Lymph node diseases | Lymph nodes

Lymph node diseases

Lymph nodes can change in case of inflammation in their catchment area. They then swell up, sometimes painfully, and can be felt through the skin from the outside. Examples of such inflammatory changes are respiratory tract infections in which the neck lymph nodes can become enlarged.

Even after infection with HIV (AIDS) or the EBV virus (mononucleosis), the lymph nodes can swell as one of the first symptoms at the beginning of the disease. Furthermore, there are tumor diseases that affect lymph nodes. Frequently, metastases of another tumor are found in the body when the cancer cells in the lymph nodes, which have been washed up in the lymph, cannot be eliminated, but instead settle and multiply.

More rarely, cancer develops directly in the lymph node. In such cases, one speaks of lymphoma, whereby Hodgkin lymphomas are distinguished from non-Hodgkin lymphomas. Lymph nodes can swell for a variety of reasons – in general, there is a defensive reaction of the body.

When the body has to fight off invading pathogens, the immune system is activated. The lymph nodes contain important filter stations of the body as well as immune cells that can migrate from the lymph nodes. In the lymph fluid, harmful substances and pathogens are also flushed into the lymph nodes, where a defense reaction can then be initiated.

In this context, the lymph nodes then swell. This can be quite painful, as the lymph nodes can become considerably enlarged within a very short time in the case of an acute infection. In medical terms, lymph node swelling is also known as lymphadenopathy or lymphadenitis.

However, the lymph nodes can also swell in other diseases, such as malignant diseases.However, the increase in size of the lymph nodes is often due to the migration of degenerated cells into the lymph nodes. There the malignant cells then divide further and form a lymph node metastasis of the primary tumor. In the context of breast cancer, for example, the lymph nodes in the armpits can become swollen due to the spread of the tumor.

Painful lymph nodes are generally a good sign and are more likely to be a benign cause of lymph node enlargement. During an infection, the lymph nodes react to pathogens and enlarge. Since the surrounding tissue is not accustomed to rapid enlargement, nerve fibers and other surrounding structures are stretched, which can cause pain.

Sometimes, rapidly swollen lymph nodes can also cause reddening of the skin. In contrast, malignant lymph node enlargements often grow slowly and over a long period of time, giving the surrounding tissue enough time to make room and stretching it slowly. For this reason, malignant lymph nodes are less painful than benign lymph nodes.

Cancer can spread to the lymph nodes. In the early stages of the disease, only a circumscribed area is affected. However, as the cancer continues to grow, it can connect to lymph vessels and surrounding structures.

Thus, it can grow into neighboring organs, but can also attack lymph nodes. Tumour cells can be flushed into the lymph nodes via the lymph channels. The first lymph node that receives lymph fluid from a region of the body is also called sentinel lymph node.

If cancer is detected, the sentinel lymph node is searched for. If this is tumor-free, it can be assumed that the other lymph nodes also contain no tumor cells. However, if the sentinel lymph node is already affected by the tumor, it must be removed and/or irradiated together with other lymph nodes in the corresponding body region, depending on the therapy concept.

The metastases of the tumor into the lymph nodes are also called lymph node metastases. Affected lymph nodes continue to enlarge and often feel bumpy, irregular and rough. Often they have grown together with their surroundings and therefore cannot be moved around in the tissue as is normally the case. In most cases, pressure on malignant lymph nodes causes no pain at all. However, in the case of enlarged lymph nodes as part of an inflammation, pressure on these lymph nodes usually causes pain.