What is an enlarged lymph node (lymphadenopathy)?
Lymph nodes, which are an important component of the immune system, spread to various parts of the body. The lymph glands, which ensure that various pathogens are removed from the body without causing diseases, are also called lymph nodes. Lymph node swelling, which is usually caused by bacteria and viruses, is a common disease. It is generally seen in the head and neck, groin and armpit area. Although rare, lymph node swelling can also be a sign of cancer diseases.
Diagnostic criteria for enlarged lymph nodes (lymphadenopathy)
The first step in the diagnosis of enlarged lymph nodes is the history of the disease. The doctor will ask for details such as when the patient's symptoms started, what examinations were carried out and what medications were used. In addition, the physical examination performed by the doctor is also extremely important. During this examination, findings such as whether the lymph nodes are swollen bilaterally, whether there is pain, whether they are symmetrical, texture and presence of redness are taken into consideration. Various laboratory tests such as blood counts as well as radiological examinations are used to support the diagnosis. In addition, lymph node biopsy can be performed if deemed necessary by the specialist.
The following criteria should be considered to decide whether a biopsy is necessary. A patient meeting these criteria does not necessarily require a biopsy. Special circumstances guide doctors on whether a biopsy sample should be taken. In general, the characteristics of the patient who should have a biopsy include the following.
- Lymph nodes do not shrink or continue to enlarge within 4-8 weeks
- Lymph node sizes above the limits
- Laboratory tests are insufficient to reveal the cause of the disease
Causes of lymph node enlargement (lymphadenopathy)
The main cause of swollen lymph nodes is localized inflammation. There are many different factors that can cause this inflammation. In addition, abnormal proliferation and tumorization of lymph gland cells also cause swelling of the lymph gland. In addition, metastasis of cancer cells to the lymph nodes also causes the lymph node to swell. Among the factors that cause swollen lymph nodes are often the following.
The most common cause of enlarged lymph nodes is infectious diseases. The most common among these diseases are the following.
- Ear infection
- Tooth apnea
- Wound infections
- Pyogenic lymphadenitis caused by group A streptococci or staphylococcus aureus
- Scarlet fever caused by group A streptococci
- Lymphogranuloma venereum
- Granuloma inguinale
- Cat scratch disease
Various antibiotics are used in the treatment of these bacterial diseases. Among the causes of lymph enlargement seen with viral causes are the following.
- Herpes virus infections
- CMV mononucleosis (CMV)
- Infectious mononucleosis (Epstein-Barr Virus)
- Kiss disease
- Hepatitis C
- Rubella (Rubella virus)
- Measles (Rubeola virus)
Fungal infections include the following.
- Cryptococcus infections
- Candida infections
- Aspergillus infections
- Pneumocystis carinii pneumonia
Among the causes of parasitic infection that cause enlarged lymph nodes are the following.
- Trypanosoma infections
- Leishmania infections
Some types of cancer and lymphoproliferative disorders
One of the most worrying reasons for patients is that enlarged lymph nodes can be caused by certain cancer diseases. In the case of enlargement of the lymph nodes due to cancer, patients usually consult doctors with the complaint of a palpable swelling in the affected lymph area. Types of cancer and lymphoproliferative diseases that cause lymph node enlargement include the following.
- Kikuchi's disease
- Cancer metastases
- Rosai -Dorfman disease
- Acute and Chronic Leukemias
- Non Hodgkin Lymphomas (NHL)
- Castleman's disease
- Hodgkin's Lymphoma
Some of the diseases that affect the scalp are highly contagious. This is why it needs to be treated quickly. These diseases include the following.
- Hair breakers
- Head lice
- Scalp psoriasis
- Scalp impetigo
Diseases that occur when the immune system attacks the healthy tissues of the person are among the factors that cause lymph gland enlargement. These diseases include the following.
