Lymphoma. General information about the disease and its treatment.

general characteristics

Enlarged lymph nodes are soft, tight-elastic or dense round formations that can be felt under the lower jaw, in the neck, axillary area, groin and other places.
The surface of the lymph nodes can be smooth or bumpy. Often the increase is preceded by acute infectious and inflammatory processes (ARVI, sore throat, pulpitis), trauma with skin damage, vaccination. Sometimes changes in the lymph nodes are detected by chance by the patient or doctor during a preventive or advisory examination. Lymph nodes are said to be enlarged when their density, surface and mobility change, and their dimensions exceed 1 cm (for elbow formations - 0.5 cm, for inguinal formations - 1.5 cm). When palpated, the nodes can be both painful and painless. In addition to lymphadenopathy, skin manifestations (elements of rash, redness of the skin), fever up to 38 ° C and above, prolonged low-grade fever, complaints of fatigue, sweating, heaviness in the left or right hypochondrium caused by an enlarged spleen and liver are possible.

The reason for contacting a doctor is the independent detection of large painless lymph nodes, sharp pain in the lymphoid tissue when trying to palpate, a combination of lymphadenopathy with other pathological signs - rash, hyperthermia, weight loss, fatigue. Particular concern should be caused by lymph nodes measuring 2-3 cm, which have enlarged for no apparent reason, are located in several zones and persist for more than 2 months.

Content:

1. Possible reasons
2. Dental causes of inflammation of the lymph nodes on the chin
3. How to understand that the problem is in the lymph nodes
4. Diagnostic measures
5. How are lymph nodes treated?
6. Preventive measures

If the lymph nodes are inflamed, it is important to undergo a comprehensive medical examination.
This condition can be accompanied by many diseases, both related to the field of dentistry and not related to it. Lymph nodes are peripheral organs of the lymphatic system. They perform the functions of a biological filter. Passing through their tissues, lymph enters different parts of the body and internal organs.

If the lymphoid structure has increased, it means there is an inflammatory process. It is necessary to find out as soon as possible what functional disorders it is associated with. This will allow you to create an effective treatment plan and prevent the development of severe complications.

Development mechanism

Enlargement of lymph nodes occurs in several ways, each of which involves the accumulation of a certain type of cell in the lymphoid tissue. The reaction of peripheral lymphatic organs is often associated with increased blood flow, proliferation of lymphocytes and macrophages in response to the appearance of foreign genes. With antigenic stimulation, the node can increase 5-15 times in 5-10 days. Systemic neoprocesses are characterized by active proliferation of degenerated lymphoid cells with an increase in the size of the affected lymph node.

The stroma of lymphatic formations can be infiltrated by inflammatory elements (in infectious diseases), tumor cells located in the lymphatic drainage zone of a given node. Metastatic lesions are often accompanied by proliferation of connective tissue. In some disorders of lipid metabolism (Niemann-Pick disease, Gaucher syndrome), macrophages filled with undigested glycosphingolipids are retained in the lymph node.

Axillary lymphadenitis in a child

Prevention of the inflammatory process

To reduce the risk of developing lymphadenitis, you must strictly follow the recommendations:

• Have annual preventive examinations at the dental clinic. Treat all emerging oral diseases in a timely manner. Avoid caries and take care of your gums.
• Do not ignore the presence of infections and treat them. During therapy, strictly follow all medical prescriptions.
• For any damage to the skin, treat wounds with antiseptics. This minimizes the risk of contracting an infectious disease.
• If you feel unwell, consult a doctor and get laboratory tests. This simple measure allows you to detect violations at the earliest stages.

It is necessary to understand that using “grandmother’s” methods for inflamed lymph nodes is dangerous. So, under no circumstances should you heat the inflamed area or apply cold compresses to it. It is unacceptable to massage him or put pressure on him. All of these actions can make the situation worse. Then it will be much more difficult to reverse the disease.

