Herpesvirus infections are a group of diseases caused by viruses of the Herpesviride family, which are characterized by wide epidemic distribution and diversity clinical manifestations. Eight types of viruses cause disease in humans: herpes simplex virus types 1 and 2; Varicella Zoster virus (VZV or herpes type 3); Epstein Barr virus (EBV, herpes type 4); cytomegalovirus (CMV, herpes type 5); human herpes viruses types 6, 7 and 8. Antibodies to herpes...
What is lymph? The fluid contained in the blood (plasma) passes through the walls of the capillaries and penetrates the tissues. Now it is interstitial fluid. It seeps into the intercellular spaces, nourishes the cells and takes some toxic products their life activities. In the interstitial fluid there is an accumulation of metabolic products - ions, fragments of disintegrated lipids, fragments of destroyed cells. Part of the interstitial fluid is collected by the veins, the rest is excreted by the lymphatic...
Discussion
The lymphatic system is one of the most complex and intricately designed human systems.
In addition to lymphatic capillaries, the lymphatic system includes a network of lymphatic vessels with internal valves that provide only centripetal movement of lymph. Capillaries and vessels form networks and plexuses, the nature of which depends on the structure of the organ (in the head and spinal cord, spleen, cartilage are completely absent).
Along the path of the vessels there are lymph nodes - oval, 0.3-3 cm in size, formations, passing through which the lymph is released from harmful substances and pathogenic principles and is enriched with lymphocytes, i.e., it performs one of the barrier functions of the body.
Lymphatic vessels merge into trunks, and subsequent ones into lymphatic ducts. In this case, from most of the body, lymph collects into the left thoracic duct (length 30-45 cm), which flows into the left venous node (the junction of the left subclavian and internal jugular veins), and from the upper right part of the body - into the right lymphatic duct, which flows into right subclavian vein.
This is an infectious disease of viral etiology, characterized by a variety of clinical manifestations and occurring in the form of acute and chronic mononucleosis, malignant tumors, autoimmune diseases, syndrome chronic fatigue. The virus was discovered in 1964 by Epstein and Barr and belongs to the group of gamma herpes viruses (herpesvirus type 4). Epstein-Barr viral infection is one of the most common infectious diseases person. Antibodies to the virus...
At school age, more than half of children complain of recurring abdominal pain. In some cases, the pain goes away without a trace and does not require serious treatment, but in 50–70% it continues to bother patients, turning into chronic gastroenterological diseases. There are a large number of diseases that are accompanied by abdominal pain. By nature, acute, chronic and recurrent abdominal pain is distinguished. Acute abdominal pain may be a consequence of acute...
The most common disease reproductive system In girls, pubertal uterine bleeding (PUB) is common, which accounts for about 50% of all visits to a gynecologist by teenage girls. Uterine bleeding during puberty occurs with a frequency of 10% to 37.5%. Uterine bleeding during puberty is a multifactorial disease caused by a complex of causes, including bacterial or viral infection, hypovitaminosis, vitamin and...
As a result, the prostate gland also suffers. After 35 years, men begin to develop androgen deficiency, microcirculation in the prostate tissue deteriorates, and the consequences of chronic diseases accumulate, which contribute to the development of prostatitis. Also, with age, the prostate increases in size, and so-called fibrous tissue appears in some parts of the organ. This is prostatic hyperplasia, the more common name is adenoma. Having grown to a certain size, the adenoma begins to compress the urethra, causing unpleasant, often disruption of erectile and sometimes reproductive function. The connection between prostatitis and infertility is due to the fact that the prostate gland secretes a secretion that...
Lymphadenopathy is an increase in size, as well as a change in the shape of one or an entire group of lymph nodes of various origins, without signs of inflammation. A person has about 600 lymph nodes. Normal sizes are up to 1 cm. The cervical, axillary, inguinal, and intra-abdominal lymph nodes are more often enlarged. Playing a protective role, lymph nodes are among the first to stand in the way of the spread of infections and other foreign antigens (allergens, tumor cells etc.). Before reaching...
This is an infectious disease of viral etiology, characterized by a variety of clinical manifestations and occurring in the form of acute and chronic mononucleosis, malignant tumors, autoimmune diseases, and chronic fatigue syndrome. The virus was discovered in 1964 by Epstein and Barr and belongs to the group of gamma herpes viruses (herpesvirus type 4). Epstein-Barr virus It is one of the most common human infectious diseases. Antibodies to the virus are found in 60...
My daughter has an enlarged lymph node on her neck, tell us how this thing is treated, we won’t see the doctor until tomorrow
Discussion
ANOTHER QUESTION: When can you visit the pool, because these nodes can last quite a long time, or until they go away at all close this topic
There are a lot of reasons. It could be teeth, throat. They can occur on their own, as an organism’s reaction to an infection.
He is only 4 years old, and he doesn’t even know if he will live to see the next New Year? A nice little boy with a nice name - Vyacheslav and with a terrible diagnosis: Diagnosis: gangioneuroblastoma of the retroperitoneal space on the left, stage III, conditions after combination treatment. Relapse of the disease. Multiple nodes in the retroperitoneal space on the left, metastases to the sacrum. Complications: hydronephrosis on the left. Anemia. The child is indicated for examination and treatment in specialized department pediatric oncology. At RBC...
