In 2009, when the news of Luo Jing, a famous CCTV announcer, died of lymphoma, the number of patients with swollen lymph nodes or suspected lymphoma in hematology clinics increased drastically, and then the media reported that some celebrities like Gao Mingjun had lymphoma, which really caused some people to panic. So what is it about swollen lymph nodes and lymphoma? Lymph nodes are important immune organs in human body. There are about 500-600 lymph nodes in normal people, which are scattered all over the body in the lymphatic return pathway. Lymph nodes can be divided into superficial lymph nodes and deep lymph nodes according to their locations. Those located on the surface of the body are called superficial lymph nodes. Normal lymph nodes are mostly below 12.5px in diameter, with soft texture, smooth surface, no pressure pain, and no adhesion to the surrounding tissues. Lymph nodes are connected with lymphatic vessels, so when pathogens such as bacteria and other harmful substances invade your skin or a part of your body, they can easily enter the capillary lymphatic vessels all over the body and reach the lymph nodes with lymphatic flow, and most of them are removed or confined in the lymph nodes, which effectively prevents harmful components from entering the blood circulation and attacking other parts of the body. The lymph nodes also produce specific memory cells for such antigens, which are ready to monitor the reinvasion of these harmful components. Thus, lymph nodes are the posts and battlefields of the lymphatic defense system and play an important role in defending against foreign aggression. When swollen lymph nodes occur, round, oval or striated nodes can be felt under the skin, especially in the neck, submandibular, supraclavicular fossa, armpit and groin, which are most easily felt, and this is an indication that the body may have an abnormal condition. Enlarged lymph nodes are common, can occur in people of any age, and can be seen in a variety of diseases. In some people, the lymph nodes in the neck swell up once they catch a cold or have a sore throat. When encountering this situation, people often worry and fear that they have a tumor. In fact, swollen lymph nodes are mostly benign lesions. When we find swollen lymph nodes, it is important to identify the causes and treat them actively. The causes of swollen lymph nodes can be broadly divided into the following three categories. 1. Inflammatory reaction Such as acute and chronic lymphadenitis, lymph node tuberculosis. When bacteria enter the organism, the lymph nodes respond by generating more lymphocytes and histiocytes, secreting lymphatic factors and antibodies to effectively kill the bacteria, and will show swollen lymph nodes. Although lymphadenitis is a minor disease, necrotizing lymphadenitis can sometimes be serious, showing clinical manifestations such as acute onset, high fever, and swollen and painful lymph nodes. 2. Lymph node reactive hyperplasia Like some chronic diseases in the body, such as breast hyperplasia, thyroid nodules, immune system diseases, etc., can stimulate lymphocyte proliferation and lead to lymph node enlargement. Other conditions that can cause reactive hyperplasia of lymph nodes include viruses, certain chemical drugs, toxic products of metabolism, degenerated tissue components and foreign bodies. This situation is often complicated, and the doctor can not get more evidence to explain the cause, even if the lymph nodes are taken for pathological examination, there is only a conclusion of reactive hyperplasia. 3. Tumor cell lymph node metastasis or lymphoma. The most worrying thing about enlarged lymph nodes is tumor. In case of malignant tumors in various parts of the body, tumor cells often metastasize along the lymphatic vessels and stay in the lymph nodes to divide and proliferate, resulting in swollen lymph nodes. The lymphatic system itself can also suffer from tumorigenic lesions, such as lymphoma. On the one hand, we say that swollen lymph nodes are an alarm of disease and cannot be ignored, on the other hand, there is no need to panic, as swollen lymph nodes are still mainly inflammatory in most cases, and the incidence of lymphoma is still very low. After the occurrence of swollen lymph nodes, it is most crucial to distinguish the different nature of swollen lymph nodes. Professional doctors can roughly determine the benign and malignant nature of the lumps from several aspects such as the length of time they have been present, the softness and hardness of the lumps, the presence or absence of pain, whether the lumps have become larger and