Enlarged lymph nodes in the neck

The lymphatic system is an integral part of the vascular system of the human body. It performs many functions, participates in metabolic processes, works as a cleansing and protective mechanism. The system of lymph nodes and ducts transports proteins and tissue fluid from the interstitial space to the blood vessels, transfers fats from the small intestine to the same place. The fluid that circulates in the lymphatic system is lymph.

The structure and structure of the lymphatic system in the human body

The structure of a multilevel and complex mechanism includes lymphatic vessels – these are cylindrical cavities through which lymph flows, lymph nodes (accumulations of small lymphatic tissue located in different places throughout the body), lymphatic organs – the thymus gland, tonsils and spleen.

In addition, two ducts participate in the system – the left and thoracic, flowing into the right and left subclavian veins, respectively. All these elements are united by a fluid that circulates through all cavities – lymph.

The capillaries of the lymphatic system are tubes closed on one side that form a network in human tissues and organs. Capillaries have very thin walls through which proteins, liquid and large particles freely enter the cavities. Due to the peculiarities of the structure of the walls of blood vessels, these elements cannot penetrate into the vessels, so they enter the blood precisely through the capillaries of the lymphatic system.

In turn, the lymphatic vessels are an accumulation and fusion of small capillaries. In fact, they resemble veins in their structure, but have thinner walls. In addition, they have a large number of valves that regulate the outflow of lymph.

Each vessel passes through its corresponding lymph node. All nodes are combined into several groups located along the course of the vessels. The mechanism of lymph movement looks like this: through a large number of small capillaries, lymph enters the node, and it leaves it through several efferent vessels.

The nodes themselves are tissue formations, shaped like ellipses or beans, less often – ribbon-shaped, up to 2 centimeters long. In these “beans” the lymph is filtered, during which various foreign inclusions are separated and destroyed. In them, lymphocytes mature – cells that make up part of the body’s immune system. The vessels emerging from the nodes are connected into trunks that form the thoracic and right lymphatic ducts.

Through the right duct, lymph is collected from the right arm, the right half of the head and chest into the right subclavian vein. Through the thoracic duct, fluid moves from the left upper half of the body to the left subclavian vein. In this way, the lymph moves from the interstitial spaces into the blood.

What are cervical lymph nodes

Lymph nodes are bean-shaped and ribbon formations of lymphatic tissue. In the neck, the nodes are located in clusters of up to 10 pieces, near blood vessels, mainly large veins.

Their surface is represented by connective tissue, which forms a capsule. Inside the node, trabeculae, also connective tissue support structures, depart from it.

The internal structural basis of the node is the stroma of the reticular connective tissue with process cells. These cells, together with the reticular fibers they form, form a three-dimensional network. The structure of the stroma also includes several types of phagocytic cells.

The inner part of the node is called the medulla. Closer to the plane of the capsule is a cortical substance with a superficial part and a zone of deep cortex.

The accumulation of lymphoid tissue within the space of the node forms follicles – lymphatic nodules located closer to the capsule. The deep cortex contains a large number of lymphocytes with a dense and uniform arrangement.

The lymph node, in fact, is a barrier to the retention of infection, pathologically altered and tumor cells. It is the maturation of lymphocytes – protective cells that destroy foreign elements.

The cervical lymph nodes are divided into:

• anterior cervical;
• posterior cervical;
• occipital;
• chin;
• submandibular nodes.

In a normal state, in a healthy person, the nodes are not palpable, since they are small in size, they are soft and elastic, quite mobile under the skin.

Characteristics of inflammation of the cervical nodes

Lymph nodes can become inflamed, increase in size, which is due to the development of lymphadenitis.

Lymphadenitis is a disease associated with a specific or non-specific inflammatory process in the nodes. An increase in the size of the nodes is accompanied by a feeling of soreness, headache, general malaise and weakness, subfebrile or, less commonly, high fever.

Most often, pathology occurs as a secondary complication in the presence of inflammatory processes of any localization. The causative agents of infections, together with the toxins they secrete, penetrate into the regional lymph nodes along with the lymph flowing from the primary lesion. In some cases, this focus has already disappeared by the time lymphadenitis appears, and it cannot be recognized. Sometimes the disease occurs as a result of infection entering the lymphatic network directly through damage to the mucous tissue or skin.

