Lymph node enlargement is the phenomenon of cell proliferation or tumor cell infiltration in the lymph node, which is very common.It can be found by touching submandibular, neck, supraclavicular fossa, armpit and groin, and can occur in people of any age.It can be seen in a variety of diseases, ranging from benign to malignant.Therefore, lymphadenopathy should be treated and diagnosed in time so as not to delay the condition.
TCM disease name
Superficial lymph node enlargement
Visiting department
General surgery
Common diseases
lymph gland
Common causes
Infection, tumor, reactive hyperplasia, histiocytosis and metabolic abnormalities
common symptom
Lymph node enlargement in different degrees
atlas
Science popularization in China
Committed to authoritative science communication
The certification expert of this term is
Zhang Jiayong|Chief physician
General Surgery Department, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicineto examine
(4) Tumor metastasis: gastric cancer, liver cancer, breast cancer, nasopharyngeal cancer, etc.
3. Reactive hyperplasia
(1) Necrotizing proliferative lymphadenopathy.
(2) Serum disease and serum disease like reaction.
(3) Allergic sub sepsis.
(4) Systemic lupus erythematosus, rheumatism, etc.
4. Histocyte proliferation and metabolic abnormalities
(1) Langerhan histiocytosis.
(2) Lipid deposition disease.
(4) Sarcoidosis.
clinical manifestation
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There are different manifestations due to different primary diseases, and lymph node enlargement is common in the following three types:
1. Benign swelling
It includes swelling caused by various infections, connective tissue diseases and allergic reactions.The clinical manifestation is usually benign. With the removal of the etiology, it can be completely recovered in a certain time.
2. Malignant swelling
It includes malignant tumors originating from lymph nodes such as lymphoma, lymphocytic leukemia and malignant histiocytosis, and lymph node metastasis of other malignant tumors such as lung cancer, stomach cancer and breast cancer.The clinical manifestation is malignant.
3. Between benign and malignant
Such as vascular primitive immune cell lymphadenopathy and vascular follicular lymphadenopathy.It is usually benign at first, but can become malignant and fatal.
inspect
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1. Physical examination
During palpation, attention should be paid to the location, number, size, texture, tenderness, mobility, adhesion, redness, ulceration and scar of the swollen lymph nodes.
2. Laboratory inspection
(1) Blood picture: The total number and classification of peripheral blood leukocytes have certain reference value in judging the cause of lymph node enlargement.
(2) Bone marrow examination: The cell morphology examination of bone marrow smear has decisive significance for the diagnosis of leukemia, plasmacytoma and malignant histiocytosis.
(3) Serological examination: heterophilic agglutination test can be performed when infectious mononucleosis is suspected.
3. Instrument inspection
(1) Lymphangiography
(2) Radionuclide scanning
(3) Others: X-ray examination, CT examination, B-mode ultrasound, fiber endoscope and other examinations can help to clarify the location and nature of the primary focus.
diagnosis
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Understand the details related to lymph node enlargement, such as the location, development range, development speed, and accompanying symptoms.
differential diagnosis
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It should be differentiated from adult Sail disease. Juvenile rheumatoid arthritis in adults is mainly characterized by chills, high fever, swollen lymph nodes, slightly enlarged liver and spleen, and transient erythematous papules, while muscle and arthralgia are not obvious.A few can be complicated with multiple serositis (pericarditis, pleurisy, etc.), leukocytosis, neutrophils, rapid ESR, but no obvious infection focus can be found, and rheumatoid factor, antinuclear antibody, lupus cells, etc. in blood are negative.Antibiotic treatment was ineffective, and salicylic acid treatment or combined with adrenocortical hormone treatment had better effect.Except for a few patients who may have joint deformity several years later, most of the others have good prognosis, but can recur.
treatment
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The treatment of lymphadenopathy depends on the disease. For example, streptomycin and ramifene can be used for lymphotuberculosis. If it is malignant lymphoma, combined chemotherapy should be the main treatment. If it is late metastasis of cancer, the prognosis is very poor.
prevention
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1. Develop good living habits, have healthy eating habits, and eat more fruits and vegetables at ordinary times.
2. Keep a good attitude, stable mood and improve self immunity.
3. When you must work in the heavy oil smoke area, try to do a good job of self-protection, such as wearing a mask and going out regularly to breathe fresh air.
4. Keep away from smoke, alcohol, drugs, radiation, pesticides, noise, volatile harmful gases, toxic and harmful heavy metals, etc.