Discussion
Check out www.pomogi.org
Oryol region
HEALTH DEPARTMENT
REGIONAL STATE HEALTH INSTITUTION
CHILDREN'S REGIONAL HOSPITAL
302028
Orel, Oktyabrskaya str., 4 tel/fax 763656
Glushonkov Svyatoslav Aleksandrovich 4 years old, (born 05/31/2002), cdvcdf Diagnosis: ganglioneuroblastoma of the retroperitoneal space on the left, stage III, conditions after combined treatment.
In 2003 – 2004 was held at the Russian Children's Clinical Hospital complex treatment regarding stage III retroperitoneal neuroblastoma. Surgical treatment November 19, 2003, laparotomy, biopsy of a tumor in the left retroperitoneal space. Adjuvant polychemotherapy according to the ULN-2000 program. Remission achieved.
In June 2006, a routine examination was carried out at the Department of Children's Hospital; a significant increase in lymph nodes was noted in abdominal cavity and retroperitoneal space.
On ultrasound of the abdominal organs and retroperitoneal space (07/17/2006) the intestinal walls are not thickened, the mesenteric lymph nodes in the area of the ileocecal angle are round in shape, with a diameter of 19-21 mm, Para-aortic lymph nodes are multiple with a maximum size of 20x30 mm, 15x24 mm, 20x35 mm. The structure is of medium echogenicity, homogeneous. The lymph nodes compress the inferior vena cava, the flow in it is pseudoarterial. Celiac trunk 4.5 mm.
In the general blood test: er-ty 4.1x1012/l, NV 123 g/l, platelets 281 thousand, l-7.5 x10 9/l, e-1 p-5 s-51 l-38 m-5 ESR 32 mm/hour.
Conducted antibacterial treatment: cefotaxime 750 mg x 3 times a day, amikacin 150 mg x 2 times a day intramuscularly.
The abdominal pain stopped. The general condition of the child improved somewhat; according to dynamic ultrasound data, the enlargement of the mesenteric and para-aortic lymph nodes remained.
An examination in Moscow was recommended: a blood and urine test for tumor markers of neuroblastoma (excretion of catecholamines - vanillinmandelic and homovanillic acids, NSE, ferritin) in Moscow with a decision on further tactics of observation and treatment.
In August 2006, an examination was carried out on an outpatient basis.
NSE 67.21. Cortisol (blood serum, 7-10 hours, 500.1 nmol/l (normal 120-620), catecholamines within normal limits.
However, in September 2006, pain appeared in the back, neck, and then in lumbar region spine. He was examined at the clinic at his place of residence. An ultrasound of the kidneys and abdominal organs was performed. No pathological changes were detected. X-ray of organs chest without pathology.
In the general blood test dated 02.11. 2006. er-ty 3.8x1012/l, NV 90 g/l, l-7.1 x10 9/l, e-1 p-6 s-61 l-25 m-7 ESR 65 mm/hour.
The child’s general condition worsened, and pain appeared in the back and tailbone.
The child is indicated for examination in a specialized oncology department to exclude recurrence of neuroblastoma. A request was sent to the Russian Children's Clinical Hospital. The response from the Russian Children's Clinical Hospital recommended an outpatient follow-up examination of the child (most studies in the field are not carried out) with a repeat correspondence consultation.
The child's condition gradually worsened progressively. He has lost weight and his appetite has sharply decreased. Intense pain is noted in the knee joints, back, and tailbone. Fever is at febrile levels. He was sent to the hospital. Objective status: the child’s general condition is serious. In consciousness, accessible to contact. He has a very negative attitude towards the inspection. Any change in body position causes pain in the back and legs. Skin pale with an icteric tint, clean. Peripheral lymph nodes are not enlarged. By auscultation, breathing is carried out in the lungs; no wheezing is heard. Heart sounds are rhythmic, sonorous; heart rate is 134 per minute.
The stomach is not bloated superficial palpation possible, but causes a negative reaction from the child; with deep palpation, pain in all parts, more along the left lateral canal, where in the depths, a tumor-like formation is vaguely defined, painful. Palpation of the spinous processes of the vertebrae is painful, palpation of the ilium, the area of the sacrum and coccyx is also painful. Palpation of the area knee joints painful. The joints are slightly increased in size. Stool with a tendency to constipation (due to lack of appetite) Urination is not impaired.
A series of radiographs of the chest and spine show no pathological shadows in the lungs. A survey X-ray of the abdominal organs shows a high position of the diaphragm, paravertebral from the liver to the pelvis, more to the left “silent zone” due to a high-intensity shadow with a polycyclic contour. Intestinal loops on both sides. Destruction of bodies S2-3-5. No other foci of destruction were identified.
Conclusion: suspicion of metastases of neuroblastoma in the sacral vertebrae.
Ultrasound examination of the abdominal organs and retroperitoneal space: the liver parenchyma is of medium echogenicity, heterogeneous. The vascular pattern is preserved. The walls of the vessels are compacted.
Gallbladder oval in shape, wall 2 mm, stagnant bile. The pancreas is poorly visualized. Kidneys, right – 89x40x50 mm, parenchyma 17 mm, left 110x48x50 mm, parenchyma 11.5 mm, pelvis 30 mm, calyces 18-20 mm, CMD smoothed. Ureter up to 20 mm.
