Swollen lymph nodes in the armpit

Introduction The phenomenon that the lymph nodes are enlarged due to internal cell proliferation or tumor cell infiltration is a common clinical sign. It can be found by touching the armpit area. The lymph node is enlarged due to internal cell proliferation or tumor cell infiltration. Common clinical signs. Lymph node enlargement is very common, can occur in any age group, can be seen in a variety of diseases, benign, but also malignant, so pay attention to lymphadenopathy.

Cause

The cause of axillary lymphadenopathy

(1) Infection:

1. Acute infection: caused by bacteria, viruses, rickettsia, etc., such as acute cellulitis, upper respiratory tract infection, infectious mononucleosis, ascariasis and so on.

2. Chronic infection: bacteria, fungi, worms, chlamydia, spirulina, filariasis, sexually transmitted lymph node granuloma, syphilis, AIDS, etc.

(2) Tumor:

1. Malignant lymphoma: Hodgkin's disease and non-Hodgkin's lymphoma.

2. Leukemia: acute lymphocytic leukemia, acute non-lymphocytic leukemia, chronic lymphocytic leukemia, chronic myeloid leukemia, plasma cell leukemia, and the like.

3. Plasma cell tumor: multiple myeloma, primary macroglobulinemia.

4. Tumor metastasis: gastric cancer, liver cancer, breast cancer, nasopharyngeal cancer, etc.

(3) Reactive hyperplasia:

1. Necrotizing proliferative lymphadenopathy.

2. Serum disease and serum disease-like reactions.

3. Allergic subsepsis.

4. Systemic lupus erythematosus, rheumatism, etc.

(4) Tissue cell proliferation and metabolic abnormalities:

1. Langerhan tissue cell hyperplasia.

2. Lipid deposition disease.

3. Sarcoidosis.

an examination

Related inspection

Local lymphatic imaging

Laboratory inspection:

1 blood picture: the total number and classification of peripheral blood leukocytes have a certain reference value for the diagnosis of lymph node enlargement. Lymph node enlargement with total white blood cell count and neutrophil increase is common in bacterial infections. However, some Gram-negative bacilli infections may not be high in total number of white blood cells. The granulocytes often have enlarged lymph nodes with normal or decreased white blood cell counts. Those with lymphocytosis often consider viral infections. Infectious mononucleosis patients caused by EB virus infection often have elevated white blood cells in the second week and in three weeks. Abnormal lymphocytes (1O%-20% or more) eosinophilia are often found to indicate parasitic infection or eosinophilic granulomatous lymphadenopathy with peripheral blood immature cells mostly leukemia or cancerous malignant tissue In the case of cytopathic disease (malignant group), in addition to fever, hepatic spleen lymph node enlargement, it usually shows a decrease in whole blood cells.

2 bone marrow examination: bone marrow smear cell morphology examination is critical for the diagnosis of leukemia plasmacytoma malignant histiocytosis high snow disease Niemann-Pick. If necessary, bone marrow pathology should be performed. Although metastatic cancer is difficult to identify the primary The site is decisive for identifying metastatic cancer cells.

3 serological examination: suspected infectious mononucleosis can be used for heterophilic agglutination test titer at 1:80 or more has clinical value > 1:200 can be diagnosed as infectious mononucleosis for suspected hook Spirochete patients can do agglutination lysis test more than 1:400 titer is positive for suspected sexually transmitted diseases can be done HlV antibody syphilis serological test for suspected SLE and other autoimmune diseases caused by reactive lymphadenopathy should be corresponding Serological examination.

4 lymph node puncture needle smear examination: lymph node enlargement is more obvious and the position is superficial can be used for thicker needles for lymph node puncture with a large negative pressure to a small amount of content smear to check this method is simple and easy.

5 lymph node pathological examination: lymph node enlargement is obvious and the cause is unknown. If there is no surgical contraindication, it is necessary to routinely perform lymph node biopsy and pathological examination. At the same time, lymph node printing can be done to make the morphological examination of the diseased cells clearer than pathological sections. .