Classification

When determining the forms of lymphadenopathy, the location of enlarged lymph nodes is primarily taken into account. Lymphoid tissue is the main protective barrier against the spread of infectious pathogens and tumor cells. Therefore, the location of altered lymphatic formations facilitates the diagnosis of the disease that caused the lymphadenopathic reaction. Depending on the localization of the process, the following are distinguished:

• Enlargement of the submandibular lymph nodes
  . Characteristic of pathological processes in the head and neck area - diseases of the eyes, ENT organs and paranasal sinuses, skin damage. Submandibular lymphadenopathy often signals dental problems and chronic tonsillitis.
• Enlarged cervical lymph nodes
  . Usually observed with respiratory infections, oral pathology, infectious mononucleosis, late stages of tuberculosis. Cervical nodes can be affected by lymphomas, lymphogranulomatosis, metastasis of thyroid cancer, lung cancer.
• Enlarged supraclavicular lymph nodes
  . Most often due to tumor causes. Detection of an enlarged node on the right is pathognomonic for cancer of the esophagus and lungs. The left lymph node is affected by malignant processes in the abdominal cavity, pelvis, and retroperitoneal space.
• Enlarged axillary lymph nodes
  . Inflammatory lesions are possible in the presence of wound infections, cat scratch disease, and brucellosis. Damage to the nodes of the axillary group is typical for breast cancer, melanoma of the upper extremities, and the installation of silicone breast implants.
• Enlarged inguinal lymph nodes
  . As a rule, nodes in the groin react to the development of syphilis, gonorrhea, chancroid, and other genital infections. Inguinal lymphadenopathy is also a sign of malignant lesions of the pelvic organs, lymphoma, and bubonic plague.

Somewhat less frequently, lymph nodes of other groups are involved in the process - submental, cubital (in the area of ​​the elbow), parotid, occipital, jugular. During a routine instrumental examination, an increase in internal lymph nodes can be determined - intrathoracic (mediastinal), bronchopulmonary, para-aortic, splenic, mesenteric, retroperitoneal.

In the diagnostic plan, it is important to take into account other criteria for the classification of lymphadenopathy - the characteristics of altered lymphoid formations, the extent of the lesion. This approach allows us to assume the type of pathological process occurring in the involved nodes and the body as a whole. Important criteria for the classification of enlarged lymph nodes are:

• Dimensions
  . With I degree lymphadenopathy, the diameter of the affected formations is 0.5-1.4 cm, with II degree - 1.5-2.4 cm, and with III degree - 2.5 cm or more. A significant and prolonged increase in the size of lymph nodes is more typical for malignant processes.
• Soreness
  . Intense pain is often caused by inflammation of the lymph nodes, especially acute purulent lymphadenitis. Formations that have undergone malignant degeneration are often painless, except in cases of hemorrhage into the necrotic center.
• Density
  _ Enlarged, inflamed lymph nodes are usually soft; when they suppurate, fluctuation (fluctuation of fluid) is felt during palpation. The stony consistency of the formations is typical for the metastatic process, and tight elasticity is typical for lymphomas.
• Communication with each other
  . A pathological formation of lymph nodes that can be felt as a single unit and move together is called a conglomerate. Lymph nodes fused together are detected in tuberculosis, sarcoidosis, lymphogranuloma venereum, lymphomas and metastasis.
• Quantity
  . It can affect either one or two or several nodes in one zone. In the first case, they talk about single enlarged nodes, in the second - about local lymphadenopathy. The more active the process, the more formations are affected, however, with metastasis, one large node is often detected.
• Prevalence
  . With local lymphadenopathy, single nodes are identified in one area, with regional lymphadenopathy - several formations in 1-2 adjacent zones. A generalized (widespread) process is characterized by damage to lymphatic structures in three or more areas.

Taking into account the pathogenesis, enlargement of lymph nodes can be primary (systemic), secondary (reactive) and inflammatory. Primary polyadenopathies develop with systemic malignancy of lymphoid tissue (leukemia, lymphogranulomatosis, non-Hodgkin's lymphoma) and benign processes (sinus histiocytosis). Reactive lesions are a response to another pathology (infection, immune disease, proliferation of tumor cells, metabolic disorders). Inflammation (lymphadenitis) occurs when infectious agents multiply in the tissue of the node.

How are lymph nodes treated?

The treatment tactics chosen by the doctor directly depend on the characteristics of the clinical symptoms and the diagnosis. If it's all about a bacterial infection, you can't do without antibiotics. For viruses, antiviral drugs and immunostimulants are indicated. In the case of an autoimmune disorder, the focus is on reducing the activity of specific culprit markers. If cancer is confirmed, chemotherapy, surgery, and immunomodulators are necessary.