more numerous, and the presence or absence of other general discomfort. We can also do self-examination, for example, if the lymph nodes are swollen for a short period of time, soft to the touch, and painful or painful to the touch, they are generally benign and may be caused by acute or chronic inflammation and other chronic diseases. In contrast, if the swollen lymph nodes do not subside for a long time, are as hard as stones, without pain or pressure, and the lymph nodes increase and enlarge with time, you should be alert to the possibility of tumor. Of course, there are exceptions, such as cervical lymph node tuberculosis, which is hard at the beginning and often has multiple swollen lymph nodes connected in a string or fused into a piece, and even sometimes misdiagnosed as tumor. Lymph node biopsy is the gold standard for the diagnosis of lymph node lesions. The superficial enlarged lymph nodes are preferred for lymph node biopsy and are removed as completely as possible, usually without needle aspiration. Lymph node enlargement must be searched and treated for primary disease Lymph node enlargement is not a disease of a single lymph node itself, but often means that there is inflammation or other lesions in organs within its genus, so when a patient comes to see a lymph node enlargement, the doctor will ask and check whether the patient has lesions in other surrounding tissues, search for the primary foci according to the lymph node drainage area, and by “following the vine By “following the pathology” and comprehensive analysis, the disease that is hiding behind will be revealed. If enlarged lymph nodes are felt under the jaw, it means there are lesions in the mouth, such as tonsillitis, pharyngitis, periodontitis, etc. After finding the lesion, the right medicine should be prescribed. For example, antibiotics are effective in treating acute lymphadenitis caused by bacterial infections such as pharyngitis; chronic lymphadenitis and viral infections can be treated with anti-inflammatory and node-dispersing herbs; lymph node tuberculosis should be treated with anti-tuberculosis drugs; tumor lymph node metastasis should undoubtedly be treated with anti-tumor therapy as the root. The following clinical manifestations should be considered as the possibility of lymphoma and need to be seen in the hematology department in time: 1. Progressive lymph node enlargement of unknown origin, especially if the location, hardness and activity are consistent with the characteristics of lymphoma (common lymph node enlargement in the neck and axilla); 2. “Chronic lymphadenitis” when the regular course of anti-tuberculosis or general anti-inflammatory treatment is ineffective; 3. Lymph node enlargement and fever, although recurrent, tend to be progressive in general; 4. Long-term low fever or periodic fever of unknown origin, especially when accompanied by itchy skin, excessive sweating, wasting, and superficial lymph node enlargement. Lymphoma is a systemic hematologic disease, and its development is closely related to the immune function status of the body. Lymphoma treatment measures include chemotherapy, radiotherapy, targeted therapy, biological therapy, stem cell transplantation, etc. In recent years, significant progress has been made in the treatment of lymphoma. Most of Hodgkin’s lymphoma can be cured, while non-Hodgkin’s lymphoma is less effective than Hodgkin’s lymphoma, but some cases can be cured. The cause of lymphoma is not well understood and may be the result of many factors interacting with the body. However, certain types of lymphoma may be associated with bacterial and viral infections. Therefore, we should develop good living habits and have regular medical checkups to detect lesions early and treat them early. There are no special symptoms for clinical manifestations of lymphoma, but if there are unexplained prolonged fever, night sweats, weight loss or sudden painless enlargement of lymph nodes, we should go to the hospital as soon as possible. Health tips 1. What tests should be done for swollen lymph nodes: routine blood tests can understand the presence of inflammation and blood system diseases; ultrasound tests can understand the size and shape of lymph nodes; pathological biopsy is the most accurate diagnosis method. 2.What are the common diseases causing lymph node enlargement: most of them are benign diseases such as acute and chronic lymphadenitis, lymph node tuberculosis, etc., and a few are caused by lymphoma, tumor lymphatic metastasis, etc. 3, painless progressive lymph node enlargement should be promptly sought medical attention.