Lymphadenopathy is very common, which can occur in people of any age and can be seen in many diseases, including benign and malignant diseases. Therefore, it is very important to pay attention to the etiology of lymphadenopathy and make a diagnosis in time to avoid misdiagnosis and missed diagnosis. Let's start with the common causes of lymphadenopathy.
Chronic lymphadenitis
Most of them have obvious infection focus, often local lymph node enlargement, pain and tenderness, generally less than 2 ~ 3 cm in diameter, which will shrink after anti-inflammatory treatment. Enlargement of inguinal lymph nodes, especially long-term flat lymph nodes, is of little significance. However, the cervical and supraclavicular lymph nodes have no obvious causes of swelling, suggesting that systemic lymphoproliferative diseases should be paid attention to and further examined.
tuberculous lymphadenitis
Fever, hyperhidrosis, fatigue and accelerated erythrocyte sedimentation rate are more common among young people. Often accompanied by tuberculosis, lymph nodes are uneven in texture, some of which are light (caseous degeneration) and some of which are hard (fibrosis or calcification), which adhere to each other, to the skin and have poor mobility. These patients are positive for tuberculin test and tuberculosis antibody in blood.
malignant lymphoma
It can also be seen in any age group, and its lymph node enlargement is often painless, from soybean to jujube, with medium hardness. Generally, it is not attached to the skin, but it does not fuse with each other in the early and middle stages and can move. Advanced lymph nodes can grow very large, or they can fuse into large blocks with a diameter of more than 20cm, invade the skin, and will not heal for a long time after rupture. In addition, it can also invade mediastinum, liver, spleen and other organs, including lung, digestive tract, bone, skin, breast, nervous system and so on. Diagnosis requires a biopsy. Clinically, malignant lymphoma is often misdiagnosed. Superficial lymphadenopathy was the first manifestation, and 70% ~ 80% of them were diagnosed as lymphadenitis or tuberculosis at the initial diagnosis, which delayed treatment.
Giant lymph node hyperplasia is a rare disease, which is easily misdiagnosed. Often manifested as unexplained lymphadenopathy, mainly invading the chest, mostly mediastinum, but also invading the hilum and lungs. Other sites of invasion were neck, retroperitoneum, pelvic cavity, armpit and soft tissue. It is often misdiagnosed as thymoma, plasmacytoma and malignant lymphoma. Understanding the pathological and clinical manifestations of this disease is very important for early diagnosis.
Pseudolymphoma often occurs outside lymph nodes, such as pseudolymphoma in orbit and stomach, and lymphatic polyps in digestive tract, which can form masses. It is generally considered to be reactive hyperplasia, which is caused by inflammation.
Lymph node metastasis
Lymph nodes are often hard and uneven in texture, and the primary focus can be found. This is a rare systemic lymphadenopathy.
Acute leukemia and chronic lymphoblastic leukemia also often have lymphadenopathy, especially acute lymphoblastic leukemia common in children, which is often accompanied by fever, bleeding, hepatosplenomegaly, sternal tenderness and so on. Hematology and bone marrow puncture can make a definite diagnosis and differential diagnosis.
Sarcoidosis is rare in China, often invading bilateral hilum, radiating and accompanied by long-term low fever. Lymph nodes are swollen all over the body, especially around the ears, under the chin and beside the trachea. It is difficult to distinguish it from malignant lymphoma in clinic.
Infectious mononucleosis is more common in young men and is caused by EB virus. However, patients are usually in good condition, ranging from fever and generalized lymphadenopathy to mild splenomegaly. There are heteromorphic lymphocytes in peripheral blood, and a positive heterophilic agglutination test can make a diagnosis.
Serum sickness is a disease that occurs after patients use serum products (tetanus antitoxin, rabies vaccine, etc.). ). The first symptom of a few patients is lymphadenopathy. However, most of the lymph nodes at the injection site and above the trochlea were swollen first. The diagnosis can be made according to the injection history, fever, rash and eosinophilia.
Lymph node enlargement is common. The above 10 causes are listed, hoping to give you inspiration, timely treatment, diagnosis and syndrome differentiation, so as to get timely and effective treatment.