is necessary to make a diagnosis.

The reasons

Thus, the list of diseases in which there is an increase in the lymph nodes is quite long, so in case of suspicion of inflammation of the lymph nodes, it is often necessary to carry out differential diagnostics with a non-inflammatory increase (tumor metastases to the lymph nodes, lymphogranulomatosis, etc.).

Inflammation of the lymph nodes - symptoms, causes, complications and what to do? - video

How to determine the inflammation of the lymph nodes? Pain, temperature and increase in size, as symptoms of acute inflammation of the lymph nodes

Thus, with inflammation of the lymph nodes, there is always an increase in their size. However, there are many pathologies that occur with a regional or systemic increase in lymph nodes, not accompanied by their inflammation.

Therefore, when making a diagnosis, one has to take into account other signs that indicate this symptom. So, a mandatory sign of any inflammatory process is pain. Therefore, in case of acute inflammation, the lymph nodes are always painful to the touch. In addition, with severe inflammation, patients complain of pain in the affected lymph node, which increases with movement.

If the inflammation of the lymph node develops acutely and rapidly, then it is easy to detect the gate of infection - the focus of inflammation, from which, along the current of the lymphatic vessels, the pathogens entered the affected node. This may be a wound on the surface of the skin, tonsillitis, an inflammatory lesion of the external genitalia (vaginitis, balanitis), etc.

And finally, with acute inflammation of the lymph node, a general reaction of the body is observed:

• an increase in body temperature (sometimes to very high numbers);
• chills;
• headache;
• weakness;

Thus, the differential diagnosis of inflammatory and non-inflammatory lymph node enlargement can be very difficult.

Therefore, with inflammation of the lymph nodes, it is necessary to consult a doctor in order to undergo a thorough examination, identify the cause of their increase and start adequate therapy in a timely manner.

Nonspecific infections as the cause of enlargement and inflammation of the submandibular, cervical, axillary, elbow, inguinal, femoral, or popliteal lymph nodes: symptoms and treatment

Nonspecific infection as one of the most common causes of pathology

These are microorganisms that often colonize the human body, as a rule, without causing signs of disease. However, when favorable conditions arise (hypothermia, illness, stress, trauma, etc.), the opportunistic microflora begins to multiply intensively, which leads to the development of the disease.

Most often, nonspecific inflammation of the lymph nodes is caused by the so-called pyogenic cocci:

• less often - Escherichia coli;
• even less often - other opportunistic pathogens.

• submandibular;
• cervical;
• axillary;
• elbow;
• inguinal;
• femoral;
• popliteal.

In acute inflammation, an infection enters from a local focus (carbuncle, furuncle, open infected wound, panaritium, etc.) into the lymph node, and causes an acute reaction there, for which there is the following clinical and morphological classification:
1. Acute catarrhal lymphadenitis.
2. Acute purulent lymphadenitis.
3. Adenophlegmon.

These types of acute inflammation of the lymph nodes are the stages of the pathological process, which, with timely and adequate treatment, can be stopped at the stage of catarrhal lymphadenitis.

Chronic nonspecific inflammation of the lymph nodes, as a rule, occurs as a local complication of chronic foci of infection. Less commonly, it develops as a result of untreated acute catarrhal lymphadenitis.

The course of chronic inflammation of the lymph nodes is productive (there is a proliferation of connective tissue inside the lymph node), so that over time, an increase in the affected lymph node is replaced by its degenerative wrinkling. In this case, suppuration occurs extremely rarely.

What does acute purulent inflammation of the lymph nodes look like?

If the patient does not receive adequate treatment, the catarrhal process can turn into a purulent one. Purulent lymphadenitis is characterized by a sharp pain in the affected area, aggravated by movement. Palpation of the lymph nodes is extremely painful, a dense infiltrate is felt in the affected area, consisting of inflamed nodes and edematous surrounding tissues. Over the inflamed formations, redness and swelling appear. The general reaction of the body increases: the temperature rises to febrile numbers (38-39), patients complain of increasing weakness and headache.

Then, in the center of the infiltrate, a purulent fusion of tissues is formed, which is palpated in the form of a softening focus. With further development, adenophlegmon is formed - diffuse purulent inflammation of the tissues surrounding the affected lymph node. At the same time, the patient's condition worsens: movements in the affected part of the body are sharply difficult due to pain, fever with chills increases, heart rate increases, blood pressure may decrease, headache increases, nausea and dizziness appear.