The developing inflammatory reaction is a protective function of the lymphatic system: with the help of such a barrier, the body limits the further spread of pathogenic particles through tissues, organs, and blood.

At the same time, along with the development of inflammation in the nodes, a person may begin to form purulent processes – sepsis and adenophlegmon. The danger of this condition lies in the approach of the current of infected lymph to the brain. If the liquid with the infection contained in it enters the brain, it becomes infected, and then serious complications, disability, and sometimes death.

Inflammation of the lymph nodes of the neck does not belong to independent diseases – it is a signal of the presence of other pathologies and disorders. In addition, inflammation is accompanied by a disruption in the functioning of the entire system of lymph nodes and blood vessels.

Causes of inflammation in the lymph nodes

Usually lymphadenitis is a concomitant syndrome:

• some infectious and viral diseases, for example, manifested in chickenpox, mononucleosis, herpes, rubella;
• diseases of the oral cavity, nasal passages, respiratory tract (with sinusitis, tonsillitis, colds, stomatitis);
• decreased immunity;
• injury or mechanical impact on the nodes;
• state of hypothermia of the body;
• lack of vitamins and some useful trace elements;
• allergies;
• nervous disorders such as stress or depression;
• sexually transmitted diseases, including syphilis or HIV.

In young children, enlargement and pain on palpation in the lymph nodes may develop during teething. Sometimes inflammation occurs in women during pregnancy.

Against the background of a decrease in immunity in a person, chronic inflammation of the lymph nodes can be observed not only in the neck, but also in the groin, armpits, on the back of the head, in the collarbone area and in the abdominal cavity.

It should be noted that normally a person is allowed a slight increase in lymph nodes in the neck – up to a size of no more than 1 centimeter, in the groin – up to 2 centimeters. As for cases where inflammation is more intense, this condition requires mandatory diagnostics in order to determine its etiology. So, for example, if inflammation is localized in the nodes in the neck on the right and left, this may indicate the development of mononucleosis, tuberculosis, sarcoidosis, lymphoma, infectious lesions of the upper respiratory tract, and also occurs with a highly sensitive reaction to vaccination against a tuberculosis pathogen. Lymphadenitis in the nodes behind and in front of the auricles develops with rubella, under the lower jaw – with chronic tonsillitis or gum disease. If there is a gradual or sharp inflammation at the same time of all groups of lymph nodes in the body, that is, multiple, such a pathology is characteristic of an early stage in the development of HIV infection. With lymphoma, the condition of the nodes is characterized as painless, while they become mobile. If a person develops metastases in the nodes, they are felt on palpation as dense and soldered.

Symptoms of inflammation of the cervical lymph nodes

The most important manifestation is the appearance of some seals and swelling at the sites of the nodes. When pressed, pain may be felt.

With the progressive development of the disease, the patient develops:

• general weakness and malaise;
• loss of appetite;
• headache;
• elevated temperature.

Children often develop intoxication against the background of the inflammatory process.

Enlargement of the cervical lymph nodes can be chronic or acute.

Chronic lymphadenitis

A condition common to people with severely reduced immunity as soon as they develop any kind of illness, even a mild form of the common cold. At the same time, the inflamed nodes are painless both during remission and during exacerbation of the chronic form. In rare cases, suppuration occurs. Chronic enlargement of the lymph nodes in the neck may accompany the development of tuberculosis at different stages – such lymphadenitis usually resolves without temperature, or with slight fluctuations to subfebrile values.

Acute form

It is a complication of the present disease, accompanied by purulent processes in the lymph nodes, a sharp increase in temperature to 38-39 degrees. In this case, the skin over the node acquires a red tint, resembles a boil in shape and appearance. The further the disease progresses, the larger the size of the lymph node becomes, its contours lose their clarity.

Such a condition without medical assistance can lead to the development of sepsis or adenoma.

Unilateral enlargement of the lymph nodes of the neck

Cervical or submandibular nodes, enlarged on one side, signal the possible development of lymphoma or a tumor process of a non-lymphoid nature in the neck or head. It can be combined with unilateral inflammation of the supraclavicular lymph nodes, as well as those located in the area of ​​the scalene muscle, if, for example, the tumor metastasizes to the chest cavity or the gastrointestinal tract.