Device inspection:

1 lymphangiography: deep lymph nodes such as pelvic retroperitoneal para-aortic lymph nodes are not easy to touch lymphangiography is a special method to understand whether it is swollen or not. In lymphangitis often shows lymph node enlargement edge smooth malignant lymphoma The internal structure of the enlarged lymph node is destroyed. The edge of the lymph node metastasis of the foamy lymph node metastasis is irregularly worm-like, often with internal structure filling defects or lymphatic obstruction.

2 radionuclide scanning: radioactive colloids injected into the subcutaneous or interstitial space are phagocytosed by phagocytic cells and then drained into the lymphatics of the human lymph nodes to the corresponding lymph nodes. Images of lymph nodes and lymphatic channels can be obtained by Y camera or scanner, such as injection into the toes. After a certain period of time, the inguinal herocardium and total para-aortic lymph nodes can be important for judging the deep lymphadenopathy and clear swelling. For example, one or more lymph nodes are significantly enlarged. The radioactivity is mostly lymphoma. If one or more lymph node images are missing or the radioactivity is significantly reduced or significantly delayed, there is often a metastatic tumor in the lymph nodes.

3 other X-ray examination CT examination B-type ultrasound fiber endoscopy and other examinations can help to identify the location and nature of the primary lesion.

Differential diagnosis

Symptoms of axillary lymphadenopathy

Local lymphadenopathy: It is a phenomenon in which the lymph node is locally enlarged due to internal cell proliferation or tumor cell infiltration. It can be found by touching the submandibular, neck, supraclavicular fossa, axilla, and groin, but swollen lymph nodes in the hilar, mediastinum, retroperitoneum, and mesentery can be found by X-ray, CT, and B-ultrasound. .

Lymph node congestion: mucosal skin lymph node syndrome, the main clinical manifestations of persistent fever, conjunctival hyperemia, lip flushing and cleft palate, hard redness of the hands and feet, systemic pleomorphic rash and cervical lymphadenopathy. Some patients develop arthritis and cardiovascular disease after the acute phase, and severe cases can die from myocardial infarction.

Lymph node enlargement: very common, can occur in any age group, can be seen in a variety of diseases, benign, but also malignant, so it is very important to pay attention to the cause of lymphadenopathy, timely treatment, diagnosis, to avoid mistakes, missed diagnosis, is very important . Let's talk about the common causes of lymphadenopathy. : 1 benign enlargement. It includes swelling caused by various infections, connective tissue diseases and allergies. Clinically, it is often benign, and it can be completely recovered within a certain period of time as the cause is removed. 2 malignant swelling. It includes lymph node metastasis such as lung cancer, stomach cancer and breast cancer, which are primary lymph nodes, such as lymphoma, lymphocytic leukemia and malignant histiocytosis, and other malignant tumors. Clinically malignant, lymph nodes continue progressive enlargement, if not actively treated, often progressive deterioration. 3 between the benign and malignant swelling. Such as vascular primitive immune cell lymph node disease and vascular follicular lymph node hyperplasia. It is often benign at first, and can become malignant and deadly.

There are 3 common cases of lymphadenopathy:

1 benign enlargement. It includes swelling caused by various infections, connective tissue diseases and allergies. Clinically, it is often benign, and it can be completely recovered within a certain period of time as the cause is removed.

2 malignant swelling. It includes lymph node metastasis such as lung cancer, stomach cancer and breast cancer, which are primary lymph nodes, such as lymphoma, lymphocytic leukemia and malignant histiocytosis, and other malignant tumors. Clinically malignant, lymph nodes continue progressive enlargement, if not actively treated, often progressive deterioration.

3 between the benign and malignant swelling. Such as vascular primitive immune cell lymph node disease and vascular follicular lymph node hyperplasia. It is often benign at first, and can become malignant and deadly.

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