In the small iazu, a formation is determined to be 46x35x72 mm, in the mesogastrium on the left, a formation is 56x44x71 mm, with a clear contour, uneven boundaries, isoechoic, heterogeneous. With CDK and ED, vessels are identified in them. There is a small amount of free fluid in the left side channel.
Biochemical analysis blood from 13.12. total protein 70 g/l, bilirubin 9.3 µmol/l transaminases: AST 0.27 mmol/l, ALT 0.124 mmol/l, (within normal limits), glucose 5.5 mmol/l, urea 4.9 mmol/l , amylase 42 U/l, sialic test 3.8 units, rheumatic factor negative, CRP-96 mg/l, DPA-negative, ASLO-negative.
In the general blood test: er-ty 1.6x1012/l, NV 41 g/l, platelets 287 thousand, l-4.8 x10 9/l, e-3 p-2 s-64 l-28 m-3 ESR 65 mm/hour.
12/15/2006. A transfusion of washed erythrocytes was performed (EMOLT individual selection, Blood group (B III) RH+) in the amount of 200.0 ml.
Blood counts have improved - ER 3.6x1012/l, NV 100 g/l, platelets 244 thousand, l-5.0 x10 9/l, e-1 p-1 s-69 l-23 m-6 ESR 35 mm/hour.
Diagnosis: gangioneuroblastoma of the retroperitoneal space on the left, stage III, conditions after combined treatment. Relapse of the disease. Multiple nodes in the retroperitoneal space on the left, metastases to the sacrum.
Complications: hydronephrosis on the left. Anemia.
The child is indicated for examination and treatment in a specialized pediatric oncology department.
Hi all! I hasten to address people who have a disease such as myasthenia gravis and have undergone surgery to remove thymus gland, as well as neurologists and surgeons. My sister is 31 years old, at the beginning of this year she was diagnosed with thymic hyperplasia due to myasthenia gravis. In the spring, she underwent a course of treatment in the neurology department of the regional hospital, and is now admitted to planned surgery to remove the thymus gland. While he is in neurology for examination, one of these days he should be transferred to the department...
Girls, has anyone come across this... My five and a half year old daughter has inflamed lymph nodes (or lymph nodes) in her neck and near her jaw. Previously, in our childhood, doctors always checked them during examination, but now no, I didn’t feel them myself, I came across them by accident, and the doctor didn’t even look, so I don’t know, maybe they were inflamed even when... We haven’t been getting sick since December for sure, maybe a little sniffles came out, but the rhinoflum quickly. were cleaning up. and we continued to go to the pool, it seemed like everything was washed. Happy New Year...
Discussion
check for mumps (mumps).
02/10/2011 08:45:39, JillLianaAt about 2.5 the lymph nodes came out, first on one side, then on the other. We treated and went to doctors for almost 6 months, donated blood, took antibiotics - until the adenoids and tonsils were removed. It turned out that all the inflammation was in the nasopharynx, adenoids - tonsils - water in the ears. And everyone takes turns infecting each other. Since then, pah-pah-pah, everything has been calm in Bogdad. Good luck to you, don't be upset! Everything will be fine!!! Well @@@-@@@@
The endocrinologist warns: is the child nervous, losing weight? Possibly hyperthyroidism
Discussion
My daughter is 12 years old. She has TSH4-6. Her eyebrow hair is falling out. Is it because hormones are falling out? TSH increased or normal? Should I contact an endocrinologist?
Good afternoon Daughter is 14 years old. We went to the pediatrician with symptoms of nausea and headaches. Heart palpitations last year rapid pulse reaches 111 beats per minute. During the year, the menstrual cycle is irregular.
We tested for hormones, the indicators are as follows:
T4 - 1.12
TSH - 1.30
Total T3 - 79.5 (normal 84-172).
An ultrasound of the thyroid gland was performed. A 1.9 mm cyst was discovered in the right lobe.
What diagnosis can we talk about based on the test data?
What are the consequences?
“Prevention” of the disease by destroying the “patient” Nina Aleksandrovna Sokolova - candidate of biological sciences, senior researcher at VINITI RAS, executive editor of two scientific journals: “Human and Animal Physiology” (issue “Endocrine system. Reproduction. Lactation”) and “Clinical Endocrinology” " Massino Yulia Sergeevna - candidate of biological sciences, senior researcher at the Institute of Higher nervous activity and neurophysiology RAS. [link-1] [link-2] ...according to...
And now an elephant made by one of the maids at the Concord Front Hotel in Sharm
Baths with infusions of chamomile herbs, oak bark, tricolor violet (20 in quantity) every other day or baths with pine extract (10-15), sea salt(10) every other day. Acupressure to stimulate the immune system: massaging points above the manubrium of the sternum, in the area submandibular lymph nodes, behind the angle of the lower jaw, near the wings of the nose, on the eyebrows, behind the ear, near thumb hands. The choice of the listed measures and their combination should be decided by the doctor, taking into account the characteristics of the child and his family....
Discussion
And now it’s not enough at all healthy children. The environment around is bad, and that’s why children get sick.
24.10.2009 19:57:05, mamamamaBut why do they get sick so often and for a long time?
Maybe there are external factors that provoke frequent illnesses, maybe immunity is reduced for some reason?
