introduction

Lymph nodes are found all over the body. They are part of the lymphatic system, consisting of the lymph vessels and the lymphatic organs. They are responsible for the immune system.

The lymphatic organs can be divided into primary and secondary organs. The lymphocytes are formed in the primary lymphatic organs - the bone marrow and the thymus (in German Bries). They belong to the white blood cells and are made from stem cells in the bone marrow.

They mature into ready-made immune cells that can recognize foreign substances and dangerous antigens secondary lymphoid organs. In addition to the lymph nodes, these also include the spleen, lymphoid tissue in the mucous membranes (for example the Almonds (Tonsils)) and the Appendix in the intestine (often mistakenly called appendix).

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Read detailed information on the subject: Lymphatic organs

Be here Antigens, so potentially dangerous foreign substancesthat circulate in the body. The spleen is responsible for antigens that circulate in the blood. The lymphatic tissue in the mucous membranes checks the antigens that have penetrated the surface of the mucous membranes via the mouth. Lymph nodes, on the other hand, react to substances that have already penetrated the tissue and spread through the lymph vessels.

Because the lymph vessels form a Drainage system, which absorbs tissue fluid and returns it to the bloodstream. It consists of tiny, blind-ended vessels which are found in almost all organs (that central nervous system for example is an exception). you take free liquid up, lead them to the center via ever-increasing lymph vessels and finally lead them into the Venous angle (there the Veins from the neck and arm), with most of it in the left venous angle from where it passes through the venous blood superior vena cava flows to the heart.

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The lymph nodes are interposed with the lymph vessels and serve as Filter stations.

anatomy

The lymph nodes are mostly rounded or bean-shaped, are between 2 and 20 mm in size and filter the lymphbefore this again the blood circulation is forwarded.

Lymph refers to the fluid in the Lymph vessels, the intermediate step between tissue fluid and blood plasma. she is slightly yellowish, consists mainly of water, contains Lymphocytes and also some electrolytes and proteins. It can also be cloudy and milky white after meals, as fats are also absorbed through the lymph.

In the whole body there is about 600 to 700 lymph nodes, with each organ and each body part having its own so-called regional lymph nodes which is the first filter station for this area. The area for which this lymph node is responsible, so to speak, is called tributary territory.

The afferent lymph vessels enter the lymph node from all directions, then the lymph flows via certain pathways, the so-called sinuses, through the lymph node to a pole (the hilum), where it is discharged again via an exiting lymph vessel. In the tissue of the lymph nodes there are lymphocytes that have reached it via a feeding artery and that can come into direct contact with antigens from the lymph here.

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location

The most important lymph node stations are located on the head (below and behind the ear, on the occiput, on the lower jaw and on the chin), on the neck (neck and along the cervical vessels), in the armpit, in the abdomen and chest, on the collarbone and in the groin .

The lymph nodes in the neck area make up about a third of all lymph nodes. The body is particularly exposed to pathogens because of the air and food routes, and a large part of the lymph flows together here, namely from the head, neck, torso and arms.

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The lymph nodes are mainly located in the front along the windpipe and around the thyroid gland and laterally along the blood vessels and on the sternocleidomastoid muscle (in German "the big head turner": the muscle that emerges when you turn your head to one side). There are superficial and deep lymph nodes, with most of the lymphatic drainage from the neck going through the deeper nodes along the internal jugular veins.

Read more on the topic: Swelling on the side of the neck

Lymph nodes swollen and painful

With tonsillitis, the lymph nodes swell.

Since many of the lymph nodes on the neck are relatively superficial, they are often easy to see and feel, especially if they are swollen.

Read more on the topic: Lymph nodes swollen

With diseases in the so-called tributary area (see above) of a lymph node, this enlarges. Because via the lymph, foreign cells and particles reach the regional lymph nodes, whereupon the ducts widen and more lymphocytes accumulate. Causes for the swelling of a lymph node can be an inflammation in the area of ​​the lymph node, a tumor disease of another organ, or a lymphoma itself.

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In the vast majority of cases, neck swelling is due to swollen cervical lymph nodes.
These can also be painful when they are under pressure and are a reaction to harmless inflammation in the neck and head area or the respiratory tract, such as a cold, tonsillitis or tooth infection.

Read more on the topic: Lymph node swelling after surgery

But more serious bacterial or viral infections such as borreliosis after a tick bite, tuberculosis, Pfeiffer's glandular fever or HIV can also cause lymph node swelling. It shows that the immune system is active. Normally, the lymph nodes swell again after the disease has passed. But they can still be felt as small, painless, movable indurations.

This phenomenon of swollen lymph nodes is called reactive lymph node swelling or lymphadenitis. The benign enlargements can also be referred to as pseudolymphoma.

