Swollen lymph nodes – Diagnosis and treatment

Diagnosis

To diagnose what might be causing your swollen lymph nodes, your doctor may need:

• Your medical history. Your doctor will want to know when and how your swollen lymph nodes developed and if you have any other signs or symptoms.
• A physical exam. Your doctor will also want to check lymph nodes near the surface of your skin for size, tenderness, warmth and texture. The site of your swollen lymph nodes and your other signs and symptoms will offer clues to the underlying cause.
• Blood tests. Certain blood tests may help confirm or exclude any suspected underlying conditions. The specific tests will depend on the suspected cause, but most likely will include a complete blood count (CBC). This test helps evaluate your overall health and detect a range of disorders, including infections and leukemia.
• Imaging studies. A chest X-ray or computerized tomography (CT) scan of the affected area may help determine potential sources of infection or find tumors.
• Lymph node biopsy. Your doctor may have you undergo a biopsy to secure the diagnosis. He or she will remove a sample from a lymph node or even an entire lymph node for microscopic examination.

More Information

Show more related information

Treatment

Swollen lymph nodes caused by a virus usually return to normal after the viral infection resolves. Antibiotics are not useful to treat viral infections. Treatment for swollen lymph nodes from other causes depends on the cause:

• Infection. The most common treatment for swollen lymph nodes caused by a bacterial infection is antibiotics. If your swollen lymph nodes are due to an HIV infection, you’ll receive specific treatment for that condition.
• Immune disorder. If your swollen lymph nodes are a result of certain conditions, such as lupus or rheumatoid arthritis, treatment is directed at the underlying condition.
• Cancer. Swollen nodes caused by cancer require treatment for the cancer. Depending on the type of cancer, treatment may involve surgery, radiation or chemotherapy.

Lifestyle and home remedies

If your swollen lymph nodes are tender or painful, you might get some relief by doing the following:

• Apply a warm compress. Apply a warm, wet compress, such as a washcloth dipped in hot water and wrung out, to the affected area.
• Take an over-the-counter pain reliever. These include aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve) or acetaminophen (Tylenol, others). Use caution when giving aspirin to children or teenagers. Though aspirin is approved for use in children older than age 2, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. Talk to your doctor if you have concerns.
• Get adequate rest. You often need rest to aid your recovery from the underlying condition.

Preparing for your appointment

If you have swollen lymph nodes, you’re likely to start by first seeing your family doctor. When you call to set up your appointment, you may be urged to seek immediate medical care if you’re experiencing severe symptoms such as difficulty breathing or swallowing.

Here’s some information to help you get ready for your appointment.

What you can do

• Be aware of any pre-appointment restrictions. At the time you make the appointment, ask if you need to do anything in advance.
• List any symptoms you’ve been experiencing, and for how long. Among other symptoms, your doctor will want to know if you’ve had flu-like symptoms, such as a fever or sore throat, and may ask whether you’ve noticed changes in your weight. Include on your list every symptom, from mild to severe, that you’ve noticed since your lymph nodes began to swell.
• Make a list of all recent exposures to possible sources of infection. These may include travel abroad, hiking in areas known to have ticks, eating undercooked meat, being scratched by a cat, or engaging in high-risk sexual behavior or sex with a new partner.
• Make a list of your key medical information, including other conditions you’re being treated for and the names of the medications that you’re taking. Include every prescription and over-the-counter (OTC) drug you use, as well as any vitamins and supplements.
• List questions to ask your doctor.

For swollen lymph nodes, some basic questions to ask your doctor include:

• What’s causing my symptoms?
• What are other possible causes for my symptoms?
• What kinds of tests do I need?
• What treatment do you recommend?
• How quickly will I start to feel better?
• Am I contagious? How can I reduce the risk of infecting others?
• How can I prevent this from happening in the future?
• I have these other health conditions. Do I need to change the treatments I’ve been using?
• Is there a generic alternative to the medicine you’re prescribing for me?
• Do you have any brochures or other printed material that I can take with me? What websites do you recommend?

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

• What are your symptoms?
• When did you first begin experiencing symptoms?
• Have your affected lymph nodes gotten larger over time?
• Are your affected lymph nodes tender?
• Have you been experiencing a fever or night sweats?
• Have you lost weight without trying?
• Do you have a sore throat or difficulty swallowing?
• Have you experienced any difficulty breathing?
• Have your bowel habits changed?
• What medications are you currently taking?
• Have you recently traveled to another country or to tick-inhabited regions? Did anyone who traveled with you get sick?
• Have you recently been exposed to new animals? Were you bitten or scratched?
• Have you recently had sex with a new partner?
• Do you practice safe sex? Have you done so since you became sexually active?
• Do you smoke? For how long?

What you can do in the meantime

While you wait for your appointment, if your swollen nodes are painful, try easing your discomfort by using warm compresses and an OTC pain reliever, such as ibuprofen (Advil, Motrin IB, others) or acetaminophen (Tylenol, others).

Oct. 09, 2019

Show references

1. Fletcher RH. Evaluation of peripheral lymphadenopathy in adults. https://www.uptodate.com/contents/search. Accessed Sept. 3, 2019.
2. Jameson JL, et al., eds. Enlargement of lymph nodes and spleen. In: Harrison’s Principles of Internal Medicine. 20th ed. The McGraw-Hill Companies; 2018. https://accessmedicine.mhmedical.com. Accessed Sept. 3, 2019.
3. Lymphadenopathy. Merck Manual Professional Version. https://www.merckmanuals.com/professional/cardiovascular-disorders/lymphatic-disorders/lymphadenopathy#. Accessed Sept. 3, 2019.
4. Papadakis MA, et al., eds. Lymphangitis and lymphadenitis. In: Current Medical Diagnosis & Treatment 2019. 58th ed. McGraw-Hill Education; 2019. https://accessmedicine.mhmedical.com. Accessed Sept. 3, 2019.
5. American Cancer Society. Lymph nodes and cancer. https://www.cancer.org/cancer/cancer-basics/lymph-nodes-and-cancer. html. Accessed Sept. 3, 2019.

Related

Associated Procedures

Show more associated procedures

Products & Services

Show more products and services from Mayo Clinic

Swollen Lymph Glands (Lymph Nodes) – Causes, Treatment, Info

What are swollen glands?

Dr Sarah Jarvis MBE

What are lymph glands?

Detail of lymph gland names

Small lymph glands (sometimes called lymph nodes) occur throughout the body. Lymph glands that are near each other often form into groups or chains. Examples of where lymph glands group together are the sides of the neck, the armpits and the groins. The diagram shows the main groups of lymph glands in the head and neck. However, lymph glands occur in many other places in the body.

Lymph glands are joined together by a network of lymph channels. Lymph is a fluid that forms between the cells of the body. This watery fluid travels in the lymph channels, through various lymph glands, and eventually drains into the bloodstream.

Lymph and lymph glands are major parts of the immune system. They contain white blood cells (lymphocytes) and antibodies that defend the body against infection.

What causes swollen lymph glands?

Lymph glands are normally pea-sized. You can sometimes feel them as lumps under the skin. People often feel their lymph glands in the neck. Lymph glands under the skin become more noticeable and easier to feel if they swell. They can swell to the size of marbles or even bigger.

You cannot see or feel lymph glands that are deeper in the chest or tummy (abdomen) but they may be uncomfortable or tender.

Causes of swollen lymph glands include the following:

Infection – the common cause

The lymph glands near to an infection swell quickly and become tender as the immune system ‘fights off’ infecting germs (bacteria, viruses, etc). The lymph glands usually go back to their normal pea size when the infection is over. It can take a week or so for them gradually to go back to normal after the infection. Examples of infections include the following:

Cancers, lymphomas and leukaemias – the less common causes

Some cells from a cancer can break off and spread (metastasise) to nearby lymph glands via the lymph channels. These cancer cells then grow and multiply in the lymph glands and cause the glands to swell. For example:

As a rule, swollen lymph glands due to cancers, lymphomas and leukaemias develop more slowly than those due to infections. They also tend to be painless at first.

Other less common causes

Rarely, swollen lymph glands can be due to causes such as:

What is the treatment for swollen lymph glands?

The treatment depends on the cause. Swollen lymph glands are like a marker of various conditions, all with different outlooks and treatments. So, for example, the common cause is due to a viral infection. In this case no specific treatment may be advised and the lymph glands will normally go back to normal after a week or so. However, swollen lymph glands caused by a cancer, lymphoma or leukaemia may need extensive treatment.

What should I do if I find swollen lymph glands?

Swollen lymph glands due to viral infections are common. For example, swelling of neck lymph glands may go up and down if you have frequent throat infections. This is of little concern. However, you should see your doctor if your lymph glands have not gone down after two weeks.

Swollen lymph glands are more of a concern if there is no apparent reason for them to swell. Tell your doctor if:

• You find swollen lymph glands and you do not know why they have swollen. For example, you do not have an infection to cause them to swell.
• You find swollen lymph glands just above or just below your collar bone (clavicle). Swollen glands in this area are more likely to suggest a cause for concern.
• Swollen lymph glands due to an infection do not go down again within two weeks.

The Adult Neck Mass – American Family Physician

1. Bhattacharyya N.
Predictive factors for neoplasia and malignancy in a neck mass. Arch Otolaryngol Head Neck Surg.
1999;125:303–7….

2. Armstrong WB,
Giglio MF.
Is this lump in the neck anything to worry about?. Postgrad Med.
1998;104:63–4,67–71,75–6. passim.

3. Kelley DJ, Myer CM. Congenital anomalies of the neck. In: Twefik TL, der Kaloustian VM, eds. Congenital anomalies of the ear, nose, and throat. New York: Oxford University Press, 1997.

4. Gourin CG,
Johnson JT.
Incidence of unsuspected metastases in lateral cervical cysts. Laryngoscope.
2000;110(10 pt 1):1637–41.

5. Beenken SW,
Maddox WA,
Urist MM.
Workup of a patient with a mass in the neck. Adv Surg.
1995;28:371–83.

6. Johnson IJ,
Smith I,
Akintunde MO,
Robson AK,
Stafford FW.
Assessment of preoperative investigations of thyroglossal cysts. J R Coll Surg Edinb.
1996;41:48–9.

7. Tunkel DE,
Domenech EE.
Radioisotope scanning of the thyroid gland prior to thyroglossal duct cyst excision. Arch Otolaryngol Head Neck Surg.
1998;124:597–9.

8. Rice DH.
Chronic inflammatory disorders of the salivary glands. Otolaryngol Clin North Am.
1999;32:813–8.

9. Marcy SM.
Cervical adenitis. Pediatr Infect Dis.
1985;4(3 suppl):S23–6.

10. Medina M,
Goldfarb J,
Traquina D,
Seeley B,
Sabella C.
Cervical adenitis and deep neck infection caused by Streptococcus pneumoniae. Pediatr Infect Dis J.
1997;16:823–4.

11. McDermott LJ,
Glassroth J,
Mehta JB,
Dutt AK.
Tuberculosis. Part I. Dis Mon.
1997;43:113–80.

12. Suskind DL,
Handler SD,
Tom LW,
Potsic WP,
Wetmore RF.
Nontuberculous mycobacterial cervical adenitis. Clin Pediatr [Phila].
1997;36:403–9.

