Submandibular lymph node swelling and tenderness

Introduction Submandibular lymph nodes due to inflammation of the mouth and pharynx. Lymph node enlargement refers to a condition in which the diameter of the lymph node exceeds 1.5 cm, the shape changes, and the texture is abnormal. The condition may be acute lymphadenitis, and the lighter ones are only mild swelling of the local lymph nodes and mild tenderness. Most occur in the submandibular, neck, armpit, groin, etc., generally without treatment, can be self-healing. Heavier local lymph nodes are markedly swollen and accompanied by redness, swelling, heat, pain, and fever. If the treatment is not timely, it can be developed into an abscess by acute lymphadenitis.

Cause

In the case of inflammation, the submandibular lymph nodes are swollen by bacteria and their toxins and can be touched by hand, often accompanied by painful symptoms. There are many causes of the disease. When an infection occurs in a certain part of the body, the bacteria can cause swelling and pain of the lymph node group as the lymph fluid passes through the lymph nodes. When a body has a malignant tumor, it often metastasizes along the lymphatic vessels and stays in the lymph nodes to divide and proliferate, causing the lymph nodes to enlarge.

an examination

Related inspection

Oral X-ray examination of blood lymphocytes count oral endoscopy facial five-dimensional MRI examination

The main clinical manifestations are fullness of the submandibular area, swollen lymph nodes, and tenderness.

1, may have respiratory infections, oral inflammation, carbuncles, skin lesions and other primary infections.

2, local lymphadenopathy, pain, or redness, sputum has a sense of volatility, often accompanied by fever, loss of appetite and so on.

3, if necessary, lymph node biopsy to exclude malignant tumor infiltration.

Differential diagnosis

Common diseases of lymphadenopathy:

Chronic lymphadenitis

Most of them have obvious infections, and often have localized lymphadenopathy, pain and tenderness, generally no more than 2 to 3 cm in diameter, and will shrink after anti-inflammatory treatment. Inguinal lymphadenopathy, especially long-standing and unchanged flat lymph nodes, is of great significance. However, there is no obvious cause of swelling of the neck and supraclavicular lymph nodes, which marks the systemic lymphoproliferative disease, which should be taken seriously and further examined and confirmed.

Tuberculous lymphadenitis

There are fever, sweating, fatigue, and increased blood sedimentation, which are more common in young adults. Often accompanied by tuberculosis, the lymph nodes are uneven in texture, some are lighter (cheese-like), some are hard (fibrosis or calcification), and adhere to each other, and adhere to the skin, so the activity is poor. This type of patient is tuberculin test and blood tuberculosis antibody positive.

Malignant lymphoma

Also found in any age group, its lymphadenopathy is often painless, progressive swelling, from large soybeans to jujube, medium hardness. Generally, it has no adhesion to the skin, and does not fuse with each other in the first and middle stages. In the later stage, the lymph nodes can grow to a large size, and can also be fused into a large piece, the diameter of which is more than 20cm, invading the skin, and it will not heal after rupture. In addition, it can invade the mediastinum, liver, spleen and other organs, including the lungs, digestive tract, bones, skin, breast, nervous system and so on. The diagnosis requires a biopsy. Clinically, malignant lymphoma is often misdiagnosed, with superficial lymph node enlargement as the first manifestation, 70% to 80% of patients diagnosed with lymphadenitis or lymph node tuberculosis at the time of initial diagnosis, resulting in delay in treatment.

Giant lymph node hyperplasia

It is a rare disease that is easily misdiagnosed. Often manifested as unexplained lymphadenopathy, mainly invading the chest, with the most mediastinum, but also invading the hilar and lungs. Other affected sites include the neck, retroperitoneum, pelvis, armpits, and soft tissue. Often misdiagnosed as thymoma, plasma cell tumor, malignant lymphoma. Understanding the pathology and clinical manifestations of this disease is extremely important for early diagnosis.

Pseudo lymphoma

Tumors can often form in areas outside the lymph nodes, such as the eyelids, pseudo-lymphoma of the stomach, and lymphatic polyps of the digestive tract. It is generally considered to be a reactive hyperplasia caused by inflammation.

Lymph node metastasis

Lymph nodes are often hard and uneven in texture, and the primary lesion can be found. Very few systemic lymphadenopathy.

Acute leukemia and chronic lymphocytic leukemia

There are often lymphadenopathy, especially acute lymphocytic leukemia, which is common in children. It is clinically acute, often accompanied by fever, hemorrhage, liver and splenomegaly, sternal tenderness, etc. Hematology and bone marrow puncture can confirm the diagnosis.

Sarcoidosis

It is rare in China, often invading the bilateral hilar, which is radial, accompanied by long-term low fever. The lymph nodes of the whole body can be swollen, especially before and after the ear, under the jaw, and next to the trachea. It is clinically difficult to distinguish from malignant lymphoma.

Infectious mononucleosis

More common and young men, caused by Epstein-Barr virus, but patients are generally in good general condition, may have fever and systemic lymphadenopathy, may also have mild swelling of the spleen. There are atypical lymphocytes in the peripheral blood, and the positive heterophilic agglutination test can confirm the diagnosis.

Serum disease

A disease that occurs after the patient has used serum products (tetanus antitoxin, rabies vaccine, etc.). A small number of patients with lymphadenopathy as the first clinical symptoms. However, most of the lymph nodes on the injection site and the pulley are swollen first. According to the history of injection and fever, rash, eosinophilia, etc. can be diagnosed.

Lymph node enlargement is very common. The above 10 diseases listed are hoped to give you inspiration, timely consultation, diagnosis and identification so that timely and effective treatment can be obtained.

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