- Systemic lupus erythematosus (also known as butterfly disease)
- Rheumatoid arthritis
- Sjögren's Syndrome
Symptoms of enlarged lymph nodes (lymphadenopathy)
An enlarged lymph node is a common and generally considered harmless condition. Among the general symptoms seen in lymph node enlargements are the following.
- Swelling of the lymph nodes
- Pain and tenderness in the lymph nodes
- Pea-sized or larger lumps in the lymph nodes
- Fixed and hard lymph nodes
- Rapid enlargement of the lymph nodes
- Some upper respiratory symptoms
- High fever
- Unexplained weight loss
- Night sweats
- Sudden emergence
- Redness on the skin surface
- Softness of the lymph node
- If the patient's age is over 40 years, cancer should be suspected.
- The lymph gland seems to be adherent to the skin
- The presence of multiple lymph groups that seem to stick to each other and have a rubbery consistency
Lymph node enlargement (lymphadenopathy) treatment methods
The treatment to be applied in lymph node enlargement varies according to the factor that caused the condition. For this reason, no treatment method is applied to reduce the size of the lymph glands. By treating the causative disease, the lymph node also returns to its normal size.
Antibiotic treatment is applied in lymph node enlargements caused by bacterial infections.
Antifungal treatment is applied when the lymph nodes are swollen due to fungal diseases. Antifungal treatment is also utilized in scalp diseases.
If the lymph nodes are swollen due to autoimmune disease, treatments that suppress the immune system are used.
Treatment of lymph node enlargement caused by cancer can be planned in different ways. The type and stage of cancer are of great importance in planning treatment. Cancer treatment usually involves surgery, radiotherapy, chemotherapy and various smart drugs.
Since the causes of enlarged lymph nodes are usually caused by mild illnesses such as colds and flu, in addition to medical treatments, some methods that can be applied at home can help normalize the size of the lymph nodes. These methods include rest, drinking plenty of fluids, mineral and vitamin supplements.
In which parts of the body does lymph node enlargement (lymphadenopathy) occur?
Lymph nodes are spread all over the body. However, the majority of lymph nodes are located in the neck region. The areas where lymph nodes are concentrated include the following.
- Neck region
- Under the chin
- Both sides of the neck, cervical, supraclavicular
- Front and back of the ear
- Back of the neck, occipital, etc.
- Chest cavity
- Other lymphatic organs such as tonsils and spleen
- Abdominal cavity
- Back parts of the knees
- Front parts of the elbows
Armpit lymph node enlargement
A significant proportion of formations such as swelling and lumps in the lymph nodes are considered normal. For this reason, it does not cause any problems. These are typically self-healing and consist of common infections. In addition, enlargement of the axillary glands can be a harbinger of much more serious conditions such as breast cancer. Among the most common causes of enlarged lymph nodes in the armpit are the following.
In lymph node enlargement caused by viral causes, swollen lymph nodes are usually tender and red. Some viruses do not cause any symptoms besides enlarged lymph nodes. Viral infections that cause enlarged lymph nodes in the armpit include the following.
- Varicella Zoster Virus (the virus that causes chickenpox)
- Mumps (Mumps)
- Measles (Measles)
- Rubella (Rubella)
Influenza, also called flu, is a respiratory infection caused by influenza viruses that causes swelling of the lymph nodes. They have the same symptoms as the viruses that cause other types of problematic respiratory tract infections. However, symptoms can be much more severe than with other respiratory infections.
Infectious mononucleosis, also called meringue fever, is one of the viral infections. It causes swelling not only of the lymph nodes in the armpit but also of the lymph nodes in the neck. The symptoms caused by the disease usually improve within 2-4 weeks. During this period, patients should drink plenty of fluids and rest, and over-the-counter painkillers can be used if necessary.
Bacterial diseases also cause enlargement of the axillary lymph nodes. Cellulite is also included in these bacterial diseases. In addition, diseases such as tuberculosis, syphilis and chlamydia also cause enlarged lymph nodes in the armpit.