Reactive lymph node hyperplasia- hyperplasia of the lymphoid tissue of the lymph nodes with a pronounced immune response. At the same time, the lymph nodes increase in size, have a soft-elastic consistency, and typical cases their diameter exceeds 2 cm. Chronic (persistent) reactive hyperplasia refers to a long-term process (usually more than 2 months). In children, enlarged lymph nodes may be an expression of generalized hyperplasia of lymphoid tissue with lymphatic-hypoplastic diathesis (status thymico-lymphaticus). In the acute course of the process, it is called acute reactive hyperplasia. Some authors also highlight the most acute form reactive hyperplasia that develops after the introduction of a vaccine; others consider them as post-vaccination lymphadenitis.
There are several morphological variants of reactive hyperplasia. Of these, the most common are follicular, paracortical hyperplasia and reactive sinus histiocytosis. With follicular hyperplasia, there is usually an increase in the size and number of secondary follicles (follicles with light centers) in the cortex of the lymph node. With pronounced follicular hyperplasia, secondary follicles occupy the entire parenchyma of the lymph node. In typical cases, secondary follicles have irregular shape(for example, hourglass shape), different sizes (polymorphism of follicles), in contrast to follicular lymphoma, in which, as a rule, follicles are the same size, round in shape. The light center of secondary follicles is represented by various cells: small split cells (centrocytes), large split and non-split cells (centroblasts), follicular dendritic cells that provide antigen presentation to centrocytes, as well as a moderate number of macrophages, in the cytoplasm of which many apoptotic bodies formed during destruction are determined lymphocytes. The abundant light cytoplasm of macrophages gives the germinal center of the follicle a “starry sky” appearance.
Reactive hyperplasia with follicle lysis. Lysis of the follicle is a peculiar deformation of the terminal center of the secondary follicle, when it breaks up into fragments due to penetration (penetration) into the light center of the lymphocytes of the mantle. This change is most often detected in the lymph nodes during HIV infection, but can also be caused by other processes, for example, simply hemorrhage into the germinal center of the follicle.
Blooming reactive follicular hyperplasia. Flowering (Florida) reactive follicular hyperplasia of lymph node tissue may be idiopathic or associated with processes such as rheumatoid lymphadenopathy, syphilitic lymphadenitis, toxoplasma lymphadenitis, and the plasma cell variant of Castleman's disease. The idiopathic form usually occurs in young adults, usually involving a single lymph node in the submandibular or cervical region. Lymphoid follicles are clearly separated from each other and are predominantly distributed in the cortex. In most cases of follicular lymphoma, the follicles are closely located and scattered throughout the tissue of the lymph node. With reactive hyperplasia, the follicles are often different in shape and size (sometimes dumbbell-shaped or convoluted), and have a clearly defined mantle. They contain a heterogeneous population of follicular center cells ( large cells often predominate over small ones) with signs of mitotic activity and with macrophages with colored bodies scattered between them.
Specific variants of lymphadenopathy are often accompanied by histological changes characteristic of these diseases in addition to reactive follicular hyperplasia. At rheumatoid lymphadenopathy, As a rule, interfollicular plasmacytosis is pronounced, and neutrophilic granulocytes are usually found in the sinuses. At syphilitic lymphadenitis the capsule of the lymph node is often thickened, with signs of inflammatory changes, plasmacytosis and venulitis are characteristic, granulomas are sometimes found. At toxoplasma lymphadenitis Numerous monocytoid B lymphocytes and epithelioid histiocytes are found, scattered singly or collected in small groups. Some epithelioid histiocytes may be located in the terminal centers of the follicles. At plasmacytic variant of Castleman's disease reactive follicles, often containing PAS-positive eosinophilic material, are separated from each other by a significant infiltrate of plasma cells, extending to all parts of the lymph node cortex. Despite the above morphological characteristics, correct diagnosis requires knowledge clinical picture diseases, and in some cases special studies.
HIV-like lymphadenopathy (AIDS-related lymphadenopathy). Explosive follicular hyperplasia is very similar to follicular lymphoma. This lesion is characterized by hyperplasia of the follicles, many of which take on the appearance of “naked” (“bare”) light centers due to an underdeveloped mantle zone; lysis of follicles (destruction of the network of follicular dendritic cells and hemorrhages in the light centers); the presence of polykaryocytes in the light centers and beyond, as well as a noticeable number of monocytoid B cells. Although the follicular mantle is often poorly defined, the reactive nature of lymphoid follicles can be confidently inferred from the detection of cellular polarization and the abundance of active macrophages.
Progressive transformation of light centers- benign lesion of unknown etiology. Rarely, it precedes the development of Hodgkin's disease, especially the nodular type with a predominance of lymphocytes. Microscopically, the process is characterized by the presence of scattered large “expansively transformed” follicles located among reactive follicles of a typical type. Transformed follicles are formed predominantly by small lymphocytes, as well as scattered B cells of the follicular center, which are located singly or form irregular small groups.
Reactive lymphadenopathy in HIV infection. At the onset of the disease, an increase occurs due to follicular-paracortical hyperplasia of all groups of lymph nodes (generalized lymphadenopathy as a manifestation of the hyperplastic stage of changes in lymphoid tissue). A morphological study is characterized by thinning or destruction of the mantle of reactive follicles, which looks as if “moth-eaten” due to the focal disappearance of lymphocytes. An increase in the number of plasma cells in the lymph node tissue, proliferation and swelling of the vascular endothelium can also be detected.