Virchow’s node is a unilateral enlargement of the supraclavicular nodes in metastases of gastric cancer.

Inflammation of the lymph nodes in children

The main reason is the presence of any infectious process, and its effect on the body. In about 80% of cases, nodules do not enlarge. However, if the child has a weak immune system, his diseased condition is more likely to cause lymphadenitis. For example, inflammation of the lymph nodes can occur due to mumps, tonsillitis or laryngitis.

The development mechanism looks like this: after bacteria enter the lymphatic channels, they are transferred to the lymph nodes. In the lymph nodes, after the entry of pathogenic microorganisms, the process of producing special cells to fight the infection starts. For the most intensive release of lymphocytes (protective cells), the size of the lymph node increases.

Severe inflammation occurs because the body is unable to cope with the bacterial load. The process can lead to the formation of pus in the cavity of the node. The skin in the zone of development of lymphadenitis becomes hyperemic and edematous.

The disease in a child begins with a general malaise, he becomes lethargic and capricious, he loses his appetite. Inflammation of the lymph nodes may be accompanied by fever, signs of intoxication.

It is very easy to determine the location of the lesion by touch, in acute cases it becomes visually noticeable. On palpation, it gives pain, the tissues above the node are felt as edematous and stretched. The condition may be accompanied by headache, chills, weakness.

A slight increase in one lymph node, especially in an infant, may indicate that it simply began to work a little more actively than others, against the background of mild forms of illness, or after recovery.

Gradually, it regresses, acquires normal dimensions.

The occipital lymph nodes in a baby may increase:

• due to measles;
• with rubella;
• in mononucleosis;
• with chickenpox;
• on the background of toxoplasmosis.

It is these diseases that can often provoke inflammation of the nodes on the back of the head in a child. In severe cases, the flow of their increase can be seen. The baby’s face takes on a puffy expression.

In addition, the lymph nodes of the neck increase in size with cat scratches. This syndrome is relevant for children who have pets and who are often in contact with felines. Cat saliva contains a wide variety of microorganisms. They can easily enter the child’s body if the animal has bitten or scratched him. Lymphadenitis can be observed already 2-3 days after the injury.

Colds provoke inflammation of the lymph nodes in children, to which various diseases literally “stick”. In the presence of infectious diseases, lymphadenitis develops most rapidly in the place closest to the entrance gate of the infection, so an inflamed cervical lymph node may indicate the development of diseases of the upper respiratory tract, throat, and head.

Lymphadenopathy in adults

The development of pathology in adults is most often due to infectious factors, for example, diphtheria, tuberculosis, syphilis, brucellosis, rubella, herpes, measles viruses, fungal infections (actinomycosis, histoplasmosis), chlamydia and mononucleosis.

Also, the problem may be the defeat of the oral cavity by bacteria or viral microorganisms, but this condition is more typical for children.

About 5% of cases of lymphadenopathy in men and women are associated with non-infectious factors, including the development of oncological processes – lymphoma, leukemia, neuroblastoma.

Nonspecific infection is a condition that is quite rare in people with a low level of immunity. This type of pathological process develops due to opportunistic microflora, which normally constantly lives in the human body. While a person is healthy, the immune system is able to suppress its activity and keep it at a safe background level. If favorable conditions appear for the activation of the flora (injuries, stress, diseases, hypothermia), the immune system is no longer able to restrain its intensive vital activity, and the person falls ill.

The first, most characteristic symptom is an increase in lymph nodes to a size of more than 1 centimeter (inguinal – more than 2 centimeters). Depending on the etiological factor, the further course of the disease may be different.

Pain with inflammation of the lymph nodes is a sure sign of the inflammatory process.

Pain without lymph node enlargement

Not always pain in the lymph nodes is accompanied by their increase. If there is pain in the lymph nodes, but they are not enlarged and inflamed to the touch, this may indicate the presence of residual effects of tonsillitis, SARS, and some other respiratory infections. Doctors say that by the duration of the painful syndrome after recovery, one can judge how well the immune system works in a person: the longer the nodes hurt, the weaker the immune response.

