- Lymph nodes are considered to have high concentration of lymphocytes
- Lymphadenopathy is swelling of lymph nodes
- Lymphadenopathy can either be localized or generalized
Lymph nodes play an important role in filtering antigens from the extracellular fluid. They are ideal organs for accepting antigens that gain access through the skin and gastrointestinal tract. Lymph nodes are considered to have high concentrations of antigen-presenting cells and lymphocytes.
The size of the lymph nodes depends on the person’s age, the antecedent immunological events, and the lymph nodes location in the body. However, in some circumstances, lymph nodes swell.
What is Lymphadenopathy?
Lymphadenopathy is a condition which involves the reticuloendothelial system, causing the lymph nodes to swell. This is commonly due to the increase in the normal level of lymphocytes and macrophages as a response to antigens. A person with lymphadenopathy has palpable enlargement, greater than 1 cm compared to normal lymph nodes. It can happen in one or more regions in the body and may be categorized into:
- Localized – present in one body area
- Generalized – present in more than two body areas
A lymphadenopathy with signs of inflammation or pain is called lymphadenitis.
Younger children are commonly affected by lymphadenopathy, most of which are caused by viral infections.
How Does Lymphadenopathy Develop?
Certain cells, antigens, foreign particles and certain cellular materials enter the lymphatic vessels, which become lymphatic fluid. The lymphatic fluid is then filtered by the lymph nodes as it goes to the central venous circulation. During this process, cells and other materials are removed as well as present antigens to the lymphocytes that are inside the nodes. Cellular proliferation will then occur as a response to the lymphocytes. As a result, the nodes will become enlarged (lymphadenopathy).
Pathogenic microorganisms such as bacteria and viruses transmitted in the lymphatic fluid can infect the lymph nodes, which causes lymhadenitis. In addition, cancer cells can lodge in and multiply in the lymph nodes.
Causes of Lymphadenopathy
There are many potential causes of lymphadenopathy since the lymph nodes take part in the immune response of the body. Plenty of inflammatory and infectious diseases and cancers may cause lymphadenopathy. The most common causes include idiopathic or self-limited, local soft tissue infections and upper respiratory infections. On the other hand, the most dangerous causes include tuberculosis, cancer and HIV infection.
Signs and Symptoms of Lymphadenopathy
A person with lymphadenopathy may or may not experience symptoms. However, common symptoms of lymphadenopathy include:
- Painful lump under the skin
- Inflamed (warm, red) lump under the skin
- Skin rash
- Enlarged spleen
- General malaise
- Unexplained weight loss
- Night sweats
- Persistent fever
How is Lymphadenopathy Diagnosed?
If lymphadenopathy is suspected a visit to the doctor is necessary, as there are a variety of underlying causes and conditions associated to lymphadenopathy.
During consultation, the doctor must be able to determine if the lymphadenopathy is localized or generalized. The size, consistency and mobility of the lymph nodes must also be determined. Medical history and signs and symptoms, will also be noted and evaluated.
If medical history and assessment are not enough to determine causality, further testing is necessary. These include:
- Throat culture
- HIV test
- PPD placement
- FBC with WBC differential
- Monospot test
- Hepatitis serologies
- Chest X-ray