Chronic lymphadenitis
Most of them have obvious infection focus, often local lymph node enlargement, pain and tenderness, generally less than 2 ~ 3 cm in diameter, which will shrink after anti-inflammatory treatment. Enlargement of inguinal lymph nodes, especially long-term flat lymph nodes, is of little significance. However, the cervical and supraclavicular lymph nodes have no obvious causes of swelling, suggesting that systemic lymphoproliferative diseases should be paid attention to and further examined.
tuberculous lymphadenitis
Fever, hyperhidrosis, fatigue and accelerated erythrocyte sedimentation rate are more common among young people. Often accompanied by tuberculosis, lymph nodes are uneven in texture, some of which are light (caseous degeneration) and some of which are hard (fibrosis or calcification), which adhere to each other, to the skin and have poor mobility. These patients are positive for tuberculin test and tuberculosis antibody in blood.
malignant lymphoma
It can also be seen in any age group, and its lymph node enlargement is often painless, from soybean to jujube, with medium hardness. Generally, it is not attached to the skin, but it does not fuse with each other in the early and middle stages and can move. Advanced lymph nodes can grow very large, or they can fuse into large blocks with a diameter of more than 20cm, invade the skin, and will not heal for a long time after rupture. In addition, it can also invade mediastinum, liver, spleen and other organs, including lung, digestive tract, bone, skin, breast, nervous system and so on. Diagnosis requires a biopsy. Clinically, malignant lymphoma is often misdiagnosed. Superficial lymphadenopathy was the first manifestation, and 70% ~ 80% of them were diagnosed as lymphadenitis or tuberculosis at the initial diagnosis, which delayed treatment.
Casselman's disease
This is a rare disease and easy to be misdiagnosed. Often manifested as unexplained lymphadenopathy, mainly invading the chest, mostly mediastinum, but also invading the hilum and lungs. Other sites of invasion were neck, retroperitoneum, pelvic cavity, armpit and soft tissue. It is often misdiagnosed as thymoma, plasmacytoma and malignant lymphoma. Understanding the pathological and clinical manifestations of this disease is very important for early diagnosis.
Pseudolymphoma
It often occurs outside lymph nodes, such as pseudolymphoma of orbit and stomach, lymphatic polyp of digestive tract, etc., which can form masses. It is generally considered to be reactive hyperplasia, which is caused by inflammation.
Lymph node metastasis
Lymph nodes are often hard and uneven in texture, and the primary focus can be found. This is a rare systemic lymphadenopathy.
Acute leukemia and chronic lymphocytic leukemia
Lymph node enlargement is also common, especially in children with acute lymphoblastic leukemia. Clinical onset is urgent, often accompanied by fever, bleeding, hepatosplenomegaly, sternal tenderness and so on. Hematology and bone marrow puncture can make a definite diagnosis and differential diagnosis.
Carcinomatosis
It is rare in China and often invades bilateral hilum, radiating and accompanied by long-term low fever. Lymph nodes are swollen all over the body, especially around the ears, under the chin and beside the trachea. It is difficult to distinguish it from malignant lymphoma in clinic.
Infectious mononucleosis is more common in young men and is caused by EB virus. However, patients are usually in good condition, ranging from fever and generalized lymphadenopathy to mild splenomegaly. There are heteromorphic lymphocytes in peripheral blood, and a positive heterophilic agglutination test can make a diagnosis.
Serum sickness is a disease that occurs after patients use serum products (tetanus antitoxin, rabies vaccine, etc.). ). The first symptom of a few patients is lymphadenopathy. However, most of the lymph nodes at the injection site and above the trochlea were swollen first. The diagnosis can be made according to the injection history, fever, rash and eosinophilia.
Lymph node enlargement is common. The above 10 causes are listed, hoping to give you inspiration, timely treatment, diagnosis and syndrome differentiation, so as to get timely and effective treatment.