In addition, the cause of pain in the nodes without enlargement may be their local infection, which does not affect the general well-being.

Inflammation in oncology

The anatomical features of the structure of the neck cause frequent inflammation and metastasis to the cervical lymph nodes – this happens due to the large number of lymphatic and blood vessels, as well as nerve fibers in this part of the body.

With cancer of various localization, the cervical nodes are indicated by protruding rounded formations with relatively clear contours. On palpation, they are painless, dense and elastic texture, slight mobility.

Metastases appear in the nodes of the neck with cancerous tumors in such organs:

• in the larynx;
• in lips and tongue;
• in the thyroid gland;
• in the stomach;
• in the skin of the neck and head.

Inflammation of deep lymph nodes can not always be felt, but visually some asymmetry is noticeable on the neck.

Malignant cells in lung or esophageal cancer can enter the right supraclavicular node, and if the patient has complaints of inflammation of the left node, this may be due to the spread of malignant tumors of the liver, stomach, large intestine or rectum.

The state of the lymph nodes after chemotherapy

In some cases, against the background of radiation treatment and chemotherapy for oncology, patients may become inflamed lymph nodes, including those in the neck. This is due to the high sensitivity of the follicles of the lymph nodes to cytostatic toxins. The development of lymphadenopathy after chemotherapy is due to damage to the cells of the lymph nodes, a decrease in the number of lymphocytes and leukocytes in the blood, as well as in the specific reaction of the body to infection.

Treatment of inflammation of the lymph nodes of the neck

Therapy for lymphadenitis is prescribed only after the patient has been diagnosed. For diagnosis, he is sent for examination to narrow specialists – an otolaryngologist, an immunologist, an allergist, an infectious disease specialist, an oncologist, and they also prescribe a list of tests, including a complete blood count, PCR tests for pathogens of various infectious diseases, serological blood tests, tests for tumor markers.

The acute form of lymphadenitis is recognized by the presence of pain in the nodes, chills and high fever. Purulent processes are accompanied by redness of the skin, a sharp headache.

The initial stage of the pathology responds well to treatment until purulent formations appear. In an advanced form, a disease with a purulent lesion can lead to the destruction of the node itself, blood poisoning.

The chronic form is a typical complication of the acute stage or sluggish forms of the disease. It is not characterized by the formation of seals and pus, the presence of pain.

In any case, with inflammation of the nodes, you need to consult a doctor in order to determine the etiology of the condition. This is especially important for children, in whom, as a rule, lymphadenitis occurs somewhat more often than in adults, since they are more mobile, and the infection enters their body more easily.

If the node becomes larger than 3-4 centimeters, this may indicate the presence of purulent inflammation, which sometimes requires surgical intervention.

For the treatment of pathology, it is impossible to apply heat and warming lotions, heating pads, alcohol and vodka compresses, it is forbidden to massage and mechanically act on the inflamed lymph node, as this can contribute to tissue growth or the spread of pus.

Therefore, with lymphadenitis at home, it is enough for the patient to provide plenty of fluids, a balanced and dietary diet with plenty of vegetables and fruits, preferably stewed or baked. During an exacerbation, it is generally recommended to take liquid food. To strengthen the immune system, you can take vitamin complexes, echinacea.

If the problem is an allergic reaction, your doctor may prescribe antihistamines. The bacterial infection that caused lymphadenitis is treated with antibiotics and antimicrobials.

In any case, the drug effect on the cause of the onset of the inflammatory process should be carried out only as prescribed by the doctor. If you seek medical help immediately, without waiting for the development of complications, treatment will not become a problem.

The inflammatory process in the nodes in children is not recommended to be treated with folk remedies, compresses and other recipes, especially if the baby has a high temperature.

Cervical lymphadenia is a process of inflammation and tissue proliferation in the lymph nodes of the neck, which occurs against the background of various pathological processes. In children, inflammation can occur during eruption of milk teeth, with measles, rubella, SARS, or mononucleosis. An increase in nodes in adults can be regarded as the first sign of the appearance of malignant tumors, lymphoma, sarcoidosis.

The condition, if it does not take severe forms, can be treated at home, but only after the doctor examines the patient and establishes the cause of the disease.

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