Effects

In addition, with untimely treatment of acute inflammation of the lymph nodes, there is a risk of developing purulent thrombophlebitis (purulent inflammation of the veins of the affected part of the body), which, in turn, can be complicated by pulmonary embolism (blockage of the pulmonary vessels with fragments of blood clots and / or fragments of pus that have entered the bloodstream). ) or sepsis.

How to treat?

The most common acute inflammation of the lymph node occurs on the extremities. In such cases, immobilization (immobilization) of the affected arm or leg is carried out. This event prevents the spread of infection, and facilitates the general condition of the patient.

At the stage of catarrhal inflammation, conservative treatment is carried out. Shown antibiotic therapy, taking into account the sensitivity of microflora to antibiotics, dry heat (compresses, UHF, etc.).

With purulent melting of the lymph node and lymphophlegmon, the resulting abscess is opened, followed by drainage of the cavity.

Prolonged painless enlargement of lymph nodes in chronic inflammation caused by nonspecific microflora

• chronic tonsillitis;
• pharyngitis;
• trophic ulcer of the lower leg;
• chronic inflammatory diseases of the external genital organs, etc.

How to cure?

Antibiotics are prescribed. At the same time, samples are taken from the source of infection to determine the sensitivity of microorganisms to drugs (nonspecific microflora is often resistant to many antibacterial agents).

In addition, they carry out activities that strengthen the body's defenses: vitamin therapy, general tonic, herbal medicine, spa treatment, etc.

Is chronic enlargement and inflammation of the lymph nodes caused by nonspecific microflora dangerous?

Prolonged chronic inflammation of the lymph nodes leads to their degeneration. Sometimes, as a result of the growth of connective tissue, lymph drainage is disturbed in the affected lymph node and lymphostasis develops, which is clinically manifested by chronic swelling and trophic disorders in the affected area of ​​the body.

In severe cases, with chronic lymphostasis, elephantiasis develops - a pathological proliferation of connective tissue, leading to a significant increase and disfigurement of the affected area of ​​the body. Elephantiasis is most often observed on the lower extremities, which in such cases visually resemble the legs of an elephant - hence the name.

Specific infections as a cause of enlargement and inflammation
lymph nodes

Tuberculosis

This is the most common form of primary tuberculosis (about 80% of all cases). This increased frequency is associated with vaccination against the disease. That is why tuberculosis of the intrathoracic lymph nodes is more common in children, adolescents and young people, when artificial immunity is still strong enough.

Symptoms of tuberculous inflammation of the intrathoracic lymph nodes depend on the degree of their increase, the localization of the process and its prevalence.

A common process is manifested by a strong whooping cough that worsens at night. At first the cough is dry, then sputum appears. In addition, signs of tuberculous intoxication are characteristic: weakness, lethargy, fever (sometimes to high numbers), night sweats, irritability.

In small forms, which are more often observed in vaccinated children, the disease is almost asymptomatic and is detected only during routine examinations.

Enlarged and inflamed lymph nodes in the lungs
When infected with tuberculosis in the lung tissue, the so-called primary tuberculosis complex is often formed - inflammation of the lung tissue, combined with lymphangitis (inflammation of the lymphatic vessel) and lymphadenitis.

It should be noted that in many cases the primary tuberculosis complex is asymptomatic, and often not diagnosed - at this stage, self-healing (resorption or calcification of the focus) is possible.

In addition to enlargement and inflammation of the lymph nodes in the lungs, during primary infection, a reactive increase in superficial lymph nodes (a reaction to infection) often occurs, which is of great diagnostic value.

With an unfavorable course of the disease, further spread of the infection occurs. In this case, the lung tissue is affected and there is an increase and inflammation of other nodes.

Signs of enlargement and inflammation of the lymph nodes are detected radiographically, while clinical manifestations depend on the location and degree of their enlargement. So, with compression of the airways, an obsessive dry cough is possible, and with partial overlap of the trachea, noisy breathing.

The clinic of tuberculous lymphadenitis, as a rule, develops against the background of severe intoxication and symptoms of lung damage (cough, shortness of breath, chest pain).

Enlargement and inflammation of the submandibular, cervical, axillary, inguinal and elbow lymph nodes
An infectious-inflammatory lesion of the superficial lymph nodes in tuberculosis develops when the infection spreads throughout the body some time after the initial infection.

