Lymph node enlargement (lymph node enlargement) can be detected by palpation of the submandibular, cervical, supraclavicular fossa, axilla and groin, but enlarged lymph nodes in the body such as hilar, mediastinum, retroperitoneum and mesentery can only be detected by X-ray, CT and ultrasound. There are 3 common conditions.
① Benign enlargement. These include enlargement caused by various infections, connective tissue diseases and allergic reactions. It is often clinically benign and can recover completely within a certain period of time as the cause is removed.
(2) Malignant enlargement. These include malignant tumors originating from lymph nodes, such as lymphoma, lymphocytic leukemia and malignant histiocytosis, and lymph node metastases from other malignant tumors, such as lung cancer, gastric cancer and breast cancer. The lymph nodes are persistently and progressively enlarged, and if they are not treated actively, they often deteriorate and die.
(3) Enlargement between benign and malignant. For example, vascular primitive immune cell lymphadenopathy and vascular follicular lymph node hyperplasia. They are often benign at the beginning and can become malignant and fatal.
Therefore, after determining the enlargement of lymph nodes, it is crucial to determine their cause and nature. Local enlargement with obvious pain is often indicative of infection; progressive painless enlargement is often indicative of malignant neoplastic disease. Bone marrow aspiration, especially lymph node biopsy, can help confirm the diagnosis. The treatment of lymph node enlargement depends on the cause, such as lymph gland tuberculosis with streptomycin and ramiphon, etc. In case of malignant lymphoma, combined chemotherapy should be the main treatment, and in case of advanced cancer metastasis, the prognosis is extremely poor.
Pathogenesis
I. Infection
1.Acute infection
Bacteria, viruses, rickettsiae, etc., such as acute cellulitis, upper respiratory tract infection, infectious mononucleosis, tsutsugamushi disease, etc.
2.Chronic infection
Bacteria, fungi, helminths, chlamydia, screw borreliosis, filariasis, venereal lymph node granuloma, syphilis, AIDS, etc.
Second, tumor
1.Malignant lymphoma Hodgkin’s disease and non-Hodgkin’s lymphoma.
2.Leukemia Acute lymphocytic leukemia, acute non-lymphoblastic leukemia, chronic lymphocytic leukemia, chronic granulocytic leukemia, plasma cell leukemia, etc.
3.Plasma cell tumor Multiple myeloma, primary macroglobulinemia.
4.Tumor metastasis Stomach cancer, liver cancer, breast cancer, nasopharyngeal cancer, etc.
III. Reactive hyperplasia
1.Necrotizing proliferative lymphadenopathy.
2.Seropathy and seropathy-like reaction.
3. Allergic subsepticemia.
4. Systemic lupus erythematosus, rheumatic diseases, etc.
IV. Tissue cell proliferation and metabolic abnormalities
1. Langerhan’s histiocytic proliferative disease.
2. Lipid deposition disease.
3. Nodular disease.