The lymph glands are a unit of the immune system that protects us from any foreign bodies, substances, cells, and similar formations. The lymph glands are obliged to purify our body from foreign and harmful substances like a strainer. Providing information on lymphatic enlargement that worries parents Acıbadem University Department of Child Health and Diseases, Acıbadem Maslak Hospital, Child Health and Diseases Specialist. Dr. İnci Ayan, He said lymph node cancer, known as ad lymphadenopathy ”, is a very rare condition and the risk is less than 0.4 percent.
Professor Dr. Pearl Ayan listed the conditions that cause lymph node growth:
? The most common cause of lymph node growths are infections. Bacteria, viruses, parasites, fungi, such as harmful factors spread through the blood or the entire body (systemic) disease by creating lymph nodes affect. Or locally, they directly cause lymph nodes to become ill.
? Most often related to upper respiratory tract infection, tonsillitis, pharyngitis, otitis, conjunctivitis, gum infections, dental abscesses, intraoral aphthae, skin infections, lower respiratory tract infections, hand, arm, leg, foot, finger infections, genital and anal area infections they cause the lymph nodes of the region to grow.
? Viral infections of the upper respiratory tract are the most common cause of lymph node enlargement in children.
? Infectious mononucleosis, rubella, measles, enteroviruses, adenovirus, chicken pox, cytomegalovirus infections are the major infections.
? Bacterial infections include streptococci that cause tonsillitis, staphylococci, diphtheria, typhoid, brucellosis, tuberculosis, mycobacteria, syphilis, which also cause systemic disease.
? Toxoplasma, malaria, tick bite diseases, cat scratch disease and fungal diseases are other lymphatic disease-causing infections.
? Lymph nodes may grow as a result of the response to foreign substances other than infections. Vaccine reactions, particularly BCG vaccine; insect stings; dermatitis caused by continuous irritation of the skin; drugs such as aspirin, hydantoin, penicillin, tetracycline can be shown as examples.
? Rheumatoid arthritis and lupus, especially rheumatic diseases, congenital metabolism diseases, some internal gland diseases are among the diseases that affect the lymph nodes.
? Apart from these, the most important cause of lymph nodes is leukemia and lymphomas, and other tissue and organ cancers of childhood.
What are the settlements of lymph nodes in our body?
There are about 600 lymph nodes in the whole body. These are in the head-neck region, in front of the ear, behind the ear, in the upper nape region, in the upper-middle-lower neck regions, under the chin and anterior chin, on the collarbone, around the major middle structures in the thoracic cavity, at the lung entry doors and under the armpits, in the arms. elbow areas, abdominal cavity liver, spleen organs such as the entrance gates, around the gastrointestinal tract, midline vascular structures and spine neighborhoods, kidney and urinary tract circles, groin and thigh upper regions and behind the knee.
Under what circumstances should children undergo lymph gland size (lymphadenomegaly) or lymph gland disease (lymphadenopathy)?
The size of lymph nodes varies between 0.5 cm and 1.5 cm in healthy children, depending on the location. Generally, lymph nodes larger than 1 cm in diameter are considered abnormal and lymph node enlargement (lymphadenomegaly) is mentioned. Enlarged lymph nodes, especially in the head and neck, armpits and groin areas can be detected or visible to the eye. Lymph gland disease (lymphadenomegaly) should be suspected in lymph nodes that differ in size, continuity and number than normal. Regional lymphadenopathy is a disease of lymph nodes in a single region; Two or more non-adjacent lymph nodes are called abnormal lymphadenopathy.
Regional lymphadenopathies constitute three quarters of lymph node diseases.
How often can cancer occur in children with lymph node enlargement?
In children, the growth of benign lymph nodes, which can be exemplified by large tonsils, nasal flesh, is quite common except for lymph node growth caused by infection, allergy and other tissue diseases. Cancer as a cause of lymphadenopathy is a very rare condition with a risk of less than 0.4%.
How should parents follow a child with lymph node size?
Parents should first of all consult a pediatrician without getting too anxious but without spending time. Parents should tell doctors:
How did you notice the size of the lymph nodes?
Since when did this growth exist?
? Has there been an increase in size over time?
? Is there any accompanying fever, pain, redness or discoloration?
Is there any softening or discharge? Cough, sore throat, ear, tooth, joint or other pain occurred?
What is the history of sweating, weight loss, rash, injury, insect stings, vaccination or medication history? What kind of examinations are needed for diagnosis?
The examination of the relevant lymph node area and the whole body is the first condition for diagnosis. Lymph gland size, consistency, adherence to adjacent structures, sensitivity, color change, other lymph nodes and tonsils, liver, spleen in the organs related to the lymph system, presence of fever, paleness, skin rash or bleeding symptoms are important clues for diagnosis. . Complete blood count, detection of infectious agents and signs of infection by blood tests, culture tests for identification of infectious agents, imaging methods such as ultrasound and chest x-ray are frequently used tests. If examinations and investigations are in favor of infection, antiviral and supportive therapies in viral infections and improvement in bacterial, fungal and parasitic infections usually occur within 1-2 weeks after appropriate antimicrobial treatment. In cases where no improvement is detected and / or lymph node growth continues, biopsy is performed at the end of the follow-up period (usually 4-8 weeks) approved by the attending physician.
Who does the biopsy, is there any danger?
The pediatric surgeon or surgeons of the relevant region (eg, ear, nose and throat specialists for the neck region) will be directed by the pediatrician who has followed the biopsy event from the beginning. For the correct diagnosis, removal of the largest lymph node in a way that does not harm or hurt the child is the most appropriate approach. Fine needle biopsies may sometimes be inadequate and the biopsy may need to be repeated. With the right person and appropriate approach, lymph node biopsies are not life-threatening. The biopsy should be sent to the pathology laboratory under appropriate conditions and the result should be monitored. Research has shown that only 3% of the biopsy is necessary for lymph node enlargement.
What are the treatment methods and results in lymph node diseases?
Treatment is applied according to the cause of lymph node disease. The most common causes are infections, and both regional and systemic infectious diseases are cured with appropriate antimicrobial therapy. Sometimes the lymph nodes shrink after the treatment of the disease, but may not reach the full normal size, this is considered a normal condition, does not require additional treatment. Except for infectious diseases, there is a high chance of recovery with original treatment including cancer. Especially with early diagnosis and appropriate treatment, full recovery is seen in the majority of patients.