13. Benator DA,
Gordin FM.
Nontuberculous mycobacteria in patients with human immunodeficiency virus infection. Semin Respir Infect.
1996;11:285–300.

14. O’Brien RJ,
Geiter LJ,
Snider DE Jr.
The epidemiology of nontuberculous mycobacterial diseases in the United States. Results from a national survey. Am Rev Respir Dis.
1987;135:1007–14.

15. MacDonell KB,
Glassroth J.
Mycobacterium avium complex and other nontuberculous mycobacteria in patients with HIV infection. Semin Respir Infect.
1989;4:123–32.

16. Karem KL,
Paddock CD,
Regnery RL.
Bartonella henselae, B. quintana, and B. bacilliformis: historical pathogens of emerging significance. Microbes Infect.
2000;2:1193–205.

17. McCabe RE,
Brooks RG,
Dorfman RF,
Remington JS.
Clinical spectrum in 107 cases of toxoplasmic lymphadenopathy. Rev Infect Dis.
1987;9:754–74.

18. Engel J,
Lydiatt DD,
Ruskin J.
Toxoplasmosis appearing as an anterior neck mass. Ear Nose Throat J.
1993;72:584–6.

19. Coldwell DM,
Novak Z,
Ryu RK,
Brega KE,
Biffl WL,
Offner PJ,

et al.
Treatment of posttraumatic internal carotid arterial pseudoaneurysms with endovascular stents. J Trauma.
2000;48:470–2.

20. Landau A,
Reese DJ,
Blumenthal DR,
Chin NW.
Tophaceous neck mass presenting as a thyroglossal duct cyst. Arthritis Rheum.
1990;33:910–1.

21. Allen EA,
Ali SZ,
Erozan YS.
Tumoral calcium pyrophosphate dihydrate deposition disease: cytopathologic findings on fine-needle aspiration. Diagn Cytopathol.
1996;15:349–51.

22. Hytiroglou P,
Brandwein MS,
Strauchen JA,
Mirante JP,
Urken ML,
Biller HF.
Inflammatory pseudotumor of the parapharyngeal space: case report and review of the literature. Head Neck.
1992;14:230–4.

23. Armstrong WB,
Allison G,
Pena F,
Kim JK.
Kimura’s disease: two case reports and a literature review. Ann Otol Rhinol Laryngol.
1998;107:1066–71.

24. Yi AY,
deTar M,
Becker TS,
Rice DH.
Giant lymph node hyperplasia of the head and neck (Castle-man’s disease): a report of five cases. Otolaryngol Head Neck Surg.
1995;113:462–6.

25. Shah UK,
White JA,
Gooey JE,
Hybels RL.
Otolaryngologic manifestations of sarcoidosis: presentation and diagnosis. Laryngoscope.
1997;107:67–75.

26. McGuirt WF. Differential diagnosis of neck masses. In: Cummings CW, et al., eds. Otolaryngology—head & neck surgery. 3d ed. St. Louis: Mosby, 1998:1686–99.

27. Barakat M,
Flood LM,
Oswal VH,
Ruckley RW.
The management of a neck mass: presenting feature of an asymptomatic head and neck primary malignancy?. Ann R Coll Surg Engl.
1987;69:181–4.

28. Wanebo HJ,
Koness RJ,
MacFarlane JK,
Eilber FR,
Byers RM,
Elias EG,

et al.
Head and neck sarcoma: report of the Head and Neck Sarcoma Registry. Society of Head and Neck Surgeons Committee on Research. Head Neck.
1992;14:1–7.

29. Moosa M, Mazzaferri EL. Management of thyroid neoplasms. In: Cummings CW, et al., eds. Otolaryngology head and neck surgery. 3d ed. St. Louis: Mosby, 1998:2480–518.

30. Barnes L. Pathology of the head and neck: general considerations. In: Myers EN, Suen JY, eds. Cancer of the head and neck. 3d ed. Philadelphia: Saunders, 1996:17–32.

31. Martin H,
Morfit HM.
Cervical lymph note metastasis as the first symptom of cancer. Surg Gynecol Obstet.
1944;78:133–59.

32. Jeghers H, Clark SL Jr, Templeton AC. Lymphadenopathy and disorders of the lymphatics. In: Blacklow RS, ed. MacBryde’s Signs and symptoms: applied pathologic physiology and clinical interpretation. 6th ed. Philadelphia: Lippincott, 1983:467–533.

33. Shaha A,
Webber C,
Marti J.
Fine-needle aspiration in the diagnosis of cervical lymphadenopathy. Am J Surg.
1986;152:420–3.

34. Chao C,
Torosian MH,
Boraas MC,
Sigurdson ER,
Hoffman JP,
Eisenberg BL,

et al.
Local recurrence of breast cancer in the stereotactic coreneedle biopsy site: case reports and review of the literature. Breast J.
2001;7:124–7.

35. Yoshikawa T,
Yoshida J,
Nishimura M,
Yokose T,
Nishiwaki Y,
Nagai K.
Lung cancer implantation in the chest wall following percutaneous fine needle aspiration biopsy. Jpn J Clin Oncol.
2000;30:450–2.

36. Mighell AJ,
High AS.
Histological identification of carcinoma in 21 gauge needle tracks after fine needle aspiration biopsy of head and neck carcinoma. J Clin Pathol.
1998;51:241–3.

37. Yamaguchi KT,
Strong MS,
Shapshay SM,
Soto E.
Seeding of parotid carcinoma along Vim-Silverman needle tract. J Otolaryngol.
1979;8:49–52.

38. McGuirt WF.
The neck mass. Med Clin North Am.
1999;83:219–34.

Spotting the difference: Swollen lymph nodes in leukaemia VS during an infection

Swollen lymph nodes occur as a symptom of leukaemia in approximately 20% of patients prior to their diagnosis. Also referred to as “swollen glands”, lymph nodes are pea-sized lumps of tissue that contain white blood cells. When enlarged they can be felt or seen as raised lumps underneath the skin, most commonly in the neck, the armpits, or in the groin area.

For the vast majority of cases, swollen lymph nodes indicate nothing more than the fact that your body is fighting off an infection such as tonsillitis or even a common cold. However, because of this, swollen lymph nodes can easily be mistaken as harmless when in fact they could be a warning sign of something more serious, such as blood cancer.

“I made an appointment to go see my GP after work. He thought it was tonsillitis, so gave me antibiotics. However, at the end of the week, I was no better. I went back and was signed off again with a different antibiotic.”

Certain characteristics such as the size of the lymph nodes, the way they feel or how long they last can help to differentiate swelling caused by infection from that caused by leukaemia or another type of blood cancer. Spotting the difference between harmless and harmful lymph nodes may be crucial in diagnosing leukaemia early.

Spotting the difference

Although swollen lymph nodes are nearly always caused by infection or reaction to an allergy, there are a few things you can look out for to help spot the difference between leukaemia and infection:

1. They last for longer than two weeks – Swollen glands caused by an infection will normally go down within two or three weeks (i.e until the infection has been naturally dealt with). Make sure you visit your GP if your lymph nodes don’t seem to be improving within this time or aren’t getting better with antibiotics.

“I noticed a swollen gland near my collar bone. After a couple of weeks of it not going down, I made an appointment to see the doctor.”

“I was told I had a bad case of tonsillitis and was given two weeks’ worth of antibiotics. I carried on going to work but I didn’t seem to be getting any better.”

2. They are painless – Rather surprisingly, tenderness, redness or warmth of the nodes is actually a good sign as it is more likely to indicate infection of the node. It is important to get painless lumps checked out by a GP to determine the cause of the enlargement. This being said, leukaemia or lymphoma (another type of blood cancer) can cause painful lymph nodes on occasion. This is because they can grow big enough to press down on surrounding nerves or other organs, causing pain.

“I noticed a lump that appeared on my jaw line. I didn’t think much about it as I presumed it was just a lump of fat that was natural with age. It wasn’t painful at all, but it was a bit of a nuisance.”

3. They continue to grow in size – In their swollen state during an infection, lymph nodes can enlarge to a size of half an inch in diameter. Lymph nodes that are around 1 or 2 inches or bigger are not normal and should be carefully inspected by a GP. Because the swollen lymph nodes are often painless, they can sometimes grow in size before a person even notices them.

“I had a sort of lump on the side of my neck. I was at work one day and the chap on the desk next to me said it like it was getting bigger, so I went along to my doctor.”

4. You can’t work out what has caused them to enlarge – Normally you will have a fairly good idea as to why your lymph node is swollen, for example, you might have a cold or a tooth infection. You should make an appointment with your GP if you have a swollen gland and no other signs of illness or infection.
5. They are hard or unmovable – Unfortunately, apart from being painless and abnormally large, swollen lymph nodes in leukaemia or lymphoma tend to feel quite similar to infected lymph nodes. However, occasionally they can feel very hard and cannot be moved when pushed. Healthy lymph nodes are more rubbery than the surrounding tissue but are not solid like stone. Any lumps on the neck, groin or armpits that are hard, very enlarged, and do not move when pushed may indicate lymphoma or another type of cancer and should be investigated by your GP.
6. You are also experiencing other symptoms of leukaemia – Leukaemia symptoms normally occur in clusters. If you notice any other symptoms such as night sweats, persistent fever (more than 3-4 days), or unexplained weight loss, visit your doctor immediately.

“I felt really rough, very fatigued, and faint. I also lost weight, I had enlarged lymph nodes and I was very emotional.”

What are lymph nodes, and why do they become enlarged?

Lymph nodes are small, kidney bean-shaped structures that are found in grape-like clusters throughout the entire body. They are a part of the lymphatic system, which carries fluid (called lymph) around the body. Lymph fluid absorbs any waste materials from the blood as well as any viruses and bacteria that are trying to infect the body.

Lymph nodes “sample” the lymph for any harmful intruders and “alert” the immune system if any viruses or bacteria are detected. When the immune system is alerted, the lymph nodes in the area closest to the infection can grow in size due to inflammation. Therefore, usually, swollen lymph nodes are just a sign that they are working hard to get rid of an infection.

In leukaemia, swollen lymph nodes are caused by a build-up of large numbers of cancerous cells which have travelled from the bone marrow. Sometimes in leukemia or lymphoma, the disease is in an ‘active’ state and is producing lots of dysfunctional white blood cells. However, at times the disease can also ‘slow down’ and some of the cells can die. This can mean that the swollen lymph nodes can fluctuate in size, growing and shrinking over time.

“I was very aware of the lumps and bumps, but I’d had them for a while and they always popped up if I was run down. My doctor asked if I had enlarged lymph nodes under my armpits or groin. I said no but he then said he could feel something and asked if I could stay for blood tests.”

When should I be concerned?

It is important not to self-diagnose. Not every person with swollen lymph nodes requires immediate evaluation by a doctor and, if you have swollen lymph nodes, you shouldn’t immediately expect cancer, as this is unlikely to be the cause.

However, make sure to visit your doctor if you feel that the lymph nodes in your neck or armpits are protruding more than usual, are painless or have lasted longer than you would expect. Sometimes infections such as tonsillitis, ear or throat infections do require a visit to the GP if they are particularly bad. You might be prescribed antibiotics, however, make sure to return to the GP if your symptoms do not get better.

Knowing what other symptoms are typical of leukaemia is crucial for helping you make the decision to visit your GP sooner for a blood test. Connect the dots between the symptoms of leukaemia and spot leukaemia sooner.

