Pathologies affecting the lymph nodes are capable of triggering strong fears and worries. In fact, it often happens that feeling a swelling of the lymph nodes of the neck but also of the armpits, breasts or groin, one is led to immediately think of a neoplastic pathology as the responsible cause, therefore a tumor .
The swelling of the lymph nodes (a sign of adenopathy ) in reality, as we will see in this article, is mostly caused by infectious or inflammatory diseases, which in most cases do not lead to malignant consequences for which having to worry excessively.
However, swollen lymph nodesthey are a signal from our body that must be taken into consideration and which must be investigated by submitting the case to the attention of a doctor, so your concern is more than legitimate as well as the very fact of looking for the causes triggering the phenomenon on sites authoritative like ours.
Here you will find a detailed study of the pathology but, as always, we remind you that the information reported is for informational purposes only.
Signs and symptoms of enlarged lymph nodes
Lymph nodes are small oval formations which, under normal conditions, are less than one centimeter in size and are located along the lymphatic system, localized and grouped in lymph node stations which, as far as the neck is concerned, are 6.
When they swell, that is when the immune system has been stimulated, the lymph nodes appear as solid formations, well circumscribed and in relief to the point of being not only easily perceived through palpation of the neck, but also distinguishable to the eye in the most striking cases (especially in children of pediatric age). Swollen lymph nodes in the neck may be accompanied by difficulty in swallowing, pain, burning, itching, general malaise and fever.
As we will see later, the type of symptoms and the characteristics of the enlarged lymph nodes are subject to medical evaluation in order to guide the diagnosis and set up a therapeutic strategy suitable for the individual case.
What are the main causes of enlarged lymph nodes
Although fears often lead to think of a tumor as the first possible cause of an enlarged lymph node in the neck , it is good to reassure you right away that in reality the diagnostic suspicions should be oriented towards other causes , well more common and less severe.
Before listing them, we recommend that you bring the vision of an enlarged lymph node to the attention of the doctor, especially if the situation has lasted for several days, without taking drugs or approaching DIY treatments.
The only one who has the knowledge and notions to discriminate the factors at the origin of the problem is only the doctor. Furthermore, a delay in the actual diagnosis can cause a worsening of the situation.
At this point we just have to investigate in detail the most common causes of the swollen lymph nodes in the neck .
Infectious pathologies
They are the most common cause of neck adenopathy. In this case, the immune system is stimulated following simple affections of the respiratory tract such as pharyngitis (both bacterial and viral) or of the oral cavity (for example tonsillitis). Once the infectious process has been resolved by means of antibiotics, or without them (on exclusive medical evaluation), the lymph nodes return to their natural appearance without any consequences.
Inflammatory pathologies
They are statistically as important as infectious ones, which is why we have decided to place them in second place. In this case, the cause can be traced back to an inflammation of the oral cavity, to the inflammation of a salivary gland, especially of the sublingual or submandibular gland or to the formation of a calculus of the salivary ducts, i.e. the formation of a calcium aggregate that prevents the outflow of saliva produced by the gland into the oral cavity.
Autoimmune Diseases Autoimmune
diseases, which represent a wide variety of diseases of different etiologies, can cause adenopathy. Among these pathologies we mention: Systemic Lupus Erythematosus, rheumatoid arthritis and sarcoidosis.
Tumors Tumors
_, which is first thought of as soon as you realize you have swollen neck lymph nodes , actually represent a minority of cases. These are generally loco-regional neoplasms that have a very rigid consistency, also described as woody, which can be a consequence of a tumor of the oral cavity or secondary to neoplasms of the lung, stomach and breast.
Blood disorders
This category includes Hodgkin ‘s and non-Hodgkin’s lymphomas which have as their characteristic symptom the enlargement of the lymph node stations.
To a much lesser extent, the causes responsible for adenopathy also include hyperthyroidism and lipid storage diseasesthat it seems to us only right to report for correctness of information.
What tests to perform
Before explaining in detail how a medical examination takes place in case of adenopathy and which signs are evaluated, it is important to remember how important it is to entrust the diagnosis to a specialized doctor who can prescribe a drug treatment or indicate the need for an ENT specialist visit .
Starting from the physical examination, carried out, before proceeding to any diagnostic diagnostic instrumental investigations, let’s see which are the aspects of greatest interest.
Before starting to visit the patient, questions are asked about the mode of onsetof the problem, therefore:
- how many days have the lymph nodes swollen;
- if they have maintained the same volume or if they have suffered fluctuations;
- if the pain is constant or if it alternates with phases of relief.
It is also important to investigate whether the patient has experienced episodes of fever, phlegm production and if he has recently made trips to exotic locations. This initial information is very useful to understand if it could be an infection and thus direct the visit.
Subsequently, we move on to the inspection of the visible signs , therefore the doctor evaluates the volume of the enlarged lymph nodes and if the overlying skin has particular characteristics such as redness.
The next step is that of palpationof the neck, laterocervical and supraclavicular lymph nodes. Palpation is carried out in a delicate and light way, both in order not to alter the perception of the characteristics of the lymph nodes, and in order not to further accentuate the pain felt by the patient.
Through palpation numerous aspects can be assessed, and therefore:
- the pain ;
- the consistency ;
- the dimensions ;
- the form ;
- mobility ; _
- distribution . _
The pain occurs in a very strong way in case of infection or inflammatory pathology, scarce or absent in case of autoimmune diseases or neoplasms. As for the consistency , in case of neoplastic pathologies and of the hard-elastic or wooden type, while it is softer in case of infections.
The normal size of the lymph nodes is around 1 cm in diameter, while in case of enlargement they exceed 2 cm. However, depending on the patient’s clinical picture, the lymph nodes can be even smaller. The shape of the lymph nodes can be multiple, appearing as rounded, ovoid or even irregularly shaped.
As for the mobilityon the other hand, the lymph nodes may be mobile or hypomobile with respect to the skin that covers them (a condition that indicates an infectious pathology) or non-mobile (a condition frequently encountered in tumor pathologies). Finally, it is still evaluated if the enlarged lymph nodes are well localized in a specific location or if the problem also involves other sites of the body such as armpits, breasts and groin.
Once the doctor has carried out all the checks and collected the information necessary to have a definite idea of ​​the diagnostic picture, he can make use of diagnostic imaging, in order to investigate more deeply the structural characteristics of the lymph nodes affected by adenopathy. The most effective and used means is ultrasoundwhich provides information on the structure and vascularity of the lymph nodes and therefore allows to evaluate whether it is appropriate to proceed with a biopsy or not.
The therapy depends on the pathological event that triggered the phenomenon of enlargement of the lymph nodes, therefore it must be prescribed and administered exclusively by a doctor after having ascertained the pathological nature of the problem. Therapies can therefore be of a pharmacological type by administering anti- inflammatory or antibiotics , of a surgical type and therefore of removal of the lymph nodes, or of methods directed against a possible neoplasm.
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