Swollen lymph nodes throughout the body

Patients with swollen lymph nodes are relatively common, and patients with swollen lymph nodes all over the body are in more serious condition. Moreover, there is no age limit for swollen lymph nodes, and people of any age may get the disease. This disease can be benign or malignant. If swollen lymph nodes are found, you must seek medical attention and treatment in time. Never ignore such diseases to avoid delaying the disease and treatment.

If you suffer from swollen lymph nodes all over your body, you need to pay attention to many aspects in your daily life. Don't stay up late, get more rest as much as possible, don't eat spicy food, eat more fruits and vegetables, develop good living habits and eating habits, improve your immunity, etc. Here are some related content about swollen lymph nodes. I hope it will be helpful to you and you can recover as soon as possible.

Causes

Infect

Acute infection

1. Acute infections caused by bacteria, viruses, rickettsia, etc., such as acute cellulitis, upper respiratory tract infection, infectious mononucleosis, scrub typhus, etc.

2. Chronic infections such as bacteria, fungi, worms, chlamydia, corynebacterium, filariasis, venereal disease, lymphadenopathy, syphilis, AIDS, etc.

Mechanism

Inflammatory swelling

When acute or chronic lymph node infections are caused by bacteria, viruses, rickettsia, chlamydia, fungi, spirochetes, protozoa, worms, etc., the lymph nodes may become congested and edematous, with hyperplasia of lymphocytes and macrophages, infiltration of neutrophils, monocytes and plasma cells, and even necrosis and granulomas, resulting in enlarged lymph nodes and painful acute lymphadenitis, which is usually secondary to infection in the corresponding drainage area. Effective antibiotic treatment can shrink enlarged, inflamed lymph nodes.

Tumorous enlargement

Whether it is an endogenous tumor originating from the lymphatic tissue (such as lymphoma, lymphocytic leukemia, etc.) or a tumor metastasized from outside the lymph nodes (such as breast cancer metastasized to the axillary lymph nodes, gastric cancer metastasized to the left supraclavicular lymph nodes, etc.), it can manifest as unrestricted tumor cells proliferating in large numbers in the lymph nodes, occupying and destroying the normal tissue structure of the lymph nodes, and at the same time causing fibrous tissue hyperplasia and inflammatory cell infiltration in the lymph nodes, thereby leading to lymph node enlargement. Cancerous tissue tends to invade the peripheral lymphatic sinuses and medullary sinuses of the lymph nodes first, and then gradually spread to the entire lymph node. It can also penetrate the capsule and invade the surrounding tissues. Therefore, cancerous lymph nodes are often as hard as stone and relatively fixed.

Reactive hyperplasia

It includes two types: nonspecific reactive lymphocytic hyperplasia and immune reactive hyperplasia. It is mostly caused by biological factors (bacteria, viruses, etc.), chemical factors (drugs, environmental toxins, metabolic toxic products, etc.) and allergic stimulation, which cause a massive reactive proliferation of lymphocytes, monocytes and macrophages in the lymph nodes, manifested as enlargement of lymph follicles, hyperplasia of parafollicular lymphocytes, and sometimes necrotic hyperplasia, leading to lymph node enlargement.

Histiocytic hyperplasia

There is a large amount of tissue cell proliferation in the lymph nodes, which is distributed in a focal or diffuse manner, and granulomas may also form, such as Langerhan histiocytosis. In addition, there are a large number of Niemann-Pickz cells in the lymph nodes, and when Gautier cells aggregate, they can also cause lymph node enlargement, such as Niemann-Pickz disease, Gautier disease, etc.

diagnosis

Physical examination

During the inspection:

Swollen lymph nodes

It must be done in a certain order to avoid omissions. They are: in front of the ear, behind the ear, mastoid area, suboccipital area, submandibular and submental lymph nodes, cervical lymph node groups, supraclavicular fossa, axillary, trochlear, groin and popliteal fossa. When palpating the lymph nodes, attention should be paid to the location, number, size, texture, surface tenderness, mobility, adhesion, local skin redness, swelling, ulceration, scars, etc. In acute nonspecific lymphadenitis, the swollen lymph nodes often have obvious tenderness, and there are local redness, swelling, heat and other acute inflammation manifestations. In chronic infection, the swollen lymph nodes are generally mildly painful, with moderate texture, and may adhere to each other. In case of tuberculosis of the lymph nodes, if caseous necrosis occurs in the tissue, fluctuations can be felt. The lymph nodes of malignant lymphoma are often obviously enlarged and hard like cartilage. In metastatic carcinoma, the texture of the lymph nodes is rubbery and adheres to the surrounding tissues and is not easy to move.