For information on the other symptoms of leukaemia, click here.

Lymphomas of the Head and Neck Clinical Presentation: History, Physical, Causes

Author

Jordan W Rawl, MD Fellow in Head and Neck Oncological Surgery and Microvascular Reconstruction, Nebraska Methodist Estabrook Cancer Center, Creighton University School of Medicine

Jordan W Rawl, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society

Disclosure: Nothing to disclose.

Coauthor(s)

Aru Panwar, MD Head and Neck Surgical Oncologist, Methodist Estabrook Cancer Center, Nebraska Methodist Hospital; Associate Professor, Department of Surgery, Creighton University School of Medicine

Aru Panwar, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Head and Neck Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Karen H Calhoun, MD, FACS, FAAOA Professor, Department of Otolaryngology-Head and Neck Surgery, Ohio State University College of Medicine

Karen H Calhoun, MD, FACS, FAAOA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Head and Neck Society, Association for Research in Otolaryngology, Southern Medical Association, American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Rhinologic Society, Society of University Otolaryngologists-Head and Neck Surgeons, Texas Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan;Cliexa, eMedevents, Neosoma, MI10<br/>Received income in an amount equal to or greater than $250 from: , Cliexa;;Neosoma<br/> Received stock from RxRevu; Received ownership interest from Cerescan for consulting; for: Neosoma, eMedevents, MI10.

Additional Contributors

Daniel J Kelley, MD Consulting Staff, Eastern Shore ENT and Allergy Associates and Peninsula Regional Medical Center

Daniel J Kelley, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Head and Neck Society, The Triological Society

Disclosure: Nothing to disclose.

Erik Kass, MD Chief, Department of Clinical Otolaryngology, Associates in Otolaryngology of Northern Virginia

Erik Kass, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, American Association for Cancer Research, American Rhinologic Society

Disclosure: Nothing to disclose.

Wyndham Wilson, MD, PhD Senior Investigator, Division of Clinical Sciences, National Institutes of Health National Cancer Institute

Disclosure: Nothing to disclose.

Kieron M Dunleavy, MD Professor of Medicine, Director of Lymphoma Program, Co-Director of Microbial Oncology Program, Division of Hematology and Oncology, GWU Cancer Center

Kieron M Dunleavy, MD is a member of the following medical societies: American Society of Hematology

Disclosure: Nothing to disclose.

Local Lymph Node Swelling in the Neck, No Antibiotic Treatment

You have a swollen lymph node in your neck that is not infected. The lymph nodes are part of the immune system. They are found under the jaw and along the side of the neck, in the armpits, and in the groin. A nearby infection or inflammation causes the lymph nodes in that area to swell. They may also be mildly tender. This is normal.

Antibiotics are not used for a swollen lymph node that is not infected. You can use warm compresses and pain medicine to treat this condition. The pain will get better over the next 7 to 10 days. The swelling may take 1 to 2 weeks or more to go away.

Rarely, a bacterial infection occurs inside the lymph node itself. When this happens, the lymph node becomes very painful and the nearby skin gets red and warm. You may also have a fever. If this happens, call your healthcare provider. You may need to take antibiotics. You may also need to have the lymph node drained.

Home care

Follow these guidelines when caring for yourself at home:

• Make a warm compress by running warm water over a washcloth. Put the compress on the sore area until the compress cools off. Repeat this for 20 minutes. Use the compress 3 times a day for the first 3 days, or until the pain and redness start to get better. The heat will make more blood flow to the area and speed the healing process.

• You may use acetaminophen or ibuprofen to control pain and fever, unless another medicine was prescribed for this. Don’t use ibuprofen in children under 6 months of age. If you have chronic liver or kidney disease, talk with your healthcare provider before using these medicines. Also talk with your provider if you’ve had a stomach ulcer or digestive tract bleeding. Don’t give aspirin to anyone under 18 years of age who is ill with a fever. It may cause severe liver damage.

Follow-up care

Follow up with your healthcare provider, or as advised.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

• Redness over the lymph node

• Swelling or pain in the lymph node gets worse

• Lymph node is getting soft in the middle

• Pus or fluid drains from the lymph node

• You have trouble breathing or swallowing

• Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

• You have questions or concerns 

Lymph Nodes and the Covid-19 Vaccine

LOUISVILLE, Ky. —The COVID-19 vaccine rollout is underway, and doctors now warn about a recently discovered side effect that could cause needless worry.

What You Need To Know

• Some who receive the COVID-19 vaccine experience swollen lymph nodes
• Swollen nodes are a symptom of other ailments, including cancer
• Doctor say this is normal
• If you are concerned, contact your physician

Some people experience swollen lymph nodes at the injection site, which may be mistaken for various forms of cancer.  But actually, this is merely the body’s response to the vaccine. Dr. Jason Smith, Chief Medical Officer at UofL Heath, described his own experience with this phenomenon.

“I’ve had a lot of lymph nodes swollen in my neck, in my arm, and underneath my arm after the injection and it was just on the side I had received the injection on,” Smith explained that this is quite normal; it means the vaccine is working. He said, “(It’s) Just your body’s immune system producing the cells and the antibodies to fight the COVID infection, which is what we want, right? And so that is a good sign that means you are having a good response to the vaccine.”

Smith also understands how scary finding a swollen lymph node can be for women, which can be a sign of breast cancer.

“You are talking about lumps in your arm, armpit, on your arm, or your chest wall, and so you could mistake that possibly for a mass,” Dr. Smith said.

After a few days, things returned to normal for Dr. Smith, but he’s encouraging folks to talk to their doctor if things don’t clear up or they have additional concerns.

“If it is related to the vaccine, it should be self-limited, so it’s something to keep in mind and look for, obviously. If it comes and goes, then we are ok. If it doesn’t go away, that’s the sign that you need to talk to somebody, particularly after about five to seven days.”

Smith also says both the Pfizer and Moderna vaccine can produce this side effect.

90,000 Enlarged lymph nodes. Do you need an oncologist or a therapist?

Every third appeal to an oncologist on social networks or on portals of remote counseling is formulated something like this: “please help me, I have enlarged lymph nodes.”

As a rule, young people write, usually from 18 to 25 years old, and I do not remember a case when in the end it turned out that the situation required treatment by an oncologist. Most often, an increase in lymph nodes was caused by a sore tooth, throat, conjunctivitis, and so on.

It is clear that fear and fear for your health in such cases make you immediately run to the oncologist.

However, is it that simple, and is it worth rolling your eyes about any handling of an enlarged l / node?

My personal statistics show that if a person comes for a full-time consultation, he is already one of those few whose situation was not limited to the banal “it got sick and passed”.

Let’s take a closer look at how the lymphatic system works and understand the nature of enlarged lymph nodes.

Fact number 1

Lymph nodes are an integral part of our body.

In total, there are about several hundred of them and they are usually located along the lymphatic vessels, which usually run along the large venous vessels.

Lymphatic vessels drain lymph (interstitial fluid) and “filter” it through the lymph nodes, where an army of lymphocytes is ready to deal with almost any infection.

Fact No. 2

Lymphatic vessels are not something abstract.

It is worth crossing or bandaging them, for example, during surgery on the axillary lymph nodes for breast cancer, and lymphostasis is most likely to develop – swelling of the limb, which, again, with a high probability will not go away.

The most visible to us from the point of view of inspection – the so-called peripheral lymph nodes (cervical, supraclavicular, axillary and inguinal) can increase, and in most cases, these are manifestations of reactive lymphadenopathy – an inflammatory reaction that indicates the fight against infection.

Fact No. 3

Cervical and submandibular l / nodes are most often inflamed, because in the facial region of the skull there are many open mucous membranes and related infections.

Sore throat, carious or decayed teeth, ear and ocular bacterial and viral infections are the most common causes of cervical lymphadenopathy. Axillary and inguinal l / nodes react by the same principle.

Therefore, if the lymph node is worried, first of all you need to go to the therapist, dentist, ENT doctor.

In case of an incomprehensible genesis of lymphadenopathy, the doctor will prescribe an ultrasound scan, and in the process of this study, attention will be directed mainly not to the size of the l / node, but to its shape and differentiation of the structure.

Fact No. 4

It is impossible to understand the nature of the enlargement of lymph nodes by WTSAP or during a telemedicine consultation.

Enlargement of the lymph node even up to 1.5-2 cm in the absence of differentiation disorders.

Fact No. 5

Lymph nodes increase in cancer, because cancer cells enter the lymphatic vessels draining a certain area, which then settle in the “filters” (lymph nodes) in the form of metastases and begin to grow there.

Such lymph nodes do not shrink after the treatment of infectious diseases, but only enlarge, merging with other lymph nodes into conglomerates, going beyond the l / node and fixing it in the surrounding tissues. Such lymph nodes are rarely painful, they are dense, very dense.

Often in cancer, the lymph nodes are affected by a “chain” that is well defined on palpation. In lymphomas, conglomerates are often visible from the side. Of course, with such manifestations, one must go to an oncologist and hematologist.

A biopsy will be performed for suspicious nodules for no other reason. This is either a puncture with a needle with a sampling of material, or an operation to completely remove the lymph node for histological examination.

Summing up

Most cases of swollen lymph nodes are associated with inflammation. An ultrasound scan allows you to assess the structure of the lymph node and helps the doctor decide whether a biopsy is necessary.

And the most important thing is that before you go to an oncologist with an enlarged lymph node, you need to contact at least a therapist who will conduct an examination and try to exclude commonplace things.

Don’t get sick!

You can read Ruslan Absalyamov’s Instagram here.

90,000 Neck knot or why you need to know the cause of lymphadenitis

A lump on the neck or why you need to know the cause of lymphadenitis.

Many of us are rather frivolous about swollen lymph nodes, believing that this trouble will go away on its own. There is, of course, a successful outcome, and the lymph glands recover on their own to their usual size.But most often the enlarged nodes begin to hurt, the skin over them turns red, the temperature in this part of the body rises. This is how lymphadenitis develops – inflammation of the lymph nodes.

We asked the therapist Dmitry Nikolaevich ZABASHTA to tell you more about this disease.

– What is the lymphatic system and what is its role in the body?

– The lymphatic system consists of a network of small vessels that collect excess fluid (lymph), foreign particles and other unnecessary substances from body tissues and cells.This is a kind of drainage system (rinsing and cleaning). Small lymphatic vessels, merging with each other and falling into larger ones, pass through the lymph nodes. Lymph nodes are a kind of filters that trap and neutralize microbes and other toxic substances that have entered the body. Further, the lymphatic vessels, connecting into two large ducts, flow into the blood veins.

– Why are the lymph nodes inflamed?

– If a large number of microbes enter the lymph node, then it ceases to cope with their neutralization and begins to ‘scream’ for help, that is, to become inflamed.And this means that there is some kind of infection center in the body.

– Where do lymph nodes usually swell?