Most often there is an increase and inflammation of the submandibular and cervical lymph nodes. In the initial stage of the process, symptoms of tuberculous intoxication are observed, as well as soreness in the area of ​​the affected nodes, which during this period are palpable as mobile elastic formations.

In the future, the lymph nodes are soldered to each other and to the surrounding tissues, and then suppuration with the formation of an external fistula that does not heal for a long time.

In addition to the formation of fistulas and abscesses, enlargement and inflammation of the superficial lymph nodes in tuberculosis can lead to bleeding (with infiltration of the vessel wall) and to the generalization of the process.

Symptoms of enlargement and inflammation of the lymph nodes in the abdominal cavity (mesenteric lymph nodes) with abdominal tuberculosis
Abdominal tuberculosis is a rare form of tuberculosis that affects the abdominal organs. As a rule, abdominal tuberculosis occurs with mesadenitis - an increase and inflammation of the lymph nodes of the abdominal cavity.

There are acute and chronic course of tuberculous mesadenitis. In the acute form, patients complain of severe abdominal pain, which, as a rule, is localized along the intestinal mesentery, to which inflamed lymph nodes are attached: in the navel, in the left hypochondrium and in the right iliac region (to the right and below the navel). A characteristic symptom is a shift in pain when the patient is turned to the left side.

Chronic mesadenitis proceeds with remissions and exacerbations, and may manifest itself with attacks of intestinal colic or constant dull aching pain. Often, patients complain of bloating, increasing in the evening.

A severe complication of chronic enlargement and inflammation of the abdominal lymph nodes is the formation of bedsores of the neurovascular bundle due to prolonged pressure of calcified nodes.

Enlargement and inflammation of the inguinal, mandibular and submental lymph nodes in primary syphilis

A few days after the appearance of a hard chancre, an increase and inflammation of the nearest lymph nodes develops. Since the penetration of the infection most often occurs during sexual intercourse and kissing, the inguinal lymph nodes are most often affected (when a hard chancre is located on the genitals), as well as the mandibular or chin (when the primary ulcer is located on the lips or in the oral cavity).

Enlargement of the inguinal and mandibular lymph nodes is usually bilateral, up to the size of a hazelnut or bean. At the same time, the affected nodes retain a hard-elastic consistency, are mobile and absolutely painless. Often, accompanying lymphangitis develops - inflammation of the lymphatic vessel leading to an enlarged node. The inflamed lymphatic vessel is palpated in the form of a solid thin cord, sometimes with distinct thickenings.

Much less often, a primary ulcer occurs on the fingers (infection through damaged skin is possible if hygiene rules are violated during the examination) or on the body (most often with bites). In such cases, the corresponding regional lymph nodes become inflamed.

The duration of primary syphilis is about 12 weeks. All its manifestations are painless, and disappear on their own, without treatment. Rarely (when the body is weakened and hygiene rules are violated), a secondary infection and inflammation of the hard chancre occur. In such cases, the development of purulent lymphadenitis is possible.

Enlargement and inflammation of the occipital, cervical, parotid, popliteal and axillary lymph nodes as an important diagnostic sign of rubella

Most often with rubella, there is an increase and inflammation of the occipital, posterior cervical and parotid lymph nodes. At the same time, patients complain of neck pain, aggravated by head movements.

Palpation reveals a painful enlargement of the lymph nodes (usually up to the size of a bean), while maintaining their densely elastic consistency and mobility.

Chickenpox

It should be noted that this symptom does not develop in all cases, and in adult patients, as a rule, indicates the severity of the disease.

HIV

In addition to an increase in lymph nodes, no other manifestations are noted at this time, although the disease can already be detected in the laboratory. That is why clinicians often call this stage the stage of generalized lymphadenopathy.

The cervical, occipital and axillary lymph nodes are most often affected. It is believed that an increase in two or more groups of lymph nodes outside the inguinal localization (sizes more than 1 cm) for more than three months should raise the suspicion of HIV.

Of course, a generalized increase in lymph nodes occurs in many diseases, so this symptom cannot be considered an unconditional marker of HIV, therefore, further examination is necessary for a correct diagnosis.

Enlargement and inflammation of the lymph nodes is a constant sign of an advanced clinical stage of AIDS. It should be noted that during this period, lymphadenopathy can be caused by both HIV and infectious complications that develop at this stage of the disease.

What is the danger of enlargement and inflammation of the lymph nodes in specific infections?

Causes of enlargement and inflammation of the lymph nodes in children

In addition, some infections that cause enlargement and inflammation of the lymph nodes develop mainly in children (rubella, chickenpox, measles).

