Symptoms

Lymphatic swelling - symptoms, diagnosis and therapy


The lymphatic system is one of the most sensitive circuits in our body. Inconsistencies within the body, such as those caused by disorders in the metabolism or blood circulation, can very easily cause swelling of the lymph glands (lymphadenopathy). The swelling can occur in numerous parts of the body and, depending on the location, may indicate very different health problems. Lymph gland cancer is particularly feared here. A serious illness does not always have to be present, but persistent swelling of the lymph glands can be observed in any case. Learn more about the causes, symptoms, and treatment options for lymphatic swelling in the following article.

The lymph nodes

Like the bloodstream, the lymphatic system (Systema lymphaticum) has a large number of vessels that extend through the entire body. The lymph fluid (also called lymph) flows in them - a light yellow fluid that represents an intermediate stage between the blood plasma and the tissue water. Among other things, it transports nutrients and breakdown products through the body, which due to their size cannot be absorbed directly through the blood vessels. These include, for example, proteins and fats. Otherwise, the composition of the lymphatic fluid is very similar to that of normal tissue fluid, with the basic ingredients

  • Calcium
  • glucose
  • urea
  • potassium
  • Creatinine
  • sodium
  • and form phosphate.

The lymph glands now act as filtering units for the lymph, although the term “lymph gland” is actually quite misleading. In fact, this does not mean glands in the strict sense, but rather the lymph nodes (nodus lymphaticus), of which there are between 300 and 700 in humans. The oval-shaped nodules are on average 0.5 to 1 cm in size and consist of an outer connective tissue capsule that consists of a cell mixture

  • Reticular cells,
  • Lymphocytes and
  • Encloses antigen-presenting cells.

The latter two cell types provide an indication of another important function of the lymph nodes - that in the area of ​​immune defense. Because in addition to nutrients and degradation substances, the lymph fluid also transports lymphocytes - more precisely, B-lymphocytes and T-lymphocytes. A special unit of immune cells, which are essential for the body's defense against infectious diseases. As soon as pathogens enter the body, they must first be recognized and examined by the lymphocytes before they can be effectively combated. For this purpose, lymphocytes initially destroy smaller pathogen occurrences that they discover when they circulate through the organism, and collect information from their remains. The information is then transmitted to the lymph nodes, from where the immune response is finally initiated. This happens through the increased production of new lymphocytes, which are now equipped with the necessary special information for further resistance and improved detection of the pathogens. These optimized lymphocytes are distributed throughout the body via the blood and lymph channels so that the infection can be combated over a large area.

Causes of lymph node swelling

Due to its essential functions for the health and metabolism of the body, with regard to the transport of fine substances and sensitive immune information, the lymphatic system and the lymph nodes in particular are very susceptible to disturbing stimuli. Swelling of the lymph nodes can result from the slightest inconsistency in the composition of the lymph fluid. If the lymph is too viscous, for example, because the person concerned has not consumed enough fluid, this means additional stress for the filtering unit of the lymph nodes. A swelling cannot be ruled out here, but rather harmless, since it is quickly remedied after sufficient hydration.

In contrast, disease-related swellings of the lymph glands or lymph nodes are more serious. With existing infections, swollen lymph nodes, for example, are almost a standard symptom. Likewise, existing cell mutations, which are typical of cancer, can overload the lymph nodes and cause them to react with swelling. If the immune system of the infectious disease does not get to grips quickly enough or cancer spreads unhindered in the body, it can also lead to inflammation of the lymph nodes (lymphadenitis), which in turn leads to a permanent enlargement of the lymph nodes. One also speaks of a chronic swelling of the lymph nodes (lymphadenopathy).

Lymph node swelling due to infectious diseases

Basically, any minor infection can lead to swollen lymph nodes. The swelling results from the pathogen particles, which are carried to the nodes by the lymphocytes in order to convert them to immune information. It is a natural defense reaction against harmful germs, which should not go unnoticed. If the lymph nodes are confronted with too many infectious agents or their components over a longer period of time, the natural stimulus reaction can quickly turn into a tangible inflammation of the lymph nodes. In this case, the lymphocytes are unable to cope with the pathogen control and the germs migrate into the lymphatic system before they can be rendered harmless by the immune cells.

In contrast to short-term stress or nutritional lymph node swellings, infection-related lymph node swellings are usually associated with pain. Depending on the location of the affected lymph nodes in the body, additional accompanying symptoms are also conceivable.