I may have had this experience at ordinary times: when my foot is swollen or inflamed after injury, my groin will also feel pain. If you touch it carefully, you will touch one or several "small bumps" the size of broad beans under the skin, which are hard and painful, and that is lymph nodes. When bacteria enter your blood vessels from the injured part, lymph nodes, as "sentinel against the enemy", must first fight back against the bacteria to prevent the "enemy" from going deep. As each lymphocyte "eats" a large number of bacteria, its "belly" becomes bigger and bigger, and the whole lymph node will be swollen and painful. Therefore, lymph nodes are important immune organs of the body. Lymph nodes are also an alarm device in the human body, and lymph node enlargement may be the external manifestation of a disease.
Bacterial infection: Acute inflammation of the mouth and face often causes swelling of mandibular lymph nodes. The swollen lymph nodes are soft in texture and have good mobility, and generally can gradually return to normal with the disappearance of inflammation.
Virus infection: measles, infectious mononucleosis, etc. Can cause lymphadenopathy. Sometimes lymphadenopathy has important diagnostic value, such as rubella, which often causes retrooccipital lymphadenopathy.
Lymph node tuberculosis: cervical lymph node enlargement is the most common, some will rupture, some will not rupture, and it is sometimes difficult to distinguish it from lymphoma in clinic. The diagnosis method is to do lymph node puncture, smear and biopsy in many places to find out the primary focus of tuberculosis.
Metastatic carcinoma of lymph node: This kind of lymph node is hard, without tenderness and activity, especially in patients with gastric cancer and esophageal cancer. Small lymph nodes on the clavicle can be felt. Patients with breast cancer should always touch axillary lymph nodes to determine whether the tumor has metastasized.
Leukemia: The lymphadenopathy of this disease is systemic, but it is most obvious in neck, armpit and groin. In addition to lymphadenopathy, patients also have anemia and persistent fever, and a large number of immature cells will appear in blood and bone marrow.
Lymphoma: cervical lymph node enlargement is more common. Lymphoma is a primary tumor in lymph nodes or lymphoid tissues, and there are also some lesions other than lymph nodes, such as tonsils, nasopharynx, gastrointestinal tract and spleen.
Enlargement of lymph nodes can also lead to connective tissue diseases such as lupus erythematosus. Another example is allergic diseases and poisonous insect bites. Therefore, lymphadenopathy can not be ignored, especially when persistent lymphadenopathy is found, doctors should be invited as soon as possible.
Lymphadenopathy can be divided into two types: painful type and painless type. Pain and swelling are more common in acute suppurative infection, and the infected area can be eliminated after proper treatment. Diseases that cause painless swelling are often stubborn, difficult to find and harmful. Generally, it is more common in tuberculosis infection, lymphoma, tumor lymph node metastasis and hematological diseases (such as leukemia).
Lymph nodes are all over the body and can only touch superficial special parts. Such as submaxillary, neck, supraclavicular fossa, armpit and groin are the easiest to touch. When a woman has breast cancer, swollen lymph nodes can be felt around her breasts and armpits.
The correct touch method is: the index finger and middle finger are close together, and touch them up and down. If you feel round, oval or rope-like lymph nodes under the skin, you should go to a regular hospital for diagnosis immediately.
Lymphatic system is the body's natural defense organization, which can resist infection and toxin invasion. Superficial lymph nodes exist in the neck, armpit, groin, behind the knee and before and after the ear.
The most common cause of lymphadenopathy in children is infection. The location of swelling depends on the location of infection. Laryngeal and ear infections may lead to cervical lymph node enlargement, and head infections may lead to retroauricular lymph node enlargement; Hand or arm infection can enlarge axillary lymph nodes; Infections in the feet and legs can lead to swollen inguinal lymph nodes.
The most common child is cervical lymphadenopathy. It is easy for the mother to notice this part of the child, and she can rest assured after taking the child to the doctor for examination.
For most people, sore throat, cold, tooth inflammation (abscess), ear infection or insect bite are the causes of lymphadenopathy.
However, if lymphadenopathy occurs in the anterior middle of the neck or just above the clavicle, you will
Causes other than infection, such as tumor, cyst or thyroid dysfunction, must be considered.