The reason for the increase in lymph nodes of a non-inflammatory nature at an early age can be severe hematological diseases (acute leukemia, lymphomas, lymphogranulomatosis, congenital blood pathology).

But cancerous lesions of the skin, gastrointestinal tract, breast, which can metastasize to the lymph nodes - practically do not occur in children.

Answers to the most popular questions

What are the causes of enlargement and inflammation of the lymph nodes in the groin in men and women?

However, the most common cause of enlargement and inflammation of the lymph nodes in the groin are inflammatory processes of the external genitalia (vaginitis in women, balanitis in men), which can be caused by both specific (gonorrhea, syphilis, chancre, genital herpes) and nonspecific microflora (with colds and violation of the rules of personal hygiene).

When making a diagnosis, the possibility of non-inflammatory enlargement of the lymph nodes should be considered. It is necessary to exclude their metastatic lesions in the tumor process in the pelvic organs, as well as malignant transformation of the lymphoid tissue (lymphoma).

When does an increase and inflammation of the lymph nodes under the armpits develop in women?

In addition, enlargement and inflammation of the axillary lymph nodes in women may be due to the presence of silicone implants.

And finally, in women, as well as in men, enlargement and inflammation of the lymph nodes under the armpits develops with tumors (melanoma) and infectious diseases of the outer skin of the upper limbs and chest (infected wounds, ulcers, cat scratch disease, etc.).

It is standard to carry out differential diagnostics with lymphoma.

What could be the causes of enlargement and inflammation of the lymph nodes in the neck?

Differential diagnosis of enlargement and inflammation of the lymph nodes located on the back of the neck is much more difficult. In addition to a banal infection, such lymphadenitis may indicate rubella or tuberculosis.

In addition, the possibility of developing lymphoma and metastatic lesions of the lymph nodes in malignant neoplasms of the head and neck should be taken into account.

Which doctor should I contact?

I am expecting a baby (fourth month of pregnancy). I recently caught a cold, there was a severe sore throat, the temperature rose. Today I noticed an increase and inflammation of the lymph nodes under the jaw. How dangerous is it during pregnancy?

This condition, in itself, does not pose a danger to pregnancy, however, it is urgent to seek medical help and undergo a course of treatment, since with untimely or inadequate therapy, complications may develop - such as suppuration of the lymph node or the development of streptococcal glomerulonephritis.

This kind of complications can threaten pregnancy, and it will be much more difficult to cure them without harm to the child.

What tests are prescribed?

• type of course (acute or chronic inflammation);
• prevalence (generalized or regional enlargement of lymph nodes);
• the presence of other symptoms of the pathology of the lymph nodes (pain on palpation, violation of consistency, cohesion with surrounding tissues, etc.);
• the presence of specific signs that make it possible to suspect a specific pathology (a characteristic intoxication syndrome in tuberculosis, a hard chancre in syphilis, a rash in measles, a focus of infection in acute inflammation of the lymph node, etc.).

What antibiotic is prescribed for enlarged and inflamed lymph nodes?

In the case of nonspecific inflammation, it is recommended to conduct a test for the sensitivity of the pathogen to antibiotics. The fact is that many strains (varieties) of opportunistic microorganisms (especially staphylococci) develop resistance to antibiotics.

The sample is easy to take if there is an infection gate (infected wound, furuncle, acute tonsillitis, etc.). In the absence of an open focus of infection (healed wound), and before the results of the analysis are obtained, antibiotics are prescribed that have proven effective against nonspecific microflora.

In cases where the antibiotic does not have the desired effect (no signs of clinical improvement), another medication is prescribed. Of course, all medicines for enlarged and inflamed lymph nodes are prescribed by a doctor, taking into account contraindications.

Is it possible to put compresses?

An absolute contraindication to such procedures are malignant neoplasms (metastases to the lymph node, lymphoma), so in case of enlargement and inflammation of the lymph nodes, you should never self-medicate.

Treatment of enlargement and inflammation of the lymph nodes with the help of compresses is carried out on the recommendation and under the supervision of a doctor.

Do ichthyol ointment and Vishnevsky ointment use for enlargement and inflammation
lymph nodes?

The drug is used in a complex of other medical measures in the treatment of enlargement and inflammation of the lymph nodes in cases where the cause of the pathology was the existence of long-term non-healing wounds, abrasions, trophic ulcers or bedsores. The ointment is applied to the affected surfaces, which have become the gates of infection. In the case of chronic inflammation, therapy of the primary focus, in fact, is the treatment of lymphadenopathy.