If, for example, an infection in the throat and / or throat area is responsible for the swelling, swallowing and throat pain may result. Infectious diseases in the ENT area such as colds, flu, tonsillitis or throat infections should be mentioned here in particular. Inflammatory dental diseases, such as inflamed molars or wisdom teeth, can also be very irritating to the lymph nodes. There are also infections in which the lymph node swelling is painless, but the disease-related health risks can be all the more serious. Some examples of such diseases are:

  • Lyme disease,
  • Chlamydia,
  • Diphtheria,
  • HIV infections / AIDS,
  • Measles,
  • Whistling glandular fever,
  • Rubella,
  • Sarcoidosis,
  • Syphilis,
  • tuberculosis

Swollen lymph nodes in cancer

Lymph node swellings in various forms of cancer are a special alarm sign. Women in particular are very quickly concerned if the lymph nodes in the breast and armpit area are permanently enlarged, as this can indicate breast cancer. The tumor cells migrate relatively easily into the lymphatic system because they surround the female breast very generously.

But other cancers can also manifest themselves through swollen lymph nodes. This is especially true for lymph node cancer. Lymph node swellings are particularly characteristic of Hodgkin's disease, also known as lymphogranulomatosis. It is a malignant tumor in the lymphatic system, the cause of which is believed to be a pre-existing disease caused by the Epstein-Barr virus. Existing immune disorders are also discussed as a co-factor.

Another variant of the cancer, which manifests itself relatively early through swollen lymph nodes, is blood cancer (leukemia). Since the lymphatic system is in constant communication with the blood vessels, this type of cancer also bears the risk of causing lymphoma as a secondary disease.

Other causes

There are a number of other reasons for swollen lymph nodes. For example, there can be water retention in the lymphatic system, so-called lymphedema. Furthermore, the inflammatory disease tends to systemic diseases such as Rheumatism and joint diseases (e.g. arthritis) also have an influence on the lymph nodes and cause secondary inflammation here. Alternative medicine often makes slag and pollutants that have accumulated in the lymphatic system responsible for the swelling. In this context, in addition to an unhealthy diet with too many additives, environmental and industrial pollutants are also conceivable as possible triggers of the swelling.

Concomitant symptoms

Lymph gland swelling is usually noticeable to those affected by a palpable increase in the size of the lymph node tissue under the skin. The extent of the swelling varies from "only palpable when touched" to "visible to the naked eye."

Depending on the cause, the lymphatic swelling can occur with or without pain. If it is associated with pain, this can indicate a more or less harmless inflammation in the lymph node itself or in the drainage area of ​​the lymph node. For example, the lymph nodes swell when the body is burdened with tonsillitis. Difficulty swallowing often occurs as an accompanying symptom, which arises due to the swelling of the tonsils and the reactive swelling of the surrounding lymph nodes. Likewise, after interventions on the teeth or jaw, painful swellings of the lymph glands on the neck can occur, which are to be regarded here as a general defense reaction and do not yet indicate an overt inflammatory reaction. The same can be seen in any part of the body following surgery or other medical procedures.

If swelling of the lymph glands occurs without any apparent connection to an infection and in the absence of pain, this may indicate a malignant disease in the body. The lymph nodes swell in cancer if they identify degenerate cells as part of their filter function, or if the lymph node tissue itself is degenerate or is affected by degenerated cells. Unexplained swelling of the lymph node tissue should therefore always be taken seriously and examined by a doctor. Often, in addition to swelling of the lymph glands, sufferers describe other symptoms that are referred to in medical terminology as B symptoms. This is:

Recurrent fever

Fever, which occurs without any noticeable evidence of an upper respiratory infection, infection of wounds or cystitis, etc. It usually goes back without medical intervention (antipyretic, calf wrap) to flare up again after hours or days.

Night sweats

Affected people sweat profusely at night, wake up with soaked sleepwear, wet hair and sweaty skin, with the bedding sometimes dripping wet.

Unwanted weight loss

Affected people lose weight significantly without having to do so on a diet. It is not uncommon to describe a general loss of appetite or an aversion to certain foods (e.g. meat).

The differentiation of the lymphatic swelling based on the causative factors can be made not only in terms of existing or absent pain symptoms, but also based on other characteristic features:

featureBenign diseaseMalignant disease
consistencysoftcoarse
MovabilityWellbad
Duration of the processacute without progressive
enlargement
creeping, with significantly increasing
Increase in size

However, the features from this overview can only give a first approximation of the possible cause. They do not replace a medical diagnosis and do not give any guarantee.