When lymphadenopathy is found in the examination, the cause should be comprehensively analyzed in combination with other positive signs. Enlarged cervical and submandibular lymphadenopathy accompanied by pharyngeal congestion and swollen tonsils should be considered as acute tonsillitis. Enlarged lymphadenopathy accompanied by jaundice should be considered as jaundice, carbuncle-type hepatitis, malignant histiocytosis, leptospirosis, etc. Lymphadenopathy accompanied by rash is often seen in certain infectious diseases or allergic diseases. Systemic lymphadenopathy accompanied by fever is seen in infectious mononucleosis, leukemia, lymphoma, etc.

Deep lymph node enlargement is difficult to touch and often causes medical attention because of its enlargement and compression of adjacent organs, resulting in corresponding symptoms. For example, mediastinal lymph node enlargement can compress the superior vena cava, causing obstruction of blood return in the superior vena cava area, manifested as edema of the head, face and upper limbs, distended neck veins and other signs of superior vena cava compression; retroperitoneal lymph node enlargement can compress the ureter and cause hydronephrosis; compression of the solar plexus can cause severe and stubborn low back pain, which is relieved in a forward-leaning sitting position and aggravated in a supine position; paraspinal lymph node enlargement can compress the spinal cord and cause paraplegia; mediastinal lymph node enlargement caused by lung disease can compress the recurrent laryngeal nerve and cause hoarseness; compression of the esophagus can cause dysphagia, etc.

Laboratory tests

1. Blood picture. The total number and classification of peripheral white blood cells have a certain reference value for judging the cause of lymphadenopathy. Lymphadenopathy accompanied by total white blood cell count and neutrophilia is common in bacterial infection. However, some patients infected with Gram-negative bacteria may have a low total white blood cell count, but neutrophils often increase. Lymphadenopathy accompanied by normal or decreased total white blood cell count and increased lymphocytosis is often considered a viral infection. However, patients with infectious mononucleosis caused by Epstein-Barr virus infection often have an increase in white blood cells in the second week, and abnormal lymphocytes (10%-20% or more) can often be found within three weeks. Eosinophilia indicates parasitic infection or eosinophilic granuloma. Lymphadenopathy accompanied by peripheral blood immature cells is mostly leukemia or cancer. Malignant histiocytosis (malignant group) often presents with pancytopenia in addition to fever, liver, spleen and lymphadenopathy.

2 Bone marrow examination. Examination of bone marrow smear cell morphology is of decisive significance for the diagnosis of leukemia, plasmacytoma, malignant histiocytosis, Gaucher disease, and Niemann-Pick disease. Bone marrow pathology examination should be performed when necessary. Although it is difficult to identify the primary site of metastatic cancer, it is of decisive significance for identifying metastatic cancer cells.

3. When serological examination suspects infectious mononucleosis, a heterophile agglutination test can be performed. A titer above 1:80 has clinical value. A titer >1:200 can be diagnosed as infectious mononucleosis. For those suspected of leptospirosis, an agglutination lysis test can be performed. A titer above 1:400 is positive. For those suspected of sexually transmitted diseases, an H1V antibody syphilis serological test can be performed. When reactive lymphadenopathy caused by autoimmune diseases such as SLE is suspected, corresponding serological tests should be performed.

4 Lymph node puncture needle aspiration smear examination If the lymph nodes are obviously enlarged and superficial, a thicker injection needle can be used for lymph node puncture and a small amount of contents can be aspirated with a large negative pressure for smear examination. This method is simple and easy.

5. Pathological examination of lymph nodes: For patients with obvious lymph node enlargement and unknown etiology, if there are no contraindications to surgery, a routine lymph node biopsy and pathological examination is generally required. At the same time, a lymph node imprint can be made to perform a morphological examination of the diseased cells, which is clearer than what is seen in the pathological section.

Everyone knows about swollen lymph nodes throughout the body, so what needs to be reminded is that you must maintain a good attitude during the illness, keep your emotions stable, and do appropriate exercise to enhance your physical fitness, which is very beneficial for recovery from the illness.