– The lymph node is a barrier that prevents infection from spreading further through the body. The lymphatic system begins to fight microbes already in its vessels, and therefore very often you can see a pink thin path going from the source of infection to the inflamed lymph node. The cause of lymphadenitis can be a crack in the skin, a splinter, a scratch. A small suppuration causes mild pain, and a person usually pays no attention to it.But then suddenly it starts to hurt in the groin or axillary regions, a swelling occurs, the lymph nodes enlarge and become painful to the touch. This means that the local immunity did not cope with the infection and it spread further. Each lymph node is responsible for its own specific area in the body. And if the focus of infection is, for example, on the leg, then the popliteal node becomes inflamed first. When the defense is weakened, the germs move into the groin node. Any infectious process can be accompanied by lymphadenitis.Depending on the location of the microbes, different lymph nodes become inflamed. For example, submandibular lymphadenitis is a sign of caries, tonsillitis (inflammation of the tonsils) or gingivitis (inflammation of the gums). If several lymph nodes become inflamed at once, this means that the infection is too advanced. With a painless increase in the group of lymph nodes, a tumor process is not excluded.

– Therefore, with lymphadenitis, it is not necessary to treat the lymph nodes, but to fight the infection?

– Quite right.If you remove the root cause, the lymphadenitis will subside by itself, and the nodes will return to their original appearance (with the exception of their suppuration, which requires more serious attention). Sometimes it is enough to disinfect the wound several times a day to get rid of lymphadenitis. Some diseases (for example, tonsillitis) are accompanied by inflammation of the lymph nodes, which recover as the disease subsides. Therefore, you should not rush to discharge, even if the temperature has returned to normal and all the symptoms of the disease have passed, but the lymph nodes are still enlarged and painful.This suggests that the process of recovery in the body is not yet complete, and if you neglect this signal, then complications cannot be avoided.

– What mistakes do patients make when trying to cope with lymphadenitis on their own?

– Do not self-medicate with lymphadenitis. It is unacceptable to warm up the nodes, apply ointments on them. If the lymph nodes are enlarged and painful, you should immediately consult a doctor – a therapist or surgeon. Treatment will be prescribed depending on the disease.

– In what cases do the lymph nodes have to be removed?

– Lymph nodes are removed during tumor processes, since they accumulate non-neutralized malignant cells that can spread throughout the body and cause secondary tumors (metastases). An increase in lymph nodes with tumors is not lymphadenitis, but outwardly manifests itself in the same way.

Daria PONOMAREVA.

By the way, cat scratches are not harmless.

Swollen lymph nodes can occur from a simple cat scratch if a cat has infected you.An infected cat is no different from a healthy one. The cats themselves do not get sick, but the person is infected by scratching, biting and even licking. A few days after the injury, the victim begins to enlarge the lymph nodes that are in the immediate vicinity of the bite, the temperature may rise, and often a rash appears. If the state of the immune system is good, then the disease will go away by itself, causing a lot of trouble. To avoid them, it is advisable to take immediate action. Treat the area of ​​scratches and bites with a 2% solution of hydrogen peroxide, and then with iodine or alcohol.Self-medication is not worth it, it is better to immediately consult an infectious disease doctor. You may need to use antibiotics or hormonal drugs. Positive results can be obtained only by combating the underlying disease, which is the root cause of the enlargement of the lymph glands. Preventive measures for cat scratch disease are simple: wash the cat with disinfectants (drugs to kill parasites) and try not to bring games with a pet to scratches and bites.

Sentinel lymph node biopsy for skin melanoma in Israel

How does the lymphatic system work?

Lymph nodes are small, rounded formations that are part of the lymphatic system.They are widespread throughout the body and are connected to each other by a network of lymphatic vessels.

Group clusters of lymph nodes are localized in the neck, armpits, chest, abdomen and groin. The clear fluid that circulates through the lymphatic vessels and lymph nodes is called lymph. It is formed from intercellular fluid that “seeps” through small blood vessels called capillaries. This liquid has a complex composition and consists of blood plasma, proteins, glucose and oxygen.It washes most of the cells in the body, providing them with oxygen and nutrients necessary for their growth and functioning. The intercellular fluid utilizes toxins from the cells, and also participates in the neutralization and elimination of bacteria and viruses from the body. Interstitial fluid eventually accumulates in the lymphatic vessels, where it becomes known as lymph. Lymph flows through the body’s lymphatic vessels to reach two large ducts at the base of the neck, where it is emptied into the systemic circulation.

Lymph nodes are important components of the immune system. They contain T- and B-lymphocytes, as well as other types of cells of the immune system. These elements control the lymph for the presence of “foreign” substances such as bacteria and viruses. If a foreign substance is detected in the body, some of the cells are activated and an immune response occurs.

Lymph nodes also play an important role in diagnosis. Lymph node examinations help answer the question of whether cancer cells have spread to other parts of the body.Cancer cells in some tumors spread throughout the body through the lymphatic system, and one of the earliest sites for these tumors to spread is in nearby lymph nodes.

What is a sentinel lymph node?

The sentinel lymph node is the first watchful lymph node in which cancer cells are most likely to be expected from the primary tumor.There can be several such nodes.

Prices

What is a sentinel lymph node biopsy?

Sentinel Lymph Node Biopsy – Sentinel Lymph Node Biopsy (SLNB) – a procedure in which a sentinel lymph node is identified and removed for subsequent detection of cancer cells.Sentinel lymph node biopsy is a surgical procedure that is performed with the lymphogenous spread of the tumor process outside the primary tumor, while a biopsy of the lymph node adjacent to the tumor is performed. This manipulation is most often used to determine the prevalence of breast cancer and melanoma.

A negative SLNB result suggests that the cancer has not spread to nearby lymph nodes or other organs. A positive SLNB result indicates that cancer cells are present in the sentinel lymph node and may be in other nearby, so-called regional lymph nodes, and possibly other organs.This information can help the doctor determine the stage of the cancer (the degree of the disease and its prevalence in the body) and develop an optimal treatment plan.

How is SLNB conducted?

The surgeon injects a radioactive substance, a special blue dye, near the tumor to locate the sentinel lymph node. Then, to search for the sentinel lymph node, a device is used that detects the activity of the nodes that have absorbed the radioactive dye. After the sentinel lymph node is located, the surgeon makes a small incision (about 1/2 inch) of the skin in the projection of the lymph node and removes it.

Sentinel Lymph Node Biopsy (SLNB) is a procedure in which a sentinel lymph node is identified and removed for subsequent detection of cancer cells.

Then a histopathological examination of the sentinel node for the presence of cancer cells is carried out. If cancer is found, the surgeon may remove additional lymph nodes. This is done either during one procedure or on subsequent biopsies. SLNB is more often performed on an outpatient basis and may sometimes require a short inpatient stay.

SLNB is usually performed concurrently with removal of the primary tumor. However, this procedure can also be performed before or after removal of the tumor.

What are the benefits of SLNB?

The technique allows you to determine the stage of cancer and assess the risks of the spread of the tumor process to other parts of the body. SLNB may help some patients avoid extensive lymph node removal.Removal of additional nearby lymph nodes may not be necessary if the sentinel lymph node does not contain cancer cells. Currently, the SLNB technique is the gold standard in breast cancer and melanoma surgery. It allows you to minimize the risks of recurrence and spread of the tumor process, as well as to avoid extensive traumatic interventions on the lymphatic system.

Targeted removal of lymph nodes – prevention of complications

Any, especially voluminous, surgical interventions on the lymph nodes can have adverse consequences, while the fewer lymph nodes are removed, the less severity of complications will be.

Potential side effects of lymphatic surgery

• Lymphostasis (lymphedema) – tissue edema. Sentinel lymph node biopsy or more extensive surgery on lymph nodes and lymph vessels extending towards and away from the sentinel lymph node disrupts normal lymph drainage through the affected area, accompanied by abnormal lymphatic fluid accumulation and edema. Also, patients with lymphostasis may experience pain and discomfort in the affected area.In the case of major operations on the lymph nodes in the axillary and groin areas, the edema can spread to the entire limb. In addition, the increased content of lymph in the limb can potentiate the development of infectious complications. Very rarely, chronic lymphedema due to extensive removal of the lymph nodes is complicated by cancer of the lymphatic vessels, the so-called. lymphangiosarcoma.
• Seroma – accumulation of lymphatic fluid at the site of surgery.
• Numbness, soreness at the site of surgery.
• Dysfunction of the affected limb or body part.

Does sentinel have other side effects?

• Like any other surgical procedure, a Sentinel biopsy can be accompanied by short-term pain, swelling and hemorrhage at the site of surgery, as well as the risk of tissue infection.
• Some patients may have an allergic reaction to the blue dye used in sentinel lymph node biopsies.
• False negative biopsies are situations where cancer cells are not found in sentinel lymph nodes while they are present and may have already spread to other regional lymph nodes or other organs. In such cases, erroneous negative biopsy results give the patient and the doctor a false sense of security about the extent of cancer in the patient’s body.

Is sentinel lymph node biopsy used to treat other cancers?

Sentinel biopsy is used primarily in the treatment of breast cancer and melanoma.However, the method is currently being explored to detect other cancers, including colorectal cancer, stomach cancer, head and neck cancer, thyroid cancer, and non-small cell lung cancer.

Sentinel lymph node biopsy for melanoma

A meta-analysis of 71 studies involving 25,240 patients was to answer the question of whether melanoma patients who received a negative sentinel lymph node biopsy, in the absence of clinical signs of other lymph node involvement, can avoid major traumatic lymph node surgery during primary removal of the tumor.The results of the study show that this question can be answered in the affirmative: the risk of cancer recurrence in regional lymph nodes in patients with negative SLNB was less than 5%.

Sentinel lymph node biopsy allows you to determine the stage of cancer and assess the risks of the spread of the tumor process to other parts of the body

Currently, the National Institutes of Health and the John Wayne Cancer Institute (USA) are conducting a large-scale Selective Lymphadenectomy Study II (MSLT-II), the purpose of which is to answer the question of whether the removal of the remaining regional lymph nodes is clinically significant for survival in the presence of tumor cells in the sentinel lymph node.The study is designed for 10 years, more than 1900 patients are taking part in it.

Biopsy of sentinel lymph nodes in melanoma can be performed as an independent diagnostic manipulation, as well as during primary surgery to remove the tumor. The cost of a lymph node biopsy is variable and depends on the scope of the planned diagnosis or surgical measures. The complexity of the manipulation of the lymph node biopsy, the price, the degree of preparation of the patient and the time spent in the hospital are set individually, after prior consultation with a specialist.

Why sentinel lymph node biopsy is not performed in Russia and other CIS countries

1. Necessary elements for biopsy of the sentinel lymph node – a radioactive element and a dye are not certified in Russia today. This makes it impossible and illegal to conduct an operation on the territory of the Russian Federation.
2. Lack of required equipment
3. Lack of experience among doctors in carrying out this operation.

Due to the above factors, the number of patients from Russia diagnosed with melanoma who seek treatment at the Melanoma Unit oncodermatology clinic is growing every year.

Sources

90,000 Lymphadenitis (inflammation of the lymph nodes) in dogs

The main task of the lymph nodes is to prevent the penetration of pathogenic microorganisms into the dog’s body. In carrying out this function, they also participate in the redistribution of fluid and produce cells of the immune system. That is why their inflammation requires effective and immediate treatment. Why do lymph nodes get inflamed? How do the symptoms of the disease appear in a dog? What is the treatment? For more details, see below.

Read in this article:

What is this?

Causes of inflammation of the lymph nodes

Disease symptoms: when is it necessary to see a veterinarian?

Diagnostics: basic methods

How is lymphadenitis treated?

What to do at home?

Can complications arise?

Prevention

What is this?