If the lymph nodes are enlarged due to a certain dental disease, its step-by-step treatment is carried out. Almost immediately after this, the problem of increased lymphocyte production disappears by itself.

It is extremely important that the patient does not warm the lymph node or apply any compresses unless the doctor has prescribed it. Such actions can aggravate the situation and lead to the development of health-threatening complications.

Pulpitis and inflammation of the lymph nodes

Pulpitis is an inflammation of the pulp - the nerve tissue inside the tooth. It often occurs in people with advanced caries at a deep stage. The following symptoms are characteristic of pulpitis:

• Acute pain that occurs both at rest and when the tooth is exposed to various irritants: food, brushes, water, etc. After eliminating the factor that provoked the pain, the symptom persists for some time, but gradually subsides. The pain is usually sharp and intense; it cannot be eliminated with analgesics.

• Headaches, pain in the ear area from the affected tooth, general malaise and increased fatigue. The pain may radiate to the temple and eyebrow.
• Increase in local and general temperature. In adults it can rise to 38°C, and in children even higher.
• Swelling of the submandibular lymph nodes, pain when swallowing and chewing food.

With pulpitis, as a rule, it is necessary to remove the diseased nerve, after which the tooth becomes dead and noticeably darkens.

Stomatitis and inflammation of the lymph nodes

Stomatitis is an inflammation of the oral mucosa that occurs against the background of infectious diseases, after burns, as a result of trauma, due to an allergic reaction, etc. Traumatic stomatitis is often diagnosed, for example, when the mucous membrane is injured by crowns or braces.

After an injury, bacteria enter the wound and cause inflammation, which is accompanied by:

• painful sensations;
• the appearance of rashes and ulcers on the mucous membrane;
• release of translucent exudate;
• the formation of a white film on the surface of the wound;
• inflammation of the lymph nodes;
• high temperature, chills and fever;
• hyperemia and swelling of the gums.

As a rule, stomatitis goes away without consequences. However, it can be complicated due to weak immunity, alcoholism or smoking. There is a risk that the disease will cause inflammation of the lymphatic system.

When to see a doctor

Of course, if fatigue and some other symptoms occur separately, you should not immediately attribute this to the onset of oncology. It is necessary to undergo tests in order to understand the cause of the malaise.

Before taking the tests, you need to prepare. A day before all procedures, a person eliminates alcohol and tobacco. The stomach should be empty. The time of the last meal is at least 12 hours. It is forbidden to drink tea, juices (natural and purchased), and chew chewing gum. Only drinking water is allowed.

Another important condition is that you should not worry before the procedures. Sometimes it is difficult to prevent absolutely all factors that provoke stress. The most common cause of anxiety is waiting for a bad test result.

If a person is taking any medications, the doctor should be informed.

If the diagnosis is confirmed, then the next person the patient is referred to is an oncologist. After the examination, therapy, diet and prognosis for recovery are prescribed.

Treatment of axillary lymphadenitis

Treatment tactics for axillary lymphadenitis depend on the form and cause of the disease. In most cases, lymphadenitis does not require special therapy and goes away on its own after the underlying disease is eliminated. If the process is complicated by suppuration, then the treatment tactics completely change.

General recommendations: maintain rest, immobilize the affected area (do not rub or injure the affected lymph nodes), proper nutrition, take painkillers, anti-inflammatory medications. Therapy for acute axillary lymphadenitis depends entirely on the stage of the disease. Conservative treatment is used for the initial stages: UHF therapy, sanitation of the source of infection (opening of abscesses, leaks, cellulitis, drainage of the abscess), antibiotic therapy taking into account the sensitivity of the microbial flora in the main focus.

Surgical intervention is necessary for purulent axillary lymphadenitis: adenophlegmon, abscesses are opened, pus is removed, and the wound is drained. It happens that a biopsy confirms the presence of a tumor process - benign or malignant. Treatment may include radiation and chemotherapy. In the case of lymphadenitis, as in the presence of any other diseases, it is extremely dangerous to self-medicate.

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What is caries and why does it occur?