At the end of HIV infection (stage AIDS) atrophy of the lymph nodes is observed (involutive stage of changes in lymphoid tissue). As HIV infection progresses, the follicles decrease and the paracortical zone thins due to a decrease in the number of lymphocytes. Between the follicles the content of blast forms of lymphoid cells, plasma cells and macrophages increases. Characteristic is the development of histiocytosis of the sinuses and exposure of the reticular stroma. Diffuse fibrosis often develops.
Lymphadenitis is an inflammatory lesion of the tissue of the lymph nodes. Lymphadenitis must be distinguished from reactive hyperplasia, which may not be accompanied by inflammatory changes. However, more often hyperplasia and inflammation are combined. The severity and nature of inflammatory changes may vary. Thus, persistent (long-term) reactive hyperplasia, as a rule, is accompanied by the development of chronic nonspecific lymphadenitis, because with a long-lasting immune response, damage occurs in the lymph node tissue and, consequently, an inflammatory reaction is formed. In some cases, inflammatory changes are minimal, in others they prevail over the immune response.
I. Clinical and morphological classification of lymphadenitis:
Acute and acute lymphadenitis;
Chronic lymphadenitis (nonspecific and specific).
II. Special clinical and morphological variants of lymphadenitis:
Adenophlegmon;
Castleman's disease (Castleman morbus, angiofollicular hyperplasia);
Necrotizing lymphadenitis Kikuchi-Fujimoto;
Rosai-Dorfman disease (sinus histiocytosis with massive lymphadenopathy);
Dermatopathic lymphadenitis (dermatopathic lymphadenopathy).
Adenophlegmon - total purulent inflammation lymph node tissue. A lymph node is a “sac” of pus. Adenophlegmon can be considered as an extreme expression of acute purulent lymphadenitis.
Castleman's disease(morbus Castleman, angiofollicular hyperplasia) - reactive proliferation lymphoid tissue and blood vessels. The etiology of Castleman's disease is unknown. As a rule, children get sick. The lymph nodes of the mediastinum (in 75% of cases) and the retroperitoneal space are mainly affected. Sometimes the process occurs outside the lymph nodes (extranodal), for example in the spleen. There are two clinical and morphological variants of Castleman's disease: hyaline-vascular And plasmacytic. The disease can manifest itself as damage to one group of lymph nodes or several (multicentric variant). The hyaline-vascular variant proceeds more favorably; in the lymphoid follicles, fibrous tissue grows with its development
eprovided [plasmatic: lymph node type
Yapine dystrophy. The plasmacytic variant is accompanied
D accumulation of plasma in proliferating lymphoid tissue
cells. After surgical removal affected lymph nodes
Complete recovery usually occurs. Multicentric Castleman disease is the most severe because... involved in the process
various groups of lymph nodes are identified, as well as internal
Lymphadenitis Kikuchi-Fujimoto- acute lymphadenitis of unknown etiology with the development of necrosis in the paracortical zone. Mostly young women suffering from systemic lupus erythematosus are affected. In some cases, Kikuchi-Fujimoto lymphadenitis precedes the development of systemic lupus erythematosus. The cervical lymph nodes are mainly affected. At microscopic examination In addition to necrosis of the paracortex, noteworthy is the proliferation of macrophages with a characteristic crescent-shaped deformation of the nucleus and almost complete absence neutrophil gran-
nulocytes.
Sinus histiocytosis with massive lymphadenopathy(disease
Rosai-Dorfman) - disease unknown etiology, at which there is a significant increase various groups lymph nodes Sometimes they are amazed internal organs. Deaths have been described. Microscopically, the number of macrophages (histiocytes) sharply increases in the lymph nodes, mainly in the sinuses (hence the name of the disease). Macrophages actively phagocytose lymphoid cells. The autoimmune nature of the process is assumed: lymphocytes for some reason become foreign and are destroyed by macrophages. Mostly children in the first decade of life are affected, but the disease also occurs in adults.
2. DISREGENERATIVE CHANGES Sclerosis of lymphatic tissue nodes Focal and perivascular sclerosis is usually the outcome of lymphadenitis. It also develops when exposed to ionizing radiation (radiogenic fibrosis as a result of radiation lymphadenitis), used in therapy malignant neoplasms and a number of non-tumor lesions. Fibroplastic changes occur in cases where the lymph nodes are directly
in the irradiation zone.
Macroscopically the nodes are somewhat enlarged, compacted, in the cut the tissue is light gray with sometimes visible layers of whitish tissue.
At microscopic The study reveals a thickening of the capsule due to severe sclerosis, the presence in it of single, paralytically dilated microcirculatory vessels and mild lymphoplasmacytic infiltration. Lymphoid tissue of the nodes of the cortex, paracortex, and medulla undergoes atrophy varying degrees expressiveness. Signs of histiocytosis of the sinuses are absent or slightly pronounced.
LYMPHOMA
The main primary neoplasms of lymph nodes are lymphomas (malignant lymphomas).
Definition. Lymphomas - malignant neoplasms developing from lymphocytes, their precursors and derivatives. It is still customary to designate these tumors with the term “malignant lymphomas,” but it should be remembered that the concept of “benign lymphomas” does not exist in modern international histological classifications.