Lymphadenitis (lymphadenopathy) is an inflammatory process that affects the lymph nodes.They carry out a filtering function for lymph coming from various internal organs of the pet, and are located next to the blood vessels. That is why their inflammation is a serious threat to the health and life of the animal.

Forms of lymphadenitis that can be diagnosed in a dog:

• Sharp. All signs of inflammation develop rapidly, while the symptoms are clearly pronounced. In 9 out of 10 cases with acute lymphadenitis, the animal has a feverish state (increased body temperature).
• Chronic. Its main feature is the “blurring” of symptoms. They do not have the severity characteristic of lymphadenitis and arise gradually. Most often accompanied by pronounced pallor, poor appetite, difficulty breathing.

All dog breeds are equally prone to lymphadenitis. However, elderly pets and animals with weakened immune systems are at particular risk. Their state of health must be treated even more carefully in order to prevent dangerous consequences for the whole organism.

Causes of inflammation of the lymph nodes

Nonspecific inflammation of the lymph nodes develops when various pathogenic microorganisms enter the lymphatic system of the dog’s body (for example, bacteria, rickettsia or viruses). In addition, staphylococci, streptococci and Escherichia coli can become the causes of the disease. In this case, ulcers, inflammatory processes of soft tissues, purulent wounds, as well as caries or thrombophlebitis can serve as the primary focus of infection.

In addition to nonspecific lymphadenitis, specific lymphadenitis is also isolated, which occurs as a complication in a serious illness of an animal (for example, tuberculosis, brucellosis, salmonellosis).

In about 5-7% of all visits to a veterinary clinic in Moscow, the development of lymphadenitis in a pet is provoked by other non-inflammatory factors:

• allergies due to frequent contact with an allergen,
• intoxication of the body,
• significant mechanical damage (for example, from a collar that is too tight),
• autoimmune reactions of the dog’s body,
• parasitic disease,
• reaction after vaccination of an animal, etc.

Disease Symptoms: When Should You See Your Veterinarian?

An attentive and caring owner will be able to quickly detect a disease in his pet (for example, during a game). The main symptom indicating the development of lymphadenitis is inflammation of the lymph nodes and their pronounced increase in size. At the same time, they become painful, so the dog may react negatively even to light stroking in the area of ​​inflammation.

Note that the lymph nodes are located throughout the body of the animal: behind the ears, behind the jaw, in the groin, at the base of the neck, and also in the armpits of the forelimbs.

Other signs to help you identify lymphadenitis in your pet:

• Temperature rise.

The dog’s body temperature rises sharply, in especially severe cases it rises to 42 ° C. In this case, there is general weakness, apathy, chills. The animal refuses food, practically does not drink water. Sleep disturbances, severe anxiety are possible.

• Rapid breathing .

It becomes more difficult for the pet to breathe.He has severe shortness of breath even in the absence of small physical activity (running, walking, etc.). At the same time, there is an increase in heart rate (tachycardia).

• Visual visibility of the lymph nodes.

The lymph nodes behind the jaw and neck of the dog are highly visible. They increase in size and are easily palpable. Pay special attention to this if you have a short-haired dog – the lymph nodes will be very noticeable.

Found one or more signs of lymphadenitis in your pet? Do not hesitate – urgently contact a professional veterinarian in Moscow.Self-treatment is unacceptable! Do not risk the health and life of your dog – take it to the veterinary clinic, where your pet will be provided with qualified assistance.

Diagnostics: Basic Methods

Inflammation of the lymph nodes is a very dangerous disease. Taking into account the peculiarities of the lymph and its movement, the likelihood of the spread of infection throughout the pet’s body increases highly. If you do not respond to the problem in a timely manner and do not seek professional help, then all internal organs and systems of the pet will be affected by the infection.

The main methods used to diagnose lymphadenitis:

• close visual inspection of the pet,
• careful palpation of lymph nodes (in the groin, under the jaw, etc.),
• laboratory blood test to determine the level of leukocytes and eosinophils,
• taking a puncture from the lymph node to identify the nature of the inflammation.

X-ray and ultrasound methods are widely used in the diagnosis of the disease.In this case, a biopsy is performed (excision of a piece of tissue for microscopic examination), which allows you to establish the root cause of the inflammation in your pet’s body.

How is lymphadenitis treated?

The key to successful treatment of lymphadenitis in a dog is an appeal to a reliable veterinary clinic. Here they will not only quickly and accurately diagnose, but also prescribe an effective therapy. In the treatment of lymphadenitis, an integrated approach is important, therefore the veterinarian is prescribed pharmacological drugs of various spectrum of action.

First, the inflammatory process is suppressed. For this purpose, a course of antibiotics is prescribed, selected by the doctor, taking into account the sensitivity of pathogenic microorganisms that provoked the development of the disease in the dog.

Secondly, hepatoprotectors (drugs designed to maintain liver function) and probiotics are prescribed. They do not allow side effects from antibiotics, as they must be used for a long time and regularly.

Thirdly, a vitamin and mineral complex is prescribed. As a rule, special emphasis should be placed on vitamin A (retinol), vitamin B2 (riboflavin) and vitamin C (ascorbic acid). They will help the dog’s body recover from the disease much faster.

In cases where inflammation of the lymph nodes is accompanied by a purulent process, surgical treatment is prescribed. It is necessary to open the inflamed tissue area, and then install drainage (to remove exudate).In the future, the rehabilitation period includes the regular application of anti-inflammatory ointments and the use of drugs to strengthen the animal’s immune system.

In some cases, the pet can be assigned physiotherapy procedures. For example, heat treatment (ultra-high frequency therapy) helps to rapidly reduce the inflammatory response. However, it is important to take into account contraindications, the main of which is the detection of malignant neoplasms (oncology).

What to do at home?

The first thing to do when signs of lymphadenitis are found is to contact your veterinarian as soon as possible.This will make it possible to diagnose the disease in a timely manner and prescribe an effective course of therapy or surgery (for example, if inflammation is accompanied by purulent processes).

The next step is to provide the dog with a comfortable environment. When you return from the clinic, do not neglect your doctor’s orders. Give the animal the prescribed medications at the correct time. Keep your pet in a warm, clean, draft-free area. Take care of his nutrition, include more vitamins and minerals in it, so that your dog’s strength will recover even faster.

Can complications arise?

If you promptly seek help from a veterinarian and treat the dog in accordance with his instructions, you will be able to avoid complications that arise from inflammation of the lymph nodes in animals. If this is not done, the functioning of the entire lymphatic system will be disrupted, which means that the pet will lose the natural barrier that protects it from infections.

With nonspecific lymphadenitis, the following complications are possible:

• phlegmon,
• abscess,
• thrombophlebitis,
• sepsis,
• lymphostasis, etc.

The prognosis in the absence of treatment is a lethal outcome.

Prevention

It is best to take early care of your dog and take preventive measures to avoid swelling of the lymph nodes. The most important thing is to timely treat infectious diseases, since in most cases it is they that provoke the development of lymphadenitis in an animal. Do not self-medicate, seek the help of an experienced and qualified veterinarian.

Other preventive measures to avoid inflammation of the lymph nodes in the dog:

• Never neglect allergic reactions . It is best to quickly detect the allergen and eliminate it from the pet’s life;
• Take steps to strengthen your dog’s immune system. The stronger it is, the more reliably it resists any viruses, parasites and fungi;
• Eat a balanced diet. Choose the right food for your dog by breed and age.

Remember that your pet needs your attention and care. Unfortunately, he will not be able to say what worries him, therefore, it is necessary to carefully consider the state of animal health. Do not neglect regular preventive examinations by a veterinarian and seek qualified help in a timely manner.

Health to you and your pet!

See also:

Predictors of latent metastatic lesions of lymph nodes in the central zone of the neck in patients with differentiated thyroid cancer in the early stages | Licorice

Rationale

The incidence of cancer of the thyroid gland (TG) is growing due to differentiated forms.Thus, in the United States, from 1973 to 2009, the incidence of thyroid cancer increased 3.6 times, from 3.5 to 12.5 cases per 100 thousand population [1]. Similarly, in Russia, the incidence of this type of cancer from 2010 to 2015 increased from 5.9 to 7.2 per 100 thousand population. The growth in 6 years was more than 20%. To date, more than 10,000 new cases of thyroid cancer are registered annually in the Russian Federation [2]. The introduction of ultrasound into widespread practice has led to the fact that in the overwhelming majority of cases thyroid carcinomas are detected at early stages, often before the development of clinical manifestations [3].The frequency of metastatic lesions of regional lymph nodes in differentiated thyroid cancer (DTC) reaches 50-60% [4, 5]. There are a number of controversial issues in approaches to treatment in patients with early stages of tumor. One of them concerns the feasibility of performing prophylactic central cervical lymph node dissection (CSLD). On the one hand, CSHLD allows detecting and removing hidden metastases in 22.3–61.5% of patients [6–8] and avoiding regional recurrence in this area [9, 10].According to Y.W. Chang et al., Even with microcarcinoma, the frequency of metastatic lesions reaches 39% [11]. On the other hand, removal of level VI lymph nodes is associated with an increased risk of developing specific complications such as laryngeal paresis and hypoparathyroidism. However, in most cases, there is only an increase in the number of patients with transient hypocalcemia, and the function of the parathyroid glands is restored within 6–12 months, in comparison with the groups of patients who underwent thyroidectomy without CSHD [12, 13].In recent years, there have been reports in the literature demonstrating an increase in relapse-free survival in patients who underwent prophylactic CSHLD [14-16]. Thus, according to M. Barczynski et al., The ten-year tumor-specific survival rate was significantly higher in the group of patients after removal of the VI level neck tissue (98 vs 92.5%, p = 0.034) [17]. At the same time, to date, there is no information in the literature on an increase in overall survival in patients with thyroid cancer who underwent CSHD, which does not allow recommending it for widespread use.

Thus, the role of prophylactic lymph node dissection in the central zone of the neck in DTC remains controversial. The search for factors affecting the development of latent metastases in group VI lymph nodes, in order to clarify the indications for CSHLD, requires additional research.

Target

The aim of the study is to determine predictors of latent metastatic lesions of group VI lymph nodes.

Methods

Study design

A one-stage, single-center, uncontrolled study was carried out, it was planned to conduct a detailed analysis of a group of patients with DTC with clinical stage cT1-2N0M0 who underwent surgical treatment at the Russian Scientific Center of X-ray Radiology of the Ministry of Health of Russia.

Compliance Criteria

The study included all patients, regardless of gender and age, who, according to examination data (ultrasound of the thyroid gland, cervical lymph nodes and abdominal organs, CT scan of the chest, osteoscintigraphy), revealed differentiated thyroid cancer: a tumor of up to 4 cm, limited to the thyroid gland, without signs of regional and distant metastasis. The study did not include patients for whom surgical treatment is contraindicated due to the severity of concomitant diseases, and patients with medullary and rare morphological forms of thyroid cancer.

Conditions

The study is monocentric: it was carried out at the Federal State Budgetary Institution “RNTSRR” of the Ministry of Health of Russia.

Study duration

Duration of the study – 5 years, the beginning of the study in 2012

Description of medical intervention

Patients with differentiated thyroid cancer cT1-2N0M0 underwent surgical treatment in the amount of standard thyroidectomy with preventive bilateral CSHLD.The boundaries of lymph node dissection were: from above – the hyoid bone, lateral-medial edges of the common carotid arteries and the brachiocephalic trunk on the right, from below – the jugular notch, and behind – the prevertebral fascia [18].