Painless, swollen lymph nodes that have hardened over a long period of time and cannot be clearly demarcated from the surrounding tissue, i.e. also cannot be moved, can be caused by spreading tumor cells. If an organ is affected by a tumor, the tumor cells can reach the regional lymph nodes via the lymph fluid, where they are filtered, accumulate and grow. A lymph node metastasis forms and the lymph node becomes larger. The lymph node metastasis is one of the regional metastases. Distant metastases, on the other hand (often in the bones, liver or brain), are spread via the bloodstream.

Lymph node metastases usually only occur when the primary tumor has advanced. They can appear with accompanying symptoms such as severe weight loss, night sweats and fever, or they can lead to the discovery of a tumor as the first symptom.
Tumors in the head and neck area that could spread to the cervical lymph nodes are, for example, carcinoma of the oral cavity, thyroid gland or nasopharynx.

The third cause of enlarged lymph nodes is the malignant (malicious) Lymphoma. It describes neoplasms (Neoplasms) of the lymphatic cells due to uncontrolled growth. A distinction is made between Hodgkin's lymphomas and non-Hodgkin's lymphomas. Hodgkin's lymphoma arises from the B lymphocytes, a subtype of lymphocytes that are responsible for producing antibodies. After initially developing in a lymph node, it spreads continuously through the lymphatic system. The causes of Hodgkin lymphoma are largely unknown. The stage of spread at the time of diagnosis is decisive for the prognosis.

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Read more on the topic: Non-Hodgkin lymphoma

Typical accompanying symptoms are fever, night sweats, and weight loss. With large lymphomas, there may be shortness of breath and an upper congestion of the influence. The enlarged lymph node squeezes a vein, which then emerges through the congestion of blood.

Non-Hodgkin lymphomas can still be divided into B-cell and T-cell lymphomas.

Read more on the topic: Painful lymph nodes

Lymph nodes swollen on one side

Only unilateral swollen lymph nodes can occur as a result of a localized unilateral infection.

Malignant changes, i.e. tumors in the tributary area of ​​the lymph node or lymphomas of the lymph node itself, can initially only manifest on one side.

You may also be interested in the next topic: Swelling on the neck under the jaw

diagnosis

To diagnose the cause of a swollen lymph node, this is done by touching it Size, its consistency (soft or hard), his surface (smooth or rough), the Delimitation from the surrounding tissue, the Movability, and up Tenderness checked.

A normal finding would look like this: not palpable or less than 1 cm tall, soft, smooth surface, delimitable, movable and not tender on pressure.

If a malignant disease is suspected, a sample (biopsy) is carried out. The excised tissue is examined microscopically and checked for malignant changes.

therapy

Lymph nodes that are enlarged due to an infection usually swell again after the disease has passed. In the case of severe bacterial infections, antibiotics can be used if necessary; viral infections are usually only treated symptomatically, for example by reducing fever.

If lymph node metastases occur, all lymph nodes of the corresponding lymphatic drainage area are usually removed as part of the surgical removal of the primary tumor in order to prevent further metastasis via the lymph system. This procedure is called a lymphadenectomy. As a result of this removal, lymphedema can form, i.e. accumulations of water in the surrounding tissue, since resorption and drainage through the lymph vessels are interrupted.

In the case of breast or prostate cancer, the concept of the sentinel lymph node is implemented. The lymph node closest to the primary tumor is examined for metastatic tumor cells. If it is tumor-free, it is assumed that the following lymph nodes are not yet affected and do not need to be removed.

In the case of chemotherapy or radiation therapy, this also acts on the lymph node metastases and can help to shrink the lymph nodes.

Malignant lymphoma is also treated with a combination of radiation and chemotherapy or just chemotherapy. The intensity and type of treatment depends on the stage of the disease.

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Home remedies for lymph nodes on the neck

Against the swollen lymph nodes on the neck during one flu-like infection you can do something yourself within a certain framework. Since the lymph nodes swell again after an infection has healed, you can try this process by supporting the Immune system to accelerate. Peace and quiet, and a healthy diet rich in vitamins should speed up the healing process.

forecast

Hodgkin's disease (Hodgkin lymphoma) takes one without treatment fatal course, but with modern therapy strategies you can good cure rates be achieved. Depending on the stage of the disease, they are between 70% and over 90%. About 10% to 20% of patients will develop a second tumor in the years after treatment (Relapse).

The course and prognosis of non-Hodgkin lymphoma (NHL) vary widely. Low malignant NHL often takes years and the patient dies from uncontrollable infections and bleeding. In the case of highly malignant NHL, a cure can be achieved through intensive therapy.

Conclusion

In the vast majority of cases they are swollen lymph nodes on the neck harmless and as a sign of Activation of the immune system to see against an acute infection.

If the swelling persists for a long time and structural changes are noticeable, you should consult a doctor as a precaution and clarify the cause.


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