Classification. Currently, the generally accepted system for classifying lymphomas is the second edition of the WHO classification of lymphoid tumors (2000), according to which all lymphomas are divided into three groups:
Lymphomas from B cells, their precursors and derivatives (plasmocytes);
Lymphomas from T- and EK(NK)-mreTOK, as well as their predecessors;
Hodgkin's disease (Hodgkin's lymphoma).
The first two groups of lymphomas are traditionally designated by the term non-Hodgkin's lymphomas(i.e. lymphomas other than Hodgkin's disease).
In oncomorphology, lymphomas are histologically divided primarily into three groups - follicular, follicular-diffuse And diffuse- depending on whether or not the tumor cells form structures resembling secondary lymphoid follicles, and how pronounced the follicular or diffuse growth of the tumor is. Depending on the size of tumor cells, they are divided into small cell, mixed cell And magnocellular lymphomas.
FOLLICULAR LYMPHOMA
Definition. Follicular lymphoma (formerly known as nodular lymphoma)- B lymphoma, the cells of which form structures resembling normal secondary ones lymphoid follicles.
Clinical and morphological features. Incidence rates of follicular lymphoma vary greatly between countries. So, in the USA it makes up approximately 30% of all non-Hodgkin lymphomas, in Britain and Germany - about 20%, in Asia and Africa - about 10%. In Russia, this tumor is rare. Follicular lymphoma affects mainly adults ( middle age 55 years old). Under the age of 20, follicular lymphoma practically does not occur, so such individuals must be diagnosed with follicular lymphoma with extreme caution, with mandatory additional (immunohistochemical and molecular biological) studies.
Macroscopically the affected lymph nodes, less often other organs, are usually enlarged and often painless. Characteristic are wave-like changes in the volume of the tissues involved (during the course of the disease they either increase in size or decrease).
Microscopic picture. Follicular lymphoma tissue mainly consists of two types of cells - centrocyte-like and centroblast-like. Centrocyte-like cells- cells resembling small cells of the follicular center (centrocytes). Their characteristic feature is the presence of irregular (irregular) contours of the nucleus. Such nuclei are called cleaved, and the centrocyte-like cells themselves are designated as small split cells of the follicular center. Centroblast-like cells- cells resembling large cells of the follicular center (centroblasts). Their nuclei may have the correct shape (large undivided cells of the follicular center) or be irregular (large split cells of the follicular center).
Typically, numerous, closely spaced monomorphic (similar to each other) nodules of tumor cells form in the tissue of the affected lymph node (tumor follicles), separated by narrow layers of interfollicular tissue. Sometimes tumor follicles appear outside the lymph node, in the perinodal fatty tissue. However, follicular lymphoma does not always have such a characteristic structure, which creates difficulties in differentiating this tumor from reactive lymphoid hyperplasia.
Sometimes single cells resembling Reed-Sternberg cells are found. In large cell follicular lymphoma, a diffuse component is more common than in other subtypes of this lymphoma. In most cases of follicular lymphoma,
tumor cells circulating in the blood appear. Their number varies. Total number leukocyte count may be increased or normal. In some cases, leukemia of follicular lymphoma occurs.
Classification. There are three main types of follicular lymphoma.
1. Follicular small cell lymphoma(follicular centrocytic lymphoma) - follicular lymphoma, in the tissue of which centroblasts make up less than 25% of all tumor cells (or less than 5 cells in 20 fields of view with a microscope magnification x 400).
2. Follicular mixed cell lymphoma(follicular centrocytic-centroblastic lymphoma) - follicular lymphoma, in the tissue of which centroblasts make up 25-50% of all tumor cells (or 5-5 cells in 20 fields of view with a microscope magnification x 400).
3. Follicular large cell lymphoma(follicular centroblastic lymphoma) - follicular lymphoma, in the tissue of which centroblasts make up more than 50% of all tumor cells (or more than 15 cells in 20 fields of view with a microscope magnification x 400).
Follicular small cell lymphoma accounts for approximately 65% of cases of all follicular lymphomas, follicular mixed cell - about 25%, follicular large cell - approximately 10%.
The first two options are low-grade tumors. Follicular large cell lymphoma is somewhat more aggressive and is classified as an intermediate-grade tumor.
Hyperplasia cervical lymph nodes- This clinical symptom, in which excessive growth of lymphoid tissue occurs with a gradual decrease in the volume of the cells themselves, their degeneration and change in structure. Enlargement of the cervical lymph nodes is most often a response of the body’s immune system to an infection of various etiologies that has entered the body. In addition to infectious lymphadenitis, bacterial or viral in nature, hyperplasia of the lymph nodes of the neck can be caused by oncology.
An inflammatory process in the nasopharynx, left without appropriate treatment, provokes a response from the body from the lymph nodes located in the neck. Depending on the degree of localization of hyperplasia of the cervical lymph nodes, classification occurs inflamed areas, and these are: submandibular, occipital, supraclavicular and anterior auricular. For example, local hyperplasia of the submandibular lymph nodes is observed in: sore throat, scarlet fever, felinosis (cat scratch disease), caries, diseases that have passed into the chronic phase, mumps, diphtheria.
Fungal diseases of the upper respiratory tract, the skin of the head and even the oral cavity can provoke the development of neck hyperplasia.
