Some patients who have swollen lymph nodes in the neck and other areas are very nervous and have seen several doctors or are still unsure, mainly because he is not clear about the cause of swollen lymph nodes and only considers malignant lymphoma, not knowing that there are many other cases of benign lymphomas that are swollen. Lymph nodes are important immune organs of the organism. Various injuries and stimuli often cause reactive proliferation of lymphocytes and histiocytes in the lymph nodes, resulting in enlargement of the lymph nodes, called lymph node reactive hyperplasia. There are many reasons for this, including bacteria, viruses, toxins, toxic products of metabolism, denatured tissue components and foreign bodies, which can become antigens or allergens to stimulate lymphatic tissues to cause reactions. The degree of lymph node enlargement varies, generally less than 1 cm, sometimes up to 10 cm. There are many types of lymph node hyperplasia, which are briefly described as follows: I. Non-specific reactive lymphatic follicular hyperplasia The main characteristics of non-specific reactive lymphatic follicular hyperplasia are lymph node enlargement, lymphatic follicular hyperplasia, and obvious enlargement of the center of growth. The number of lymphatic follicles increases, and they are not only distributed in the cortex of the lymph nodes, but also in the corticomedullary junction and the medulla. The follicles were of different sizes and shapes, with distinct boundaries. The lymphocytes are enlarged and proliferated, and there are many transformed lymphocytes with large nuclei, with or without cleft nuclei, and many phagocytes, and the cytoplasm contains phagocytic debris. The growth center is surrounded by small lymphocytes. Plasma cells, histiocytes and a few neutrophils and eosinophils were seen infiltrating the lymphoid tissue between the follicles. Proliferation of reticulocytes and endothelial cells in the lymphatic sinus. Reactive lymphoid follicular hyperplasia is easily confused with follicular lymphoma, in which the lymph node structure is disrupted and the follicles are similar in size and shape and not clearly delineated. The proliferating cells in the follicles are heterogeneous, but the types are more consistent, the nuclear division image is less, the macrophages that swallow foreign bodies are usually missing, and the proliferating lymphocytes are monoclonal; while the proliferating lymphocytes in reactive lymphoid follicular hyperplasia are polyclonal. Giant lymph node hyperplasia is also known as vascular follicular lymph node hyperplasia or Castleman’s lymph node hyperplasia. It is a special type of lymph node hyperplasia, not a tumor or a malformation. It can occur at any age. Massive lymph node hyperplasia occurs most often in the mediastinal lymph nodes, but also in the hilar lymph nodes and in the cervical, axillary, mesenteric, broad ligament, and retroperitoneal lymph nodes. The lymph nodes are obviously enlarged, with a large diameter of 3-7 cm and up to 16 cm, often round, with an intact envelope and clear boundaries, and a grayish-white cut surface. Vascular immunoblastomatous lymphadenopathy is also called immunoblastomatous lymphadenopathy. It occurs mostly in middle-aged and elderly people. The main manifestations are fever, weight loss, generalized lymph node enlargement, hepatomegaly, splenomegaly, skin maculopapular rash, pruritus, and often polyclonal hypergammaglobulinemia and hemolytic anemia. The main lesion of immunoblastomatous lymphadenopathy is generalized lymph node enlargement, which is usually about 2-3 cm in diameter, grayish white, soft, mobile, and sometimes painful to pressure. Microscopically, the structures of the lymph nodes are seen to disappear, and lymphatic follicles and lymphatic sinuses are not obvious. The lymph nodes are infiltrated with a large number of immunoblasts and transformed lymphocytes. Sometimes there is also a majority of plasma cells, eosinophils, macrophages and epithelioid cells. Small post-capillary veins were markedly proliferated in a branching pattern. The vascular endothelial cells were swollen and proliferated. Amorphous eosin-like material was seen in the interstitial lymph nodes. In addition to the lymph nodes, similar lesions are seen in the liver, spleen, bone marrow, and lungs. The cause and nature of this disease is unknown. Some patients develop the disease after an upper respiratory tract viral infection and some have a history of use of certain medications such as antimicrobials prior to the onset of the disease. In the past, the disease was thought to be an overproliferation of B cells caused by impaired T-cell regulation. Recent studies have found that in many patients it is a T-cell lymphoma. Genetic recombination studies have confirmed monoclonal T-cell proliferation. It is now believed that the disease may be a clonal lymphocytic hyperplasia caused by immune system dysfunction, on the basis of which there is a massive proliferation of malignant cell lines that develop into malignant lymphoma. The prognosis of this disease varies widely. About half of the patients can survive for 2-4 years without any treatment, and about 25% can go into remission with hormonal therapy or with other chemotherapeutic agents. Some lesions are progressive and can progress to malignant lymphoma with a poor prognosis. In advanced stages, most patients die from secondary infections due to immune deficiency.