Caries is a slowly progressive disease in which tooth enamel and dentin are destroyed. It occurs due to the impact of cariogenic microbes and their metabolic products on the teeth. Bacteria feed on carbohydrates and secrete harmful acids that upset the balance of minerals in the oral fluid and enamel, gradually corroding it and leaching calcium, fluorine and other trace elements from it.

It becomes soft, loose and porous, as a result of which it cannot fully resist microorganisms.

• Cariogenic microbes live in the oral cavity of almost every person. But caries occurs only under certain conditions. These include:
• Poor hygiene. Food debris, plaque and tartar stuck between teeth are favorable factors for the spread of bacteria.
• Anatomical features of the teeth and jaw: malocclusion, deep and narrow fissures, crowded teeth, etc. Because of this, it is more difficult to carry out hygiene procedures.

• Presence of braces or other orthodontic structures. They also complicate hygiene: food debris gets stuck between the teeth and braces, which feeds bacteria.
• Disorders of saliva production. It neutralizes acids secreted by cariogenic microbes and maintains the pH of the oral fluid. If saliva is not produced in sufficient quantities, the balance of minerals is disrupted, which makes the enamel vulnerable to external factors.
• Abuse of sweets. The bacteria that cause caries live off carbohydrates, more precisely, sucrose. It is found in large quantities in confectionery products. People who eat a lot of sweet foods are more likely to suffer from tooth decay.

These are the main factors that increase the risk of caries. However, this list cannot be called exhaustive; it can also include poor ecology, genetic predisposition to dental diseases, abrasion of enamel, drinking water with a low mineral content, etc. When diagnosing caries, it is much more important to determine its stage, on which the treatment method depends.

Inflammation of the lymph nodes with carious lesions is not always observed. They often become inflamed due to advanced caries. We will tell you how this pathology occurs and why it causes other diseases that are not directly related to teeth, including lymphadenitis.

Oncological alertness

Lymph nodes are often enlarged due to lymphogranulomatosis (Hodgkin's lymphoma) or lymphosarcoma (non-Hodgkin's lymphoma). These are malignant processes that are manifested by increased density, painlessness and large diameter of the lymph nodes in the absence of other reasons for their deformation. Lymph nodes enlarge in groups, asymmetrically (for example, on one side of the neck). At the initial stage of the process, their mobility and separate arrangement are maintained. If the oncological process continues without treatment, the lymph nodes may become fused, and moderate pain rarely occurs. Source: N.V. Nagornaya, E.V. Vilchevskaya, A.P. Luachak, E.N. Marchenko, E.V. Bordyugova, A.P. Koval Hodgkin's disease (lymphogranulomatosis) in children // Child's Health, 2013, No. 1 (44), pp. 13-15

Symptoms that require consultation with a doctor are enlarged lymph nodes:

• more than 7 days;
• more than 1 group;
• accompanied by elevated body temperature;
• in a child under one year old;
• progressive over time;
• with changes in local skin.

Symptoms of pathology

The fact that a person has “caught” a lymph node usually means its increase in size. Occasionally it hurts, and the skin over it becomes red. In this case, doctors talk about lymphadenitis.

An important point is the mobility of the lymph node. Normally, it easily moves a short distance. If the lymph node is motionless and enlarged, a doctor’s consultation is urgently needed.

Not all lymph nodes can be examined independently. When magnified, they can be felt on the neck, under the armpits, and in the groin area. It is important where the inflamed area is located. If a lymph node in the neck has caught a cold, how to treat it will differ from the situation when the groin or axillary area is affected. By localization, one can judge a preliminary diagnosis, since lymphadenopathy is often only a symptom of the underlying disease.

Causes of lymphoma

There are a number of predisposing conditions that are not the true cause of lymphoma, but create a favorable environment for the development and progression of this disease:

• age, gender (the risk group includes people aged 55 to 60 years; and some forms of lymphoma are more common in men);
• viral diseases (Epstein-Barr virus, immunodeficiency virus (HIV), hepatitis C, some types of herpes viruses);
• bacterial infections (bacterium Helicobacter pylori (Latin name - helicobacter pylori), this microorganism lives on the mucous membrane of the stomach or duodenum);
• chemical factor (various substances with a toxic effect that a person encounters for a long time at work or at home; areas of activity associated with the use of various chemicals (solvents, varnishes, benzene);
• taking immunosuppressants (immunosuppressants inhibit the activity of the immune system).