Swollen lymph nodes in the neck is a common clinical symptom, and I am often asked by patients what to do if the lymph nodes in the neck are swollen. Is it cancer? Some patients, too, have swollen lymph nodes in the neck, which is an early symptom of certain malignant tumors, and as a result, they do not pay attention to it because of various reasons such as busy work, and finally delay the treatment, causing irreparable damage and leaving a sorry song of life. 1.Introduction of knowledge about lymph nodes Lymph nodes are important immune organs of human body. Normal people have about 500-600 lymph nodes. Each group of lymph nodes collects lymphatic fluid from the corresponding drainage area. If there is inflammation, tumor or other pathophysiological factors stimulating the drainage area, it can cause lymph node enlargement. The head and neck area is rich in lymphatic drainage, and there are many lymph nodes in the neck itself, which can cause swollen lymph nodes in the neck under pathophysiological conditions. 2. Causes of enlarged lymph nodes in the neck There are many causes of enlarged lymph nodes in the neck, and the four common ones are inflammatory enlargement, tumor enlargement, reactive hyperplasia and histiocytic hyperplasia enlargement. In acute and chronic lymph node infections caused by bacteria, viruses, chlamydia, fungi, spirochetes, protozoa, worms, etc., the lymph nodes may become congested, edematous, with proliferation of lymphocytes and macrophages, infiltration of neutrophils, monocytes and plasma cells, and even necrosis and granuloma formation, resulting in enlarged lymph nodes with pain. However, clinical attention should also be paid to the development of lymphatic tuberculosis, especially in patients who have failed to respond to antibiotics and whose blood tests are essentially normal. Clinical features of cervical lymphatic tuberculosis include: enlarged, nodular, painless lymph nodes in the lateral part of the neck, mostly seen in children and young people; initially isolated nodules, smooth and movable, later nodules fuse into a mass, irregular and poorly movable, the masses can form abscesses with fluctuating sensation, and sinus tracts can be formed after rupture, which are submerged with the lower part of the skin and do not heal over time; thin secretions, often containing cheese-like material, and unhealthy traumatic granulation; there can be Some patients may have a history or lesions of tuberculosis such as lung; pathological biopsy can clarify the diagnosis. The clinical features of chronic lymphadenitis are: most have obvious foci of infection and often limited lymph node enlargement with pain and tenderness, usually no more than 2-3 cm in diameter, which shrinks after anti-inflammatory treatment. Flat lymph nodes in the neck that have been present for a long time without change are mostly of no importance. Tumor enlargement Whether it is an endogenous tumor originating from lymphatic tissues (e.g. lymphoma, lymphocytic leukemia, etc.) or a tumor metastasized from outside the lymph nodes (e.g. oral cancer metastasized to the cervical lymph nodes, nasopharyngeal cancer metastasized to the cervical lymph nodes, gastric cancer metastasized to the left supraclavicular lymph nodes, etc.), it can be manifested as a massive proliferation of tumor cells in the lymph nodes, occupying and destroying the normal tissue structure of the lymph nodes. The lymph nodes are swollen due to the proliferation of fibrous tissue and inflammatory cell infiltration in the lymph nodes. Oral cancer usually has foci in the oral cavity, such as fast-growing ulcers and hard infiltrating masses. Early symptoms of nasopharyngeal cancer include blood in the nose, nasal congestion, tinnitus, headache, and enlarged lymph nodes in the neck. The clinical characteristics of cancerous lymph nodes are: they are often hard like stones and relatively fixed, with fast growth rate, fusion of lymph nodes, pain and other symptoms in the late stage, and no obvious effect of antibiotic treatment. The lymphocytes in the lymph nodes are reactive and proliferate in large numbers, manifesting as enlarged lymphoid follicles, parafollicular lymphocytes, and sometimes necrotic hyperplasia, leading to enlarged lymph nodes. Histiocytic hyperplasia is the presence of large numbers of histiocytes in lymph nodes in a lamellar, focal or diffuse pattern, and granuloma formation, as in Langerhan’s histiocytic hyperplasia. These diseases are relatively rare. Treatment of swollen lymph nodes in the neck There are many causes of swollen lymph nodes in the neck, therefore, different treatment plans should be chosen according to the causes. If it is chronic lymphadenitis, antibiotic treatment or clinical follow-up is sufficient; if it is lymphatic tuberculosis, regular anti-tuberculosis treatment is necessary; if it is caused by tumor, the primary tumor must be treated to be effective.