lymphadenopathy - is increasing the size and changing the shape of one or a whole group of lymph nodes of various origins.Most episodes of lymphadenopathy is a manifestation of the basic background of the disease, but without quality diagnostic events and full course of treatment this pathology can be transformed into other life-threatening condition and have serious complications.
Due to the fact that the lymph node, as the main collector of the lymphatic system functions as a "defender" of the human organism from the introduction and spread of various infectious agents, any pathological changes in its structure, as well as dysfunctionIt shows the development of a limited mass or inflammation.Thus, all kinds of infectious disease sooner or later provoke changes in the lymph system, namely, create conditions for development of inflammatory signs in the structure of the lymph node.
No matter what kind or type of the inflammatory agent entered the
doctor of any specialty should be aware that the use of a long course of antibiotic and antifungal therapy may be an agent provocateur development of generalized lymphadenopathy, signs of which are independently leveled after the abolition of the drug following pharmacological categories: antibacterials group of penicillins and cephalosporins, quinidine derivatives.
defeat visceral groups of lymph nodes is observed most often in a particular category of patients with metastatic cancer pathology.
symptoms of lymphadenopathy
Some form of lymphadenopathy occurs in varying degrees of intensity and can have specific symptoms, which depend on the individual reactivity of the patient and the presence of underlying disease, which was the original cause of pathological changes in the lymph nodes.
Note that in some cases the loss of one lymph node (local lymphadenopathy) may have a bright and severe symptoms than changes in the whole group of lymph collectors (generalized lymphadenopathy).The most difficult runs the so-called reactive type of lymphadenopathy, in which the severity of the patient depends on the severity of the intoxication-inflammatory syndrome.
acute period of lymphadenopathy in this situation is accompanied by the development of symptoms such as type of hectic fever, severe sweating, alternating with chills, local pain and limited flushing of the skin in the estimated localization of lymph node.Joining hepatosplenomegaly indicates a worsening of the patient.Provided that the total absence of therapeutic measures used in this situation observed melting of lymph node tissue and the rapid spread of inflammatory elements of the blood stream, resulting in the development of generalized sepsis.
In most cases, even when the primary objective examination of the patient with some form of lymphadenopathy experienced specialist can identify the main clinical criteria to judge the presence of changes in the lymph nodes.
to determine whether the changes in the major groups of lymph node palpation doctor spends not only the affected area, but also other parts of the body, which allegedly arranged lymph collectors.For example, to establish a preliminary diagnosis of "inguinal lymphadenopathy" enough of the palpation and compression of the inguinal region, especially in the projection of the inguinal ring, as the location of the group of lymph nodes rather superficial.The defeat of visceral groups of lymph nodes can be visualized and should only be used with the help of instrumental methods of diagnosis.
Primarily, the term "lymphadenopathy" means resizing lymph node, which often changes to increase parameters, but when assessing the size of the node should be considered that its normal parameters can vary widely, depending on the location.For normal size inguinal lymph node will be increased for cervical lymph node groups.
If the patient has discomfort soreness in the implementation of the compression of soft tissues, which are located close to the lymph node, it must be assumed the inflammatory nature of the lesion.In addition, signs of inflammatory genesis lymphadenopathy is redness, increased local temperature increase, and skin and soft tissues in the projection of the location of the lymph node.
important value in the differential diagnosis of diseases provoke the development of lymphadenopathy, is the definition of consistency, the structure of a lymph node and its displaceability relative to surrounding tissues.For example, if the patient has dense lymph node or lymph conglomerate increased density, the fixed palpation, favors the development of a neoplastic process or the presence of specific inflammation (tuberculosis lesion).
also need to take into account the location of affected lymph nodes, as for the majority of diseases characterized by a limited loss of one of the groups.For example, inflammatory diseases of the oral cavity in most cases of cervical lesions limited groups of lymph nodes.
Due to the fact that even the same forms of lymphadenopathy may occur differently in each individual case, in medical practice, a certain algorithm of examination of patients with pathology of a group of lymph nodes.This screening consists of specific and general laboratory methods (blood tests to identify inflammatory changes titre of specific cancer markers), as well as various ray imaging techniques (standard and contrast X-ray, ultrasound scan, computed tomography).
most common form of lymph node involvement is inflammatory lymphadenopathy cervical lymph nodes, which is largely a lot of pediatricians, as accompanying for major infectious diseases of childhood.These localized inflammatory changes are usually in the oral cavity or salivary glands, and therefore, the proximity of the cervical lymph node groups allow you to quickly join the reactive lymphadenopathy.This type of lymphadenopathy rarely requires specific therapy, and changes in the lymph nodes independently leveled after the elimination of the root causes of disease.
adult category of patients in less suffering this disease and if they have a change of cervical lymph node groups, it must be assumed tumor genesis lymphadenopathy.Therefore, in the primary treatment of a patient with cervical lymphadenopathy, a complete instrumental examination not only of the affected area, but also other organs and systems in order to exclude malignancy.
defeat of one or another group of cervical lymph nodes may be an important diagnostic and prognostic indicator of various disease states in the body.Thus, an increase in posterior cervical lymph node groups are accompanied by infectious foci localized in the scalp, as well as toxoplasmosis and rubella.Infection of the conjunctiva and eyelids often accompanied by an increase in the size of anterior cervical lymph nodes.And with the available changes all groups of lymph nodes should be assumed if the patient has lymphoma.