Ichthyol ointment is a rather weak antiseptic, however, it has a pronounced anti-inflammatory and soothing effect, so it is often used for local treatment in the initial stage of acute enlargement and inflammation of the lymph nodes caused by a nonspecific infection.

Local treatment is necessarily supplemented with antibiotic therapy, drugs and regimens are prescribed by the doctor after the examination.

The child has symptoms of enlargement and inflammation of the lymph nodes behind the ear. Which doctor should I contact? Is there any traditional treatment?

Of course, this is not the only possible diagnosis. The parotid lymph nodes receive tissue fluid from the temporal region of the head, the auricle and the external auditory canal, therefore, an increase and inflammation of the lymph node behind the ear may indicate infections of the scalp (boils, wounds) or acute or chronic inflammation of the external auditory canal (this pathology occurs often in children).

The human lymphatic system serves as a kind of filter for cleansing and removing toxins and toxins from the body. The lymphatic system is made up of nodes and vessels through which lymph flows. Violation of the work of this system leads to serious consequences and harms the body. Lymphadenopathy, or swollen lymph nodes, is the first sign of a disease.

The main characteristic of lymphadenopathy

This process indicates the course of the disease. Often of an oncological nature. With such a phenomenon as an increase in lymph nodes, you should immediately contact a specialist and conduct the necessary studies.

The specific cause of the appearance of lymphadenopathy is established after the necessary examination. The most common are the presence of viruses in the body, injuries, connective tissue diseases, fungus. In children, lymphadenopathy captures the abdominal cavity, as a result of infection with viruses or bacteria.

Forms of lymphadenopathy

Lymphadenopathy can be classified as follows:

1. Local . There is an increase in one lymph node throughout the body. An example is an increase in the node on the back of the head in the case of rubella.
2. Generalized. It is considered to be the most difficult form of the disease. Characterized by the defeat of entire areas of the human lymphatic system. The causes of this form can be considered the presence of allergic reactions, diseases of the immune system, inflammation or infection. This form is most common in HIV-infected people. There is a lesion of the cervical and axillary parts, retroperitoneal space, in rare cases, the inguinal and supraclavicular region is affected.
3. Reactive. This form of lymphadenopathy is characterized by the absence of symptoms and pain. Affects any lymph area.

Stages of disease development

The stages of the course of lymphadenopathy are divided:

• acute;
• chronic;
• recurrent.

Also, the above forms, in turn, can be tumor or non-tumor.

Distribution of lymphadenopathy

There are over 650 lymph nodes in the human body. The process of disease development can occur in any part of the lymphatic system. The most common places for the development of pathology are considered to be:

1. primary magnification
2. Malignant formations
3. Organ damage in this area
4. False tumors

The development of pathology in the mediastinal region is characterized by: sharp pains in the chest, passing into the neck or shoulder joint; pupil dilation; voice change; pain and noise in the head. Rare: blue complexion, enlarged jugular veins. In the case of neglect of intrathoracic lymphadenopathy, there may be an increase in temperature and disruption of the heart. In children, there is a violation of breathing and severe sweating at night.

Other localization

Diagnostics

To determine the type and nature of lymphadenopathy, a thorough examination and observation by a specialist is necessary. Treatment depends on the location of the disease. To begin with, the necessary tests are given: UAC, urinalysis, analysis for tumor markers. Abdominal ultrasound and x-rays are performed.

Treatment

Treatment is prescribed after establishing the cause of the enlarged lymph nodes. If there is an infection, then antiviral drugs are prescribed. Antibiotics are prescribed only if suppuration of the lymph node is suspected.

Tumor diseases require specialized treatment in the oncology department. Treatment with glucocorticosteroids is not used if it is not possible to establish the cause of the enlarged lymph nodes, because. they reduce this symptom and make it difficult to make a correct diagnosis. In the presence of tuberculosis, the use of steroids can worsen the patient's condition. In this case, it is extremely dangerous to use non-traditional treatment or to do it yourself. Treatment of lymphadenopathy is a strictly individual process for each organism.

Disease prevention

There are no specific preventive measures. This can include measures to prevent disease and oversaturation with toxins in the body, which contribute to swollen lymph nodes. Do not forget about maintaining the right lifestyle and giving up bad habits.