In addition to all of the above, hyperplasia of some of the lymph nodes of the neck is diagnosed by doctors for rubella, toxoplasmosis, syphilis and tuberculosis. In addition to hyperplasia of the submandibular lymph nodes, in patients with tuberculosis there is an increase in intrathoracic lymph nodes, which, without adequate therapy, degenerate, and healthy cells of lymphoid tissue are gradually replaced by necrotic masses.
Diseases can lead to excessive enlargement of the lymph nodes in the neck thyroid gland, failure of protein metabolism and allergic reactions of the body. In extremely rare cases, lymphoid tissues increase due to diabetes mellitus, chronic alcoholism or gout. Also in medical practice, there have been cases where hyperplasia of the cervical lymph nodes occurs against the background of a general decrease in immunity.
The growth of tumor formations in most cases occurs similarly to infectious diseases - the lymphatic tissue grows, additional protrusions are visualized under the skin at the location of these nodes, and the areas are hyperemic.
Clinical symptoms of lymph node hyperplasia depend on their size, accumulation and the nature of the inflammatory process.
The size of the lymph nodes varies from 1.0 cm to early stage up to 2-2.5 cm in their hyperplastic state. To the touch they are defined as mobile bean-shaped formations, not connected into a common mass with the surrounding tissues and located on both sides of the jaw. In some cases, when they are greatly enlarged, thin, thread-like structures (lymphatic vessels) extending from the lymph nodes can also be felt.
Painful sensations on initial stage inflammation is weak, noted only on palpation. As the process progresses, pain intensifies and accompanies any movement of the neck (while eating, when talking) and even at rest.
As the inflammatory process develops, the small vessels surrounding the lymphoid tissue dilate, their permeability increases, as a result of which swelling and hyperemia appear on the skin in the area of the enlarged lymph nodes. When palpated, an increase in temperature of 1-2 °C is noted.
If the infection has spread beyond the lymph nodes, then the patient, in addition to an increase in general body temperature to 38 °C, experiences drowsiness, headaches, and general weakness of the body.
In the absence of adequate treatment during development bacterial infection, the patient may experience suppuration of the cervical lymph nodes. What is it? The skin at the site of inflammation is tense, swollen and hyperemic, the lymph nodes are painful both on palpation and at rest, lower jaw limited in movement.
Particular attention should be paid to the slowly growing lymph nodes in the neck, which do not hurt when touched, are inactive and have a dense structure, as there is a risk of developing oncology. With metastatic enlargement of lymphoid tissue, the node feels like it fuses with the surrounding tissues, so-called colonies are formed.
If prolonged hyperplasia is observed, that is, the lymph nodes in the neck are inflamed for more than 2 months, we can no longer talk only about a chronic infection. For a more accurate diagnosis of the disease, in order to avoid the development of cancer, it is recommended to take a puncture and undergo medical examination including the following points:
The diagnosis allows the doctor to understand what causes hyperplasia of the cervical lymph nodes and prescribe appropriate treatment.
Treatment and prevention of hyperplasiaDepending on the size of the lymph nodes and the results of the study, the patient may be prescribed consultations with specialists of the following profile:
After carrying out diagnostic procedures and identifying the source of inflammation, the attending physician, depending on the results of the research, prescribes therapy for lymph node hyperplasia, which involves the prescription of antibacterial and anti-inflammatory medications. Such remedies not only treat the provoking disease, but also prevent the further spread of infection throughout the body.
To reduce swelling and cupping pain The doctor prescribes painkillers and conducts a course of treatment UHF drug. In addition, cool compresses may be applied to the area of inflammation. If an abscess develops, surgery may be required.
If hyperplasia of the cervical lymph nodes develops against the background of existing tuberculosis or any autoimmune disease, then the doctor conducts therapy according to schemes developed individually for each patient.
To strengthen the immune system and prevent the development of hyperplasia of the cervical lymph nodes, the patient is recommended to take vitamins, observe personal hygiene rules, timely treatment of colds and hardening to avoid relapse.
During the treatment period, the patient is recommended to rest, bed rest, nap. In addition, the patient's menu is being revised - spicy, fatty and fried foods are excluded, and emphasis is placed on the consumption of light soups, pureed steamed vegetables and fruits. Herbal teas, juices and compotes are allowed as drinks.
Treatment of hyperplasia at homeTraditional medicine in the treatment of lymph node hyperplasia offers:
To prevent the development of accelerated blood circulation, inflamed lymphatics should not be heated and iodine mesh should not be applied. Drinks consumed by the patient should be warm or at room temperature.
It should be remembered that even isolated hyperplasia of a single node in the neck is evidence of a systemic disorder in the body, which can be difficult to detect without the use of laboratory tests in specialized medical institutions. Therefore, in order to avoid degeneration of the lymph nodes, their independent diagnosis and therapy is unacceptable.
The name of the disease has Greek roots and, literally translated, sounds like “over-education.” Therefore, hyperplasia is an increase in tissue structure elements due to their excessive formation. An increase in the number of cells leads to an increase in the volume of an organ or tumor. At the same time, rapidly developing processes of hyperplasia lead to a decrease in the volume of the cells themselves, i.e. to disruption of their structure.
Hyperplasia can develop in various organs and have significant complications.
In medical practice, there are cases of cell proliferation in the mammary, prostate and thyroid glands, placenta and other organs. Hyperplasia can develop during pregnancy, or during the premenstrual period in the mammary glands, in the form of the mucous membrane of the stomach, uterus, and nose.