Diagnosis

In the first step, the consulted doctor will take a medical history followed by a physical examination. The affected areas are inspected and palpated, and the surrounding areas are closely observed. For example, in the case of swelling of the lymph glands in the armpit area, the chest, back and arms were also examined and examined for irregularities. In the case of swollen lymph nodes in the neck area, the throat is inspected and specific questions are asked about cough, color of the sputum, earache and possible skin rashes. The further procedure for finding a diagnosis is based on the information from the first medical examination. If an injury or ongoing infection is associated with the swelling of the lymph glands, no further diagnostic steps are likely to be initiated, but the cause is treated directly.

If there is anything unclear about the diagnosis, there are other diagnostic methods available:

  • Laboratory chemical tests: Examination of the blood with regard to the inflammation parameters, various pathogens, changes in the blood picture, liver and kidney involvement, evidence of cell disintegration (LDH, urea).
  • Imaging procedures: sonographic and radiographic images can be taken for this, which allow a first distinction of the swelling between the cyst, abscess and degenerative process. Furthermore, the extent of the swelling itself and the involvement of other lymph nodes can be assessed as part of a CT / MRI examination.
  • Surgical procedures: in the context of a so-called lymph node extirpation, pieces of tissue or possibly the entire lymph node can be removed and examined histopathologically for various cell types.

Therapy

Lymph gland swelling is not an independent disease, but a symptom that occurs in many different clinical pictures. Accordingly, there is no independent therapeutic approach to treat swelling of the lymph glands. Rather, a causal treatment of the underlying disease takes place, which aims to alleviate accompanying symptoms, such as swelling of the lymph glands. In many cases, swelling of the lymph glands does not require any special therapy at all. For example, if it arises as part of a cold or in the healing phase after an intervention on the dental apparatus. Then the affected lymph nodes usually swell off by themselves without much effort when the affected person is recovering.

Medical therapy

The pharmacy offers several groups of drugs that can attack and treat the various causes of lymphatic swelling. If bacterial inflammation is known to be the cause of the swelling, an appropriately selected antibiotic can quickly provide relief. This is usually administered orally in tablet form. However, the use of antibiotic substances should always be discussed with regard to their benefits. The body can often fight a bacterial infection even without antibiotic therapy. In some cases, for example, when the inflammation has progressed and threatens to spread to the whole body, it may be advisable to switch to an intravenous application.

The situation is similar with viral infections. Mild viral infections generally do not require any further special therapy. If the immune system is severely impaired, pain and fever can work symptomatically with various pain relievers. However, the body should be given the opportunity to manage the infection on its own. Antivirals (drugs that counteract the multiplication of viruses) are usually only used when those affected have a weakened immune system, the viral infection does not subside despite rest and symptomatic treatment, or a further infection (secondary infection) develops.

If cancer has been diagnosed as the cause of the lymphatic swelling, there are many different approaches to therapy. In addition to surgery and local radiation therapy, therapy with cytostatic drugs is often used. The necessary composition of this chemotherapy is put together based on the causative cancer and its properties. It can be introduced into the body in tablet form or as a solution for infusion.

Surgical therapy

Surgical swelling of a lymphatic gland can be used for two underlying diseases:

  • For cancer that can be treated with surgery.
  • Inflammation in the lymph nodes themselves, which are often associated with abscess formation.

Cancer cells have the property of being distributed in different ways in the body and igniting further degeneracies in the settlement area. A frequently used route is via the lymph channels and lymph nodes. For this reason, the surrounding lymph nodes are very often removed when operable cancers are removed to minimize the risk of spreading.

If the lymph node itself is inflamed, for example if pathogens enter the lymphatic system in the event of open injuries, the inflammation may be so severe that pus forms in the lymph node and an abscess develops. In order to avoid a burst of the abscess and thus an impending spread of the pathogens via the bloodstream, the affected lymph nodes are opened in an operation under sterile conditions, the pus and the destroyed tissue are removed and the wound cavity is closed again with the introduction of antibiotic tamponades . Often, a drainage is also introduced into the cavity, which is intended to ensure that the wound secretion drains off and, if necessary, irrigation of the wound cavity.