Main study outcome

The main outcome of the study was the frequency of changes in the clinical diagnosis according to the data of postoperative morphological examination.

Subgroup analysis

In the course of statistical processing of the study results to identify the significance of individual factors in predicting the risk of metastatic lesions of the lymph nodes, the participants were divided into subgroups according to several criteria: age (group ≤45 years old and group> 45 years old), gender (male, female), tumor size (group ≤1 cm and group> 1 cm), multifocality (present or not), presence of background diseases (present or not).

Methods of registration of outcomes

To register the main outcome of the study, a pathomorphological study of the postoperative material was used (detection of hidden metastases in the lymph nodes of group VI and the exit of the tumor outside the thyroid capsule, leading to a change in the clinical stage of the disease).

Ethical review

An ethical examination was carried out and the protocol was approved by the independent ethical committee of the Federal State Budgetary Institution “RNTSRR” of the Ministry of Health of Russia (meeting No. 2 of 26.02.2012).

Statistical Analysis

Principles for calculating the sample size: The sample size was not pre-calculated.

Methods of statistical data analysis. Information processing was carried out in a Microsoft Access database using Microsoft Excel tables and Biostat software (AnalystSoft Inc., Republic of Belarus). For the analysis of quantitative characteristics, we used one-way analysis of variance, and qualitative ones – the c-squared test.Multivariate analysis was performed using SPSS 20 software (IBM Company, USA). Variables with a value of p <0.05 in univariate analysis were included in multivariate logistic regression analysis to determine the odds ratio.

Results

Objects (participants) of the study

The study included 105 patients. Women accounted for 91.4% (96). Age ranged from 22 to 79 years and averaged 49.6 ± 13.2 years. Patients over 45 years old prevailed, accounting for 62.9%.102 (98%) patients had papillary cancer and 3 (2%) had minimally invasive follicular cancer. The size of the tumor ranged from 0.3 to 4 cm. In 92 (87.6%) patients, the tumor node did not exceed 2 cm in maximum dimension. Multifocal growth was noted in 29 (27.6%) cases, of which both thyroid lobes were affected in 19 (18.1%). Isthmus tumors occurred in 11 (10.5%) patients, and in 9 cases they were combined with carcinomas in the lobes. Ingrowth and germination of the anatomical capsule of the thyroid gland was detected in 38 (36.2%) patients.

Main results of the study

The number of removed lymph nodes in the central zone ranged from 2 to 24 and averaged 8.7 ± 5.1. Latent metastases were detected in 32 (30.5%) patients. The frequency of metastatic lesions of group VI lymph nodes, depending on the clinical and morphological characteristics of the tumor, is presented in table. 1.

Table 1. Factors of latent metastatic lesions of lymph nodes in the central zone of the neck according to univariate analysis

From the data presented, it can be seen that lymphogenous metastasis of the central group is more common with invasion of the anatomical capsule of the thyroid gland ( p = 0.006), under 45 years of age ( p = 0.014), the presence of its own capsule of the tumor node ( p = 0, 03) and a tumor size of more than 1 cm ( p = 0.04).At the second stage, a multivariate analysis was carried out based on the study of the same clinical and morphological signs, the results of which are presented in table. 2. According to the presented data, independent factors influencing the development of metastases in the central zone of the neck were: invasion of the anatomical capsule of the thyroid gland ( p = 0.003), patients’ age ≤45 years ( p = 0.005) and the presence of their own capsule of the tumor node ( p = 0.007). After excluding patients with invasion of the thyroid capsule, tumor size did not significantly affect the frequency of metastasis ( p = 0.187).

Table 2. Predictors of latent metastatic lesions of the lymph nodes of the central zone of the neck according to multivariate analysis data

Additional research results

It should be noted that in the group of patients with multifocal growth, the frequency of metastatic lesions of the central cervical lymph nodes was higher than in solitary tumors (42.8 versus 26%), but the difference is not significant, possibly due to insufficient sampling.For the same reason, based on the small number of men in the group, it is impossible to draw a conclusion about the influence of gender on the development of metastases. Background diseases of the thyroid gland were present in 65.7% of patients, the most frequent was chronic autoimmune thyroiditis – 48 (45.7%), however, the presence of additional thyroid pathology did not affect the frequency of metastasis (Table 2). It should be noted that in chronic thyroiditis the number of removed lymph nodes was significantly higher than in its absence (10.4 ± 5.4 vs 7.4 ± 4.4, p = 0.002).When analyzing the morphological structure of the tumor, it was noted that regional metastases did not occur in cases of follicular cancer and were rare in follicular variant of papillary cancer (Table 3).

Table 3. Dependence of the frequency of lymphogenous metastasis on the morphological structure of the tumor

Note. * Oncocytic – 3, uortin-like – 1, trabecular and solid-trabecular – 2, morullary – 1, high-cell – 1.

As follows from the table.3, latent regional metastases were more common in typical and papillary carcinomas with reduced differentiation; however, it is impossible to assess the difference in the groups due to the insufficient sample size.

Adverse events

No adverse events were observed.

Discussion

Summary of the main research result

Thus, the age of patients ≤45 years, the unencapsulated variant of carcinoma, the presence of invasion of the thyroid capsule were predictors of latent metastatic lesions of the lymph nodes of the central group of the neck in the early stages of thyroid cancer.As shown above, the germination of the anatomical capsule of the thyroid gland was detected in 30 (28.6%) patients, hidden metastases in the central zone of the neck were recorded in 32 (30.5%) patients. Based on the determination of these morphological parameters (pT3, pN1a), restaging was performed in 49 (46.7%) patients. Thus, in the study group, latent factors of negative prognosis were revealed in almost half of the patients.

Discussion of the main research result

To date, the implementation of preventive central cervical lymph node dissection remains controversial.According to the recommendations of the American Thyroid Association (2009, 2015), in the presence of a tumor out of the thyroid gland and the presence of metastases in the lymph nodes of group VI, it is indicated to perform CSHLD [19]. As shown by our study, in almost half of the patients, these factors were identified according to the data of morphological research. Unfortunately, modern diagnostic methods (ultrasound, CT), intraoperative revision and urgent histological examination do not always allow to reliably assess the local and lymphogenous spread of the tumor, which can cause errors and lead to the need for repeated operations.Research aimed at improving diagnostics, identifying prognostic parameters, as well as new techniques and technologies aimed at reducing specific complications after cervical lymph node dissection may be the main vectors for solving this problem.

Study Limitations

When assessing some factors indicating the presence of latent lymphogenous metastasis, despite the difference in indicators, reliable data were not obtained due to insufficient sampling.Further study may reveal other predictors of latent metastatic lesions of group VI lymph nodes.

Conclusion

The use of thyroidectomy in combination with prophylactic CSHLD allowed restaging in 46.7% of patients by revealing the invasion of the thyroid capsule (28.6%) and latent metastases in the lymph nodes of group VI (30.5%). The age of patients, the presence or absence of the capsule, the presence or absence of invasion of the thyroid capsule are factors that can be used as predictors of latent metastatic lesions of the central lymph nodes.

Additional information

Funding source. The study was carried out with the financial support of the Federal State Budgetary Institution “Russian Scientific Center for Roentgenoradiology” of the Ministry of Health of Russia.

Conflict of interest. The authors declare no obvious and potential conflicts of interest related to the publication of this article.

Contribution of authors. Solodkiy V.A. – development of the concept and design of the study, editing the manuscript; Fomin D.K. – development of the concept and design of the study, analysis of the data obtained, editing the manuscript; Galushko D.A. – development of the concept and design of the study, statistical data processing, analysis of the data obtained, preparation of the text; Asmaryan A.G. – collection of material, statistical processing of data, analysis of the data obtained, preparation of text.

1. Morris LG, Sikora AG, Tosteson TD, Davies L.The increasing incidence of thyroid cancer: the influence of access to care. Thyroid. 2013; 23 (7): 885-891. doi: 10.1089 / thy.2013.0045.

2. The state of cancer care for the population of Russia in 2015. / Ed. Kaprina A.D., Starinskiy V.V., Petrova G.V. – M .: MNIOI them. P.A. Herzen; 2016. [Kaprin AD, Starinskiy VV, Petrova GV, editors. Sostoyanie onkologicheskoy pomoshchi naseleniyu Rossii v 2015 godu.Moscow: MNIOI im. P.A. Gertsena; 2016. (In Russ.)]

3. Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973-2002. JAMA. 2006; 295 (18): 2164-2167. doi: 10.1001 / jama.295.18.2164.

4. American Thyroid Association Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, Cooper DS, et al.Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009; 19 (11): 1167-1214. doi: 10.1089 / thy.2009.0110.

5. Rumyantsev P.O., Ilyin A.A., Rumyantseva U.V., Saenko V.A. Thyroid cancer, modern approaches to diagnosis and treatment. – M .: GEOTAR-Media; 2009. [Rumyantsev PO, Il’in AA, Rumyantseva UV, Saenko VA. Rak shchitovidnoy zhelezy, sovremennye podkhody kdiagnostike i lecheniyu.Moscow: GEOTAR-Media; 2009. (In Russ.)]

6. Katanyan G.A., Kizhvatov S.I., Ryabchenko E.V. Central lymphadenectomy for thyroid cancer. // Clinical and experimental thyroidology. – 2012. – T. 8. – No. 2. – S. 55–58. [Katanyan GA, Kijvatov SI, Ryabchenko EV. Central lymphadenectomy for thyroid cancer. Clinical and experimental thyroidology. 2012; 8 (2): 55-58. (In Russ.)] Doi: 10.14341 / ket20128255-58.

7. Shevchenko SP, Sidorov SV, Dymov AA, et al. Removal of level VI lymph nodes in differentiated thyroid cancer – yes or no? // Oncosurgery. – 2011. – T. 3. – No. 1. – S. 30–33. [Shevchenko SP, Sidorov SV, Dymov AA, et al. Lymphadenectomy in the level VI of the neck (anterior neck dissection) for differentiated thyroid cancer – Yes or No? Oncosurgery. 2011; 3 (1): 30-33. (In Russ.)]

8.Vergez S, Sarini J, Percodani J, et al. Lymph node management in clinically node-negative patients with papillary thyroid carcinoma. Eur J Surg Oncol. 2010; 36 (8): 777-782. doi: 10.1016 / j.ejso.2010.06.015.

9. Lang BH, Chan DT, Wong KP, et al. Predictive factors and pattern of locoregional recurrence after prophylactic central neck dissection in papillary thyroid carcinoma. Ann Surg Oncol. 2014; 21 (13): 4181-4187.doi: 10.1245 / s10434-014-3872-6.

10. Jiang LH, Chen C, Tan Z, et al. Clinical characteristics related to central lymph node metastasis in cN0 papillary thyroid carcinoma: A retrospective study of 916 patients. Int J Endocrinol. 2014; 2014: 385787. doi: 10.1155 / 2014/385787.

11. Chang YW, Kim HS, Kim HY, et al.Should central lymph node dissection be considered for all papillary thyroid microcarcinoma? Asian J Surg. 2016; 39 (4): 197-201. doi: 10.1016 / j.asjsur.2015.02.006.

