Lymphadenopathy

Content

Introduction

Introduction

Lymph nodes are small organs that filter the lymphatic fluid (lymph) that circulates in the body and play a vital role in fighting infection. When lymph is filtered by the lymph nodes, infectious organisms and damaged or cancerous cells are collected and destroyed first. that can reach other parts of the body.

Lymph nodes swell when infectious agents, such as bacteria or viruses, or damaged cells become numerous.

The lymph nodes are present throughout the body but of particular groupings, such as those placed under the skin of the neck, under the chin, in the armpits and in the groin, it is possible to notice the increase in volume.

Lymphadenopathy is the term for swollen lymph nodes. When they become palpable with the hands, they indicate that something in the body is not right. The enlargement can be localized, when it is present only in one area of ​​the body, or generalized, when it is present in more than two areas of the body.

Lymphadenitis is the term used when the lymph nodes of one or more areas of the body, in addition to being swollen, also become painful or show signs of inflammation.

Treatment of lymphadenitis depends on the cause, which is usually infectious.

Symptoms

Symptoms

Lymph nodes are located throughout the body but particular groups, which tend to swell frequently, are found in the head and neck region as well as in the armpits and groin.

You can see:

  • ache, when touched (palpation)
  • enlargement, which can be about the size of a bean or even larger

Depending on the cause of the lymphadenopathy, the symptoms (symptoms) that may arise include:

  • runny nose, sore throat, fever, and other disorders (symptoms) that indicate an "upper respiratory infection"
  • generalized swelling of the lymph nodes throughout the body, a sign of a major infection (such as a widespread infection) or an autoimmune disease, such as lupus or rheumatoid arthritis
  • hard, non-motile and rapidly growing nodules, indicators of a possible tumor
  • fever
  • night sweats

Some swollen lymph nodes return to normal when the underlying cause, such as an infection, improves.

Seek medical attention if swollen lymph nodes:

  • they appear for no apparent reason
  • they continue to enlarge or have been present for 2-4 weeks
  • they are hard to the touch and are not mobile to touch
  • they are accompanied by persistent fever, night sweats, or unexplained weight loss
  • they are accompanied by difficulty in swallowing or breathing

If the lymph node is very painful or produces purulent (pus) or other material, you should seek medical attention immediately.

Causes

Causes

A normal lymph node appears small, round, or bean-shaped, and is surrounded by a covering (capsule) of connective tissue. It is composed of cells of the body's defense system (immune system), lymphocytes and macrophages, which have the task of destroying the material captured during the filtration of the lymph.

Lymph nodes are found in clusters, each of which "cleans" (drains) a specific "area" of the body. The area where the lymph nodes are enlarged (neck, under the chin, in the armpits and groin) can help identify the underlying cause.

Since lymph nodes are part of the body's immune system, the potential causes of their enlargement (lymphadenopathy) they are infections, inflammatory states and tumors.

The most common cause is an "infection, especially a" viral infection, such as the common cold. Other possible causes of swollen lymph nodes include:

Common infections

  • sore throat
  • measles
  • ear infections
  • tooth abscess
  • mononucleosis
  • skin infections and inflammations

Uncommon infections

  • human immunodeficiency virus (HIV), the virus that causes AIDS
  • tuberculosis
  • sexually transmitted infections, such as syphilis
  • toxoplasmosis, parasitic infection due to contact with the feces of an infected cat or from eating undercooked meat
  • cat scratch disease, bacterial infection transmitted by cat scratching or biting

Disorders of the immune system

  • lupus, long-lasting (chronic) autoimmune disease which can affect joints, skin, kidneys, blood cells, heart and lungs
  • rheumatoid arthritis, chronic autoimmune disease affecting the tissue lining the joints (synovium)

Tumors

  • lymphoma, a tumor that originates in the lymphatic system
  • leukemia, cancer of the hematopoietic tissue, including the bone marrow and lymphatic system
  • other cancers, spread (metastasized) to the lymph nodes

If the cause of the enlarged lymph nodes is an infection and it is not treated (treated), the following complications can occur:

  • formation of abscesses, an abscess is a localized collection of pus caused by an infection. The pus contains fluids, white blood cells, dead cells, and bacteria. The abscess may require drainage and antibiotic treatment
  • bloodstream infection (bacteremia), a "bacterial infection, wherever it is located, can progress to sepsis, a term that indicates a" widespread (systemic) bodywide infection affecting normally sterile tissues, organs, fluids or cavities causing damage. Treatment of bacteremia is urgent and involves hospitalization and intravenous antibiotic therapy
Diagnosis

Diagnosis

To ascertain (diagnose) the cause of lymphadenopathy, your doctor may need to:

  • know when and how lymphadenopathy developed, learn about the person's health and check for any other signs or ailments
  • perform the medical examination, check the size, mobility and consistency of the lymph nodes. Their position together with the other disorders will offer clues to the cause of the enlargement
  • prescribe blood tests, to confirm or rule out the suspicion of a disease. In addition to a complete blood count, which helps assess general health and detect a variety of disorders, including infections and leukemia, specific tests may be requested, which vary based on the hypothesized cause
  • ask for image-based investigations (imaging studies)chest x-ray or computed tomography (CT) of the affected area could help determine the source of the infection or identify any tumors
  • prescribe a biopsy of the lymph node (sampling of a piece or of the whole lymph node) or the needle aspirate (which allows you to take biological material through a very thin needle). The sample is examined in the laboratory to establish its nature and characteristics or to exclude the diagnosis of malignant tumor. It is usually done for swollen lymph nodes that do not heal within 3-4 weeks
Therapy

Therapy

The treatment (therapy) is directed towards the cause that led to the enlargement of the lymph node. Lymphadenopathy, therefore, should not be treated in itself.

If the lymph nodes swell due to a common virus (such as the flu), after healing from the viral infection they return to normal without any therapy. Antibiotics should not be used to treat viral infections.

Treatment of lymphadenopathy depends on the causes which include:

  • bacterial infectionThe most common treatment for lymphadenopathy caused by a "bacterial infection" is antibiotics
  • HIV infection, the doctor will prescribe specific treatment for this disease
  • immune disorder, if the cause is an autoimmune disease such as lupus or rheumatoid arthritis, the treatment will be directed towards the underlying disease
  • tumors, depending on the type of tumor, the treatment will consist of surgery, radiotherapy, chemotherapy alone or in combination with each other

In case of pain, some relief can be obtained:

  • applying a warm compress, a cloth moistened in hot water, wrung out and applied to the affected area
  • giving an over-the-counter pain reliever, such as acetylsalicylic acid, ibuprofen etc. The administration of acetylsalicylic acid to children or adolescents requires special attention
Bibliography

Bibliography

Mayo Clinic. Swollen lymph nodes (English)

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