Hyperplasia often develops with certain types of infection, with acute anemia in the form of growth of hematopoietic tissue outside the bone marrow.
The causes of hyperplasia are various processes leading to cell proliferation.
Such processes include violations nervous regulation cell metabolism and growth. Hyperplasia often develops due to an increase in tissue function under the influence of growth stimulants. This can occur under the influence of carcinogens or tissue decomposition products.
The cause of hyperplasia may be a violation of relationships in organs with internal secretion.
Hereditary factors and concomitant diseases, such as mastopathy, liver dysfunction, and other diseases can also cause hyperplasia.
The symptoms of the disease depend on the location of the area with growing tissues.
The main signs of hyperplasia include an increase in the volume of the organ, thickening of the affected layer, pain at the site of localization. Hyperplasia is often accompanied by nausea, vomiting, chills and increased body temperature.
In medicine, there are several types of hyperplasia.
Pathological and physiological hyperplasia is divided into:
In addition, hyperplasia can be focal, diffuse or polypous:
This type of hyperplasia occurs as a compensatory reaction of the liver to iodine deficiency.
The term diffuse hyperplasia reflects an increase in the overall volume of the liver due to the proliferation of its cells to support the secretion of thyroid hormones, which promote metabolism, maintain energy levels and enhance oxygen absorption.
Iodine is essential thyroid gland to maintain its hormonal activity. The absence or lack of iodine intake leads to the proliferation of gland cells and its dysfunction.
In addition, a hereditary predisposition can lead to the development of diffuse hyperplasia of the thyroid gland.
Eating goitrogenic substances (preventing the consumption of iodine for the production of hormones) can also cause hyperplasia of the thyroid gland. Such provoking agents include sweet potatoes, cauliflower and white cabbage, corn, lettuce, horseradish, and turnips.
A similar form of hyperplasia can occur with the use of certain medications or helminthic infestation.
An increase in the volume of lymph nodes, which occurs as a response of the body to inflammatory process, a generalized infection or pathology of autoimmune processes is called reactive lymph node hyperplasia.
Enlarged lymph nodes may be caused by metastases oncological tumors Therefore, it is necessary to differentiate reactive lymph node hyperplasia from metastases of malignant tumors. In the reactive form, unlike oncological processes, there is pain, enlargement and elastic consistency inflamed nodes. This form is characterized by localization of hyperplasia in the submandibular, axillary and cervical lymph nodes.
After about age fifty, about 85% of men suffer from benign prostatic hyperplasia (prostate adenoma). The disease is characterized by the formation of a small nodule (or several) on the prostate, which, as it grows, puts pressure on the urethra and causes problems with urination. Benign prostatic hyperplasia does not cause metastasis, which distinguishes this disease from oncological disease, that is, prostate cancer. That is why it is called benign hyperplasia. The disease has no clear cause and is usually associated with male menopause.
When the mammary gland enlarges by more than half, mammary gland hyperplasia is diagnosed, the severity of which is determined by its increase in height and in the anterior projection. The disease can be unilateral or bilateral. With unilateral hyperplasia, echographic diagnosis is necessary to exclude oncology.
Dyshormonal diffuse hyperplasia of the mammary gland can be expressed by an increase in the volume of the ductal epithelium as a result of an increasing number of cell layers of the duct walls and an increase in terminal tubular branches. In addition, diffuse dyshormonal hyperplasia may occur due to sclerosis connective tissue.
Diffuse dyshormonal hyperplasia, which develops against the background of connective tissue sclerosis, leads to severe premature degeneration of the mammary gland, the formation of cysts and tissue fibrosis.
Fibrous hyperplasia of the mammary gland, better known as fibrocystic mastopathy, is formed due to various dyshormonal disorders in the mammary gland. In this case, benign tumors appear in the breast.
The reasons why fibrous hyperplasia of the mammary glands can form are associated with the presence of gynecological and endocrine diseases, may be a consequence of abortion or the result of systemic diseases.
Fibrous hyperplasia of the mammary glands is characterized by the formation of connective tissue.
All forms of hyperplasia require accurate diagnosis and identification of the true cause of tissue proliferation.
An increase in tissue volume or proliferation is called hyperplasia or metaplasia. Metaplasia is a tumor growth of cells with signs of malignancy.
Hyperplasia is the same cell growth, but it is distinguished by the benign nature of the process: the overgrown tissues have the correct intracellular structure and chromosomal composition. Only if hyperplasia is started will the process become malignant.
Treatment of hyperplasia can be medication or surgery. The method is selected depending on the type of hyperplasia, its location, and stage.
The article will discuss treatment methods for the most common types of disease, such as endometrial hyperplasia, benign prostatic hyperplasia, thyroid hyperplasia, lymphoid hyperplasia.
Endometrium in healthy condition consists of a base (stroma) and gland. Therefore, depending on which endometrial tissue grows, the following types of disease are distinguished:
In addition, a new classification of the disease was recently adopted: simple hyperplasia and atypical. Atypical, in turn, is divided into two forms: diffuse hyperplasia and focal hyperplasia.
The standard treatment regimen for endometrial hyperplasia is a combination of surgery and hormonal therapy. But since we are talking about a disease of the most important reproductive organ, the woman’s age is also taken into account. If the stage and type of hyperplasia make