You may not know that there are as many as 600 or so lymph nodes in each person. Lymph nodes are one of the important immune organs of the human body and are formed by the aggregation of lymphocytes. Lymph nodes are distributed throughout the body, including those around internal organs, as well as superficial lymph nodes on the body surface. Superficial lymph nodes are mostly distributed in the neck, armpit, groin, etc. Lymph nodes are about 0.2 to 0.5 centimeters in diameter, and are generally not palpable under normal circumstances. When the diameter of the lymph node exceeds 1cm, we call it lymphadenopathy, and it is easier to find if the lymph nodes in the neck are swollen.
There are many reasons for swollen lymph nodes in the neck. When the human body encounters inflammation or tumor, the lymph nodes will act like beacon towers, sending out distress signals through swelling and pain. Among the causes of swollen lymph nodes in the neck, the more common cause is inflammation, usually caused by pathogenic microorganisms, such as colds, tonsillitis, and gingivitis. At this time, the lymph nodes are not only swollen but also painful. After the inflammation is eliminated, most of the swollen lymph nodes will also subside. Swollen lymph nodes in the neck caused by Mycobacterium tuberculosis infection are also common, and the lymph nodes will gradually shrink after systemic anti-tuberculosis treatment. Other less common infectious diseases or parasitic infections can also cause swollen lymph nodes in the neck, such as rubella, scrub typhus, brucellosis and so on.
Remember 3 points:
1. If the palpable lymphatic mass is accompanied by pain, it is mostly a good thing, and inflammation is the main factor, because the mass caused by the tumor is usually painless.
2. Lymph nodes that do not change for a long time are mostly proliferative changes caused by inflammation in the past.
3. If the supraclavicular lymph nodes are found inadvertently in people over 40 years old, and the lymph nodes are slowly increasing, the possibility of malignant tumor should be considered first.
About painless cervical lymphadenopathy, there is a “law of 28”, that is, about 20% are benign masses, and 80% may be malignant tumors; among malignant tumors, 20% are cervical Primary, about 80% are metastatic.
Common malignancies with enlarged lymph nodes in the neck include:
1. Lung cancer Lung cancer mostly occurs with right supraclavicular lymph node enlargement, and both small cell lung cancer and non-small cell lung cancer may occur. Supraclavicular lymph node enlargement generally has no chance of surgery, and only local radiotherapy and systemic medical treatment can be considered.
2. Gastric cancer Gastric cancer often occurs with left supraclavicular lymphadenopathy, also known as Virchow lymphadenopathy. Cancer cell emboli of gastric cancer can flow back to the left supraclavicular lymph nodes through the thoracic duct and the left cervical lymphatic trunk.
3. Nasopharyngeal cancer 60% of people with nasopharyngeal cancer may present with enlarged cervical lymph nodes as the first symptom. Lymph nodes are often found around one ear, and a lump is found in the upper part of the neck, which will gradually enlarge and harden.
4. Esophageal cancer Lymph node metastasis is a common way of metastasis of esophageal cancer, and the main sites of metastasis include mediastinal lymph nodes, supraclavicular lymph nodes, and cervical lymph nodes. At this time, most have no chance of surgery.
5. Lymphomas include Hodgkin’s disease and non-Hodgkin’s lymphomas. Lymphomas may present with enlarged lymph nodes in multiple lymph node drainage areas throughout the body, not only in the neck lymph nodes. However, the first diagnosis in many patients is cervical lymphadenopathy.