Home remedies

A significant proportion of the swelling of the lymph glands is caused by harmless infections, especially of the upper respiratory tract, or arises in the context of reactions of the immune system to external influences, e.g. after interventions on the teeth or slight skin injuries. In such cases, no special therapy is usually required and the swelling of the lymph glands responds very well to home remedies that strengthen the immune system:

  • Drink a lot (especially water, unsweetened tea),
  • daily exercise in the fresh air,
  • exercise two to three times a week for at least 30 minutes,
  • feed rich in vitamins,
  • good balance between physical and mental exertion and periods of rest,
  • Avoid toxins like alcohol, nicotine, drugs.

The lymphatic swelling can also be treated directly. For example, a light massage of the affected lymph node can stimulate lymphatic drainage. To do this, massage the lymph node with your fingers under light pressure. A small amount of the following substances can be used to make the skin more supple:

  • Castor oil,
  • Olive oil,
  • Marigold ointment,
  • Honey.

These substances contain an anti-inflammatory component and can be absorbed through the skin, which can help reduce the signs of inflammation. Local heat also promotes lymphatic drainage, which can have a decongestant effect on the lymph nodes. Affected people can treat the area several times a day with a warming pillow, warm compresses or an infrared lamp. Treatment should not last longer than ten minutes, but can be repeated several times a day. If the lymph nodes in the neck area are swollen as a result of tonsillitis or immediately after an intervention on the teeth, regular gargling with salt water or sage tea can quickly bring relief. Simply boil sage tea or mix half a teaspoon of salt in a cup of water. After the liquid has cooled, you can rinse your throat several times a day.

Naturopathy

There are many herbs that stimulate lymphatic drainage and thus counteract lymphatic congestion. These include:

  • Red clover,
  • Echinacea,
  • Holly,
  • Burdock root,
  • Mullein,
  • Peppermint,
  • Fenugreek,
  • Chamomile,
  • Marigold.

These herbs can be used internally as tea or in powder form. However, they can also be applied to a compress as a warm infusion and used locally on the affected area.

Both home remedies and naturopathy find their limits if the swelling of the lymph glands persists for more than two weeks and there is no sign of an ongoing infection. At the latest, those affected should have the swelling examined by a doctor.

More options

Among the Schüßler salts, potassium chloratum (No. 4), magnesium phosphoricum (No. 7) and sodium phosphoricum (No. 9) counteract lymphatic congestion. In the repertoire of homeopathy, Silicea, Natrum muriaticum and Nux vomica are successfully used for swelling of the lymph glands.

Nutritional measures

In order to purify the lymphatic system or to cleanse it after a stressful illness, the diet offers some wonderful solutions. It is particularly important here to design the diet in such a way that unhealthy food components, such as saturated fatty acids or sugar, do not put too much strain on the lymph. The more filtering work the lymph nodes have to do here, the more likely is a stimulus-reactive swelling. In addition, fats and the like can also accumulate in the lymphatic system in the event of persistent oversupply and thus lead to irritation and inflammation as slag. An immune-boosting and digestive diet with plenty of vitamins and fiber from fruits and vegetables can also help relieve the lymphatic system. A strengthened immune system reduces the risk of infection and thus the extra effort required to ward off pathogens, which the lymph nodes have to do in the event of illness.

Good digestion, in turn, takes a lot of work off the lymph nodes as filtering units and can often break down food components more efficiently, so that nutrient components only really enter the lymphatic system when it is absolutely necessary. (ma)

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Swell:

  • Karl Zilles, Bernhard Tillmann: Anatomy, Springer-Verlag Berlin Heidelberg, 1st edition, 2010
  • James D. Douketis: Lymphadenopathy, MSD Manual, (accessed July 9, 2019), MSD
  • Bernhard N. Tillmann: Atlas of Anatomy, Springer-Verlag Berlin Heidelberg, 3rd edition, 2016
  • Carol S. Portlock: Hodgkin's Lymphoma (Hodgkin's Disease), MSD Manual, (accessed July 9, 2019), MSD
  • A. Damian Dhar: Lymphadenitis, MSD Manual, (accessed July 9, 2019), MSD
  • Alexander Claviez et al .: Lymph node enlargement, guidelines of the Society for Pediatric Oncology and Hematology, (accessed July 9, 2019), AWMF

ICD codes for this disease: R59ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.


Video: Self Manual Lymphatic Drainage For The Leg (January 2022).