12. Shen WT, Ogawa L, Ruan D, et al. Central neck lymph node dissection for papillary thyroid cancer: the reliability of surgeon judgment in predicting which patients will benefit. Surgery. 2010; 148 (2): 398-403. doi: 10.1016 / j.surg.2010.03.021.

13. Moo TA, McGill J, Allendorf J, et al. Impact of prophylactic central neck lymph node dissection on early recurrence in papillary thyroid carcinoma. World J Surg. 2010; 34 (6): 1187-1191. doi: 10.1007 / s00268-010-0418-3.

14. Sywak M, Cornford L, Roach P, et al. Routine ipsilateral level VI lymphadenectomy reduces postoperative thyroglobulin levels in papillary thyroid cancer.Surgery. 2006; 140 (6): 1000-1005; discussion 1005-1007. doi: 10.1016 / j.surg.2006.08.001.

15. Popadich A, Levin O, Lee JC, et al. A multicenter cohort study of total thyroidectomy and routine central lymph node dissection for cN0 papillary thyroid cancer. Surgery. 2011; 150 (6): 1048-1057. doi: 10.1016 / j.surg.2011.09.003.

16.Hartl DM, Mamelle E, Borget I, et al. Influence of prophylactic neck dissection on rate of retreatment for papillary thyroid carcinoma. World J Surg. 2013; 37 (8): 1951-1958. doi: 10.1007 / s00268-013-2089-3.

17. Barczynski M, Konturek A, Stopa M, Nowak W. Prophylactic central neck dissection for papillary thyroid cancer. Br J Surg. 2013; 100 (3): 410-418. doi: 10.1002 / bjs.8985.

18.American Thyroid Association Surgery Working Group, American Association of Endocrine Surgeons, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society, Carty SE et al. Consensus statement on the terminology and classification of central neck dissection for thyroid cancer. Thyroid. 2009; 19 (11): 1153-1158. doi: 10.1089 / thy.2009.0159.

19. Haugen BR, Alexander EK, Bible KC, et al.2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016; 26 (1): 1-133. doi: 10.1089 / thy.2015.0020.

Head and Neck Cancer – Prevention, Stages, Symptoms and Treatments

Introduction

Cancer begins when healthy cells change and grow uncontrollably, forming a mass called a tumor.The tumor can be cancerous or benign. Cancer is malignant, meaning it can grow and spread to other parts of the body. A benign tumor can grow but not spread to other tissues.

Head and neck cancer

Head and neck cancer is a term used to describe a number of different cancers that develop in or around the throat, larynx, nose, sinuses and mouth.

The majority of head and neck cancers are squamous cell carcinomas.This type of oncology begins in the cells of the epithelium, which makes up a thin layer of superficial tissue. Directly below the epithelium, in some areas of the head and neck, there is a layer of moist tissue called the mucosa. If cancer is found only in the squamous layer, it is called carcinoma in situ. If the cancer has grown outside of this cell layer and moved into deeper tissues, it is called invasive squamous cell carcinoma.

If head and neck cancer begins in the salivary glands, the tumor is usually classified as adenocarcinoma, adenoid cystic carcinoma, or mucoepidermoid carcinoma.

Types of head and neck cancer

There are 5 main types of head and neck cancer, each named for the part of the body where it is found.

• Laryngeal cancer and hypopharyngeal cancer . The larynx is an integral part of the vocal apparatus. This tubular organ on the neck is designed for breathing, speaking, and swallowing. It is located at the top of the windpipe, or trachea. The hypopharynx (esophagus) is the lower part of the throat surrounded by the larynx.
• Cancer of the nasal cavity and paranasal sinuses .The nasal cavity is the space behind the nose where air enters the throat. The paranasal sinuses are air-filled areas that surround the nasal cavity.
• Nasopharyngeal cancer. The nasopharynx is the air cavity in the upper part of the pharynx behind the nose.
• Oral and oropharyngeal cancer . The oral cavity includes the mouth and tongue. The oropharynx includes the middle of the throat, from the tonsils to the tip of the vocal apparatus.
• Salivary gland cancer .The salivary gland produces saliva. Saliva is the liquid that is secreted in the mouth to keep it moist and contains enzymes that break down food.

Other types of cancer can also be localized in the head and neck area, but their diagnosis and treatment are very different.

Risk factors and prevention of head oncology

A risk factor is anything that increases the likelihood of developing oncology in humans. Although risk factors often influence the development of cancer, most of them do not directly cause it.Some people with multiple risk factors may never develop cancer, while others with no known risk factors will. Knowing your risk factors and discussing them with your doctor can help you make more informed lifestyle and health care choices.

There are 2 substances that significantly increase the risk of head and neck cancer:

• Tobacco. Tobacco use means: smoking cigarettes, cigars or pipes; chewing or snuff.It is the most significant risk factor for head and neck cancer.
• Alcohol. Alcohol abuse increases the risk of developing malignant neoplasms. …

Sharing alcohol and tobacco increases this risk even more.

Factors that can increase your risk of head and neck cancer include:

• Prolonged sun exposure. This is especially true for lip cancers and scalp and neck cancers.
• Human papillomavirus (HPV). Sex with someone with HPV is the most common route of HPV infection. There are different types of HPV called strains.
• Epstein-Barr virus (EBV). Exposure to EBV (the virus that causes mononucleosis or “mono”) plays a significant role in the development of nasopharyngeal cancer.
• Pos. Men are 2-3 times more likely to develop head and neck cancer. However, the incidence of head and neck cancer in women has been on the rise for several decades.
• Age . People over the age of 45 are more at risk of cancer.
• Poor oral and dental hygiene .
• Environmental or Occupational Inhalants . Inhalation of various chemical compounds (paints and varnishes, asbestos) can increase the risk of developing a dangerous disease.
• Marijuana use .
• Incorrect power supply. A diet low in vitamins A and B increases risks.
• Gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux disease (LERD) . Reflux is associated with tumor growth in a given area.
• Weakened immune system .
• Exposure to radioactive radiation. Directly related to the development of the oncological process.
• History of head and neck cancer. People who have had head and neck cancer once have a higher chance of developing another cancer in the future.

Prevention

Tobacco cessation is an essential component of prevention.

• Refusal to use alcohol and marijuana.
• Regular use of sunscreen, including lip balm with sufficient sun protection factor (SPF)
• Reducing the risk of contracting HPV through HPV vaccination or by limiting the number of sexual partners. Using a condom during intercourse may not completely protect against HPV.
• Maintain proper dental care. Poorly fitted dentures can trap carcinogens from tobacco and alcohol. Dentures should be removed every night, cleaned and rinsed thoroughly every day.

Follow-up and follow-up

Treatment for people diagnosed with cancer does not end when active therapy is completed. The attending physician will continue to check to see if the cancer has recurred, monitor any possible side effects, and monitor your overall health.This is called follow-up. It consists of regular medical examinations and tests.

Relapse control

One of the goals of follow-up is to control relapse, that is, relapse of the disease. Cancer recurs because small clumps of malignant cells may remain in the body. Over time, these cells can grow until they appear on test results or cause symptoms.During follow-up, your healthcare provider may provide you with personal information about your risk of recurrence. Your doctor will ask specific questions about your health. Blood tests or imaging tests may be required as part of regular follow-up. Follow-up recommendations depend on several factors, including the type and stage of head and neck cancer initially diagnosed and the treatment given. The doctor will also advise on what signs and symptoms to control.

Control of long-term and delayed side effects

Treatment of malignant tumors is accompanied by various side effects. Long-term effects persist after a period of therapy. Delayed side effects can develop months or even years later. Long-term and delayed effects can include physical and emotional changes.

Talk with your doctor about the risk of these side effects, depending on the type of cancer, your individual treatment plan, and your overall health.If your treatment is known to have some delayed effects, you may need to have certain additional tests. For example, if you have received radiation therapy, your doctor will recommend that you donate blood regularly to check your thyroid function. Your doctor may refer you to a specialist for delayed effects.

Rehabilitation is an essential part of follow-up after head and neck cancer treatment. Patients may be given physical therapy to maintain motor function and level of movement, and speech and swallowing therapy to restore skills such as speaking and eating.Proper assessment and treatment can often prevent long-term speech and swallowing problems. Some patients may need to learn new ways of eating or other ways of preparing food.

People may look different, feel tired, and may not be able to speak or eat as they used to. Many people experience depression. Support groups help patients cope with changes after treatment.

Maintaining Your Own Medical Records

You and your doctor will work together to develop an individual follow-up plan.Be sure to discuss any concerns you have about your own future physical or emotional health.

Stages

Staging is the determination of where the cancer is located, whether it has spread, and where, and its effect on other parts of the body.

Doctors use diagnostic tests to determine the stage of cancer; they may need information based on tissue samples obtained during surgery, so staging may continue until all analyzes are performed.Staging information helps the clinician determine which treatment is best and predict the possibility of recovery.

TNM Tumor Classification System

One way of staging a cancer is with the TNM system. Doctors use the results of diagnostic tests and scans to answer the following questions:

• Tumor (T): How big and where is it?
• Lymph nodes (N): the extent to which the process has spread to the lymph nodes?
• Metastasis (M): The prevalence of cancer to other parts of the body?

The results are pooled to determine the stage of each patient’s cancer.The stage provides a general way of describing cancer so that clinicians can collaboratively plan optimal treatment.

Head and Neck Cancer: Symptoms and Signs

Head and neck cancer patients often experience the following symptoms or signs. Sometimes, patients with head and neck cancer do not see any of the following changes. Or, the symptom may be caused by a non-cancer disease.

• Non-healing inflammation or wound
• Red or white spot in the mouth
• Lump, lump or mass in the head or neck area, painful or painless
• Long-term sore throat
• Putrid odor that does not come from the mouth hygiene
• Hoarseness or hoarseness of the voice
• Frequent nosebleeds and / or unusual discharge from the nose
• Difficulty breathing (including nasal)
• Double eyes
• Numbness in the neck or weakness in the occipital region
• Pain with chewing, swallowing even small pieces of food
• Pain in the jaw
• Bloody discharge in saliva or phlegm, mucus that is released into the mouth from the respiratory tract
• Loose teeth
• Dentures that no longer fit
• Unexplained weight loss Fatigue
• Ear pain or infection

If you are concerned about any of the above, you should contact a specialist.Your doctor will ask, among other things, how long and how often you have been experiencing the symptom (s). This conversation will help in making the correct diagnosis.

Once cancer is diagnosed, symptom relief remains an important part of cancer care. This can be called palliative or supportive care. It often begins shortly after diagnosis and continues throughout treatment.

Methods of treatment for head and neck oncology

The standards of medical care for head and neck oncology are the best of modern methods of treatment.Doctors recommend considering clinical trials as one of the treatment options. Clinical trials are testing a new approach to treatment. Experts want to know if the new treatment is safe, effective. Clinical research is an option for treatment and cancer care at all stages of cancer.