TB infection is characterized by rapidly progressive increase in cervical lymph nodes with subsequent suppuration.Supraclavicular lymph node groups affected is extremely rare, and the emergence of the lymphadenopathy should be regarded as a poor prognostic sign (metastases in the localization of the primary tumor focus in the thoracic cavity).Epitrohlearny lymph node affected in sarcoidosis and secondary syphilis, while the increase in units is a two-way symmetrical.Unilateral his defeat often accompanies infected lesions of the skin of the upper limb.
axillary lymphadenopathy in the majority of cases is inflammatory in nature.Provokes its development hit nonspecific infectious agents through the damaged skin from the lymph current.
In a situation where the patient has signs of increasing the size or changing the form of axillary lymph nodes in the existing of breast cancer, mammologists in their practice use the term "axillary lymphadenopathy."
Recently, the international community observes the steady progression of surgical morbidity of axillary lymphadenopathy form among patients of different ages, race and sex.The first is the dynamic development of lymphadenopathy is due to human impact, adverse environmental conditions, as modified by the mixed infection.Priority groups of microorganisms is part of provocateurs of inflammatory changes in the axillary lymph node groups are pyogenic bacteria coccus category.
Due to the fact that the group of axillary lymph nodes located surfactant and well accessible for surgical intervention, to avoid complications lymphadenopathy inflammatory nature in the form of a lymph node melting and forming of sepsis, in most cases surgical treatment of axillary lymphadenopathy.
Operational benefit in this case is the opening and adequate sanitation home purulent inflammation followed by drainage.Particular attention should be given sufficiently long random access allowing completely remove areas of purulent fusion with the surrounding fatty tissue intact.During the operation the patient is recommended first dose cephalosporin directly modified lymph node, followed by the parenteral course of antibiotic therapy, which in this situation is of a preventive nature.
Postoperatively need to use medications to address the underlying disease (Famciclovir virus infection in a dose of 0.25 mg 3 times / day. Orally, in a daily dose of fluconazole 200 mg for fungal infections, toxoplasmosis lymphadenopathy Fansidar at 2 tablets1 per week).Of great importance in the recovery period should be given to the state of immunity of the patient, and therefore the main treatment should be combined with means of immunomodulatory effects (Roncoleukin a daily dose of 2 mg orally).
mediastinal lymphadenopathy often accompanies heavy for specific forms of destruction of lung parenchyma inflammatory genesis, the most common abnormality is a tuberculous lesion.
Keep in mind that the majority of patients, often suffering from respiratory and viral diseases, complicated by additional bacterial infections observed lymphadenopathy light having transient.In this regard, this is diagnosed pathological condition is extremely rare.
more common cause of the classical version of mediastinal lymphadenopathy are neoplastic diseases of structures belonging to a particular department of the mediastinum.Unfortunately, the clinical manifestations of this form of lymphadenopathy begin to appear at a late stage of the disease and is the appearance of severe pain syndrome, caused by the spread of the tumor in the substrate structure of the nervous tissue.Most often the pain is one-sided with the typical radiating pain in the shoulder girdle and the upper half of the back.The emergence of pain in the projection of the bones and soft tissues of any localization should direct the physician to think about the appearance of distant metastases in a patient.
In addition, the typical clinical manifestations of mediastinal lymphadenopathy is a category of so-called "compression symptoms" that are observed in a marked increase in the size of tumors of the mediastinum.Due to the fact that in a particular department of mediastinum in addition to the authorities is the neurovascular bundle, and compression of large vessels of the beam inevitably provokes the development of hemodynamic disorders (venous hypertension, disorders of the rhythm of cardiac activity, headaches and expressed dizziness alone, acrocyanosis and diffusecyanosis of the skin).
In situations where increased mediastinal lymph nodes have a compressive pressure on the trachea and bronchial lumen, the patient begin to show symptoms suggestive of respiratory disorders (spasmodic cough, shortness of breath, increasing shortness of breath).The appearance of the patient's complaints of shortness of swallowing, the constant feeling of "lump in the throat" favors the development of the compression effect of lymphadenopathy in the esophagus.
malignant form of mediastinal tumors, namely Hodgkin limforetikulosarkoma and accompanied by the development of mediastinal lymphadenopathy is characterized by the development in humans of non-specific signs of cancer (rapid weight loss, severe weakness and decreased ability to work, hyperhidrosis).
In a situation where the patient has clinical implications, indicating the presence of mediastinal lymphadenopathy, to confirm the diagnosis and determine the cause of this syndrome is necessary to conduct radiologic examination of the patient and, if necessary, verification of the diagnosis - needle biopsy by VATS.
This form of destruction of retroperitoneal lymph node groups is often a pathognomonic sign of an existing patient tumor lesions of different localization, so the detection of enlarged retroperitoneal lymph nodes of the patient is the basis for a thorough screening with the use of specific diagnostic procedures.
main manifestations lymphadenopathy retroperitoneal lymph nodes is a short-term fever, paroxysmal intense pain in the abdomen, with no clear localization, diarrhea.Most often affects the lymph nodes in the retroperitoneal tumor lesion localization in organs of any digestive tract, kidneys, and rarely for tumors of the testes.
In some situations, the primary symptom of retroperitoneal lymphadenopathy is an intense pain in the back due to compression of the nerve endings.The most reliable way to diagnose this category lymphadenopathy is magnetic resonance imaging with contrast.