The characteristic symptoms of this tick-borne disease include enlargement of the axillary lymph nodes 3 to 30 days after the tick bite. It is a disease that can be treated with antibiotics.
Rheumatoid arthritis, another cause of enlarged lymph nodes in the armpit, is included in autoimmune diseases. This is because lymph nodes located close to joints affected by the immune system affect the excretory activity of the fluid.
In some cases, enlarged axillary lymph nodes are a symptom of various cancers. The two types of cancer that cause enlargement of the lymph nodes in this area are breast cancer and lymphoma.
Lymph node enlargement in the throat
Growth in the lymph nodes in the throat is the most commonly observed lymph enlargement. There are approximately 200 lymph nodes on each side of the neck. Neck lymph nodes, which are normally 1 to 1.5 mm in size, can become enlarged due to bacterial and viral diseases as well as rheumatic diseases, Hodgkin's syndrome or cancer.
It is considered normal for the size of the lymph nodes in the neck of adults to reach 1 centimeter. However, lymph node enlargements over 1 centimeter should definitely be checked by a specialist. Enlarged lymph nodes in the neck of children are usually caused by simple diseases.
Among the causes of enlarged neck lymph nodes in children are the following.
- Upper respiratory tract infections
- Ear infections
- Tooth infections
Enlarged lymph nodes in the left neck
The lymph nodes in the neck usually grow symmetrically. However, in some diseases, there is unilateral enlargement of the lymph nodes. The causes of enlarged lymph nodes on the left side of the neck include Hodgking's syndrome and lymphoma.
Lymph node enlargement in the abdomen
Unlike lymph nodes in other areas, enlarged lymph nodes in the abdomen often go unnoticed. For this reason, it is usually detected incidentally with various imaging methods. The lymph nodes in the part of the intestine close to the spine can become enlarged due to an infection such as tuberculosis or cancer. Contrary to fears, enlarged abdominal lymph nodes are rarely caused by cancer.
Causes of enlarged abdominal lymph nodes
The enlargement of the lymph in the abdomen is divided into primary and secondary. Primary causes are due to injuries that directly affect the lymph nodes. These situations include the following.
- Infections such as tuberculosis
- Rare conditions such as Castleman's disease, which is not cancer but causes overgrowth of the lymph nodes
- Inflammatory conditions such as sarcoidosis
- Blood cancers that develop in the lymph nodes or spread to the lymph nodes
- Cancers that spread to the lymph nodes
Secondary causes of enlarged abdominal lymph nodes include the following. These causes are more common than primary causes.
- Adrenal glands
- Kidneys and ureter
- Testicular cancer
Lymph node enlargement in the lung
The enlargement of the lymph nodes in the lungs usually occurs for the same reasons as the enlargement of other lymph nodes. However, enlarged lymph nodes in the lung indicate that options such as pulmonary sarcoidosis and cancer should also be considered.
Pulmonary sarcoidosis is a rare disease caused by infection. Involvement of many organs can be seen. If the lungs are involved, it causes small clumps of inflammatory cells. These structures, called granulomas, can interfere with the function of the lungs. If granulomas, which usually tend to heal spontaneously, do not heal, they harden and cause scar formation in the lung tissue. This condition is called pulmonary fibrosis.
Lung cancer is another serious health condition that can cause enlarged lymph nodes in the lungs. especially when it metastasizes to lymph nodes in the lungs.
Lymph node enlargement in the intestine
Enlargement of the glands in the intestines is usually caused by a condition called mesenteric lymph adenitis. Inflammation of the lymph nodes in the tissues around the intestines caused by viruses, bacteria or parasites. This condition, which causes dehydration or mineral loss in patients, rarely causes abscess formation in the intestines.
The healing process of an enlarged lymph node (lymphadenopathy)
The healing process of lymph node enlargement is parallel to the healing process of the underlying disease that caused this condition. In addition, the following steps can be taken to relax the lymph nodes.
- Hot compress applications
- Using over-the-counter painkillers
- Getting enough rest.