Oncology Team

Head and neck cancer specialists usually form an interdisciplinary team to treat each patient. The structure includes the following specialties:

• Chemotherapist: Treatment with drugs, including chemotherapy, immunotherapy and targeted therapy.
• Radiologist-Oncologist: specialized in radiation therapy.
• Oncologist: Treatment by surgery.
• Reconstructive / Plastic Surgeon: Restoration of damage caused by tumor treatment
• Orthopedic dentist : Restoration of tissues in the oral cavity.
• Otolaryngologist : restoration of tissues of the ear, throat, nose.
• Dentist-Oncologist : Experience in treating patients with head and neck cancer.
• Cancer Nurse: specializes in caring for cancer patients.
• Physiotherapist : restoration of physical activity, physical strength.
• Speech therapist : restoration of speech and swallowing skills after the performed manipulations.
• Audiologist: Treatment and control of hearing problems.
• Psychologist / Psychiatrist : Deals with the emotional, psychological and behavioral needs of the cancer patient and the patient’s family.
• Social worker . provides advice to patients, family members and support groups.
• Certified Nutritionist : Helps people understand how to eat and eat right for their specific condition.

A patient may need to be seen by several specialists before a treatment plan is fully developed.

Treatment overview

Many head and neck cancers can be cured, especially if detected early.Cancer elimination is the main goal of treatment, but preservation of the function of neighboring nerves, organs and tissues is equally important. When planning treatment, doctors consider how the treatment can affect a person’s quality of life.

The main therapy options are surgical, radiation, targeted, chemotherapy. Surgery or radiation therapy alone or in combination can be part of a treatment plan.

Treatment options and recommendations depend on several factors, including the type and stage of cancer, potential side effects, personal preference, and overall health.

Surgery

The goal of surgery is to remove a cancerous tumor and a portion of healthy tissue during an operation. For head and neck cancer, the following operations are used:

• Laser operations. This method can be used to treat a tumor at an early stage, especially if it has been found in the larynx.
• Delete . This is an operation to remove a cancerous tumor and some of the surrounding healthy tissue known as an edge.
• Lymphadenectomy or cervical dissection . If the doctor suspects that the cancer has spread, he may remove the lymph nodes in the neck. This can be done concurrently with the removal of the tumor.
• Reconstructive (plastic) surgery . If cancer surgery requires removal of an important area of ​​tissue, such as removal of the jaw, skin, pharynx, or tongue, reconstructive or plastic surgery may be required to replace the missing tissue.This operation helps to restore a person’s appearance and the functionality of individual organs. A speech therapist is required to re-teach the patient to swallow and communicate using the latest techniques.

Based on the location, size, type of cancer, the treatment process will take place in stages with several operations. If it is impossible to completely eliminate the tumor, additional procedures are recommended. If cancer cells remain after surgery, other types of cancer care (radio-, chemotherapy) are prescribed in combination or in isolation.

Side effects of surgery

Adverse effects of surgery depend on the method and location of the operation. Patients should discuss all the nuances of the side effects of the therapy with their doctor. The most common negative consequences of operations in the head and neck area are problems with the speech apparatus and the swallowing process, hearing loss. Removal of lymph nodes is accompanied by stiffness in the shoulders. In addition, lymphostasis may occur. After a total laryngectomy, which involves removing the larynx, people may have decreased thyroid function, which needs to be controlled, for example, by taking thyroid hormone medications.

Another likely side effect is laryngeal edema, which makes breathing difficult. In such a case, a temporary channel for normal breathing (tracheostomy) is made in the trachea with an instrument.

Some patients experience facial disfigurement after surgery. Reconstructive surgery may be recommended to initiate or maintain important bodily functions (eg, repairing a tracheostomy defect). Patients should meet with various members of the healthcare team to make joint treatment decisions and understand the healing process.Programs that help patients adapt to changes in their appearance can come in handy both before and after surgery.

Radiation therapy

Radiation therapy (radiotherapy) is the use of ionizing radiation for the treatment of malignant neoplasms. The treatment regimen contains several cycles of procedures carried out at specific time intervals. Radiotherapy can be prescribed both separately and in conjunction with surgery.

External beam therapy is the most optimal option.It implies the effect on the tumor of radiation emanating from the apparatus located outside the body. A special type of external external beam radiation therapy is intensity modulated radiation therapy (IMRT). It uses advanced technology to precisely direct the radiation beams to the neoplasm. IMRT significantly reduces the likelihood of damage to healthy areas, minimizing possible negative consequences.

Proton therapy is a type of external external beam radiation therapy using protons.Modern medicine practically does not use proton therapy.

Brachytherapy – contact method of radiotherapy using implants. According to the method of application, it can be manual and automated.

Before starting treatment, the patient should visit a dentist-oncologist to solve the problem of caries, since radiotherapy can aggravate the carious process. You will also need the recommendations of a speech therapist for a further recovery period.

Other unpleasant consequences of radiotherapy can be redness, swelling of the skin area in contact with radiation, loss of appetite, stomatitis (ulcers on the inner surface of the cheeks).Patients complain of dry mouth, bone aches, fatigue. Most of the symptoms disappear shortly after the end of the course of treatment. If the lymph nodes are damaged during treatment, soft tissue edema (lymphadema) may occur.

Radiation therapy can cause hypothyroidism, in which the thyroid gland (located in the neck) slows down the production of hormones responsible for alertness and activity. In this case, the endocrinologist prescribes hormone replacement drugs. If radiation therapy is given to the neck area, thyroid function should be monitored periodically.

Drug therapy

Systemic therapy is the use of drugs to eliminate the oncological process. These drugs are injected into the bloodstream to eliminate cancer cells. The systemic treatment regimen is drawn up by a chemotherapist.

Common systemic treatments are placing an intravenous (IV) catheter into a vein or swallowing (oral) the drug.

The following types of drug therapy are used for head and neck cancer:

• Chemotherapy
• Targeted therapy
• Immunotherapy The drug therapy regimen (number of drugs) depends on the form and severity of the oncological process.

Chemotherapy

The use of drugs that prevent the development and division of tumor cells is called chemotherapy.

The chemotherapy regimen is similar to radiotherapy: several stages in a certain amount of time. The number of drugs taken is individual and depends on many factors.

Negative consequences are also highly individual. First of all, there are depressive conditions, hair loss, nausea and vomiting.

Targeted therapy

Each tumor has its own characteristics, targets.A type of oncological treatment based on the destruction of target molecules (specific genes) and enzymes that feed the vital activity of malignant cells. Targeted (targeted) therapy prevents the death of normal cells and tissues by affecting only targeted molecules.

To select the necessary drug, the doctor conducts an analysis to determine the protein fractions, neoplasm genes. Inhibitors EGFR . For head and neck cancer, treatment may be directed at a specific tumor protein called the epidermal growth factor receptor (EGFR).Researchers have found that drugs that block EGFR help stop or slow the growth of certain types of head and neck cancers.

Agnostic anticancer therapy. Larotrectinib (Vitrakvi) is a certified targeted therapy drug that focuses on altered NTRK genes. Larotrectinib is relevant for the elimination of metastases, which, for various reasons, cannot be removed by surgery.

Immunotherapy

An obligatory stage of treatment designed to increase the body’s natural resistance, strengthen the immune system.Used substances produced by immune cells or produced in laboratory conditions.

Pembrolizumab (Keytruda) and nivolumab (Opdivo) are the latest effective immunotherapy for the treatment of recurrent or metastatic squamous cell carcinoma of the head and neck. Pembrolizumab can be given alone if the tumor expresses a certain amount of the PD-L1 protein. Alternatively, it can be used in combination with chemotherapy regardless of the level of PD-L1 expressed by the tumor.Nivolumab can be used if the cancer has continued to grow or spread during treatment with platinum-based chemotherapy.

Different types of immunotherapy can provoke different negative consequences. Common side effects include skin reactions, flu-like symptoms, diarrhea, and weight changes.

Physical, psychological social consequences of oncology

Patients receiving cancer care inevitably face physical, psychological stress, as well as social consequences.Supportive therapy (also called palliative therapy) controls all of these factors.

Supportive therapy is very diverse, meaning drug treatment, changes in nutrition, psychological relief.

Metastatic head and neck cancer

If the process spreads outside the affected organ, doctors call it metastatic cancer. In this case, it is important to consult a physician experienced in treating such cases.Doctors have different views on the optimal standard treatment plan. Clinical trials can also be considered as a treatment option.

A treatment plan for metastatic cancer can combine all of the above treatment methods of oncology.

Remission and the possibility of recovery

Remission is a condition in which there are no malignant cells in the body and the corresponding symptoms are absent. Remission is also called “no evidence of disease”.

Remission can be temporary or permanent.

If the disease comes back after the initial cycle of therapy, it is called recurrent cancer. The disease may recur at the same site (local recurrence), nearby (regional recurrence), or elsewhere (distant recurrence). In such a case, it is necessary to conduct a series of fresh tests in order to understand the complete picture of the general state of health.

If treatment fails

Head and neck cancer, unfortunately, is not always curable.This type of event is called progressive or terminal cancer.

Such a diagnosis is a great stress for the patient and his relatives. Therefore, it is so important to talk frankly with the medical care team, explaining your feelings, anxiety. Special training and experience help the medical team provide support to patients and their families. It is extremely important to provide a person with physical comfort, freedom from pain and psycho-emotional assistance.

Lymph node biopsy | Clinic Family Doctor

Lymph nodes are part of the lymphatic system and are connected by vessels of the same name.In oncological and infectious diseases, they often assume barrier functions, signaling the presence of a pathological focus. Swollen lymph nodes can be a symptom of various diseases.

A biopsy is a minimally invasive diagnostic method that involves the collection of a portion of tissues or cells for further examination under a microscope. The procedure is performed by oncologist surgeons if there is a suspicion of structural changes, enlarged lymph nodes. A lymph node biopsy can help clarify the suspected diagnosis.

Types of procedure

There are several types of lymph node biopsies:

• Fine-needle, or puncture. Allows, on the basis of a cytological study, to determine the defeat of the lymph nodes, to establish the presence of tumor metastasis.

• Trephine biopsy. Provides for the use of a thick needle. This allows you to collect a tissue column, which is sufficient for histological examination, while no incisions are made.

• Sentinel lymph node biopsy. Sentinel, or sentinel, lymph nodes represent the first route of early metastasis of tumors. They are the first to catch atypical cells.

The procedures are performed under local anesthesia. Sometimes the lymph node can be removed and examined completely, in this case more serious preparation will be required, the doctor will definitely explain the specifics of the manipulation.

Features of laboratory study

The resulting fluid, tissue or cells are sent to the laboratory for cytological and histological examination. In the laboratory, they are processed in a special way, under certain conditions for the study of the material and with the possibility of long-term storage.

The section is treated with dyes and placed on a glass slide. If atypical cells are detected, the data must be reflected in the written opinion.

The use of a biopsy allows:

• determine the existing disease and its nature;

• carrying out the most organ-preserving surgery;

• avoid complications of lymphadenectomy;

• improve the results of the operation;

• choose the right radiation and chemotherapy;

• make sure in the presence / absence of a malignant process.

This method is one of the most informative.

Biopsy of lymph nodes on the neck, in the axillary, inguinal and other areas is successfully performed by the oncologists of the Family Doctor clinic.

We possess the necessary diagnostic methods, use modern instruments and anesthetics, and comply with all conditions for conducting invasive procedures.

To make an appointment with a doctor, call the unified contact center in Moscow +7 (495) 775 75 66, use the online appointment service or contact the clinic’s registry.

Cost

surgeon, oncologist, doctor of ultrasound diagnostics

surgeon, oncologist, Ph.D.

surgeon, oncologist, phlebologist

surgeon, oncologist, endoscopist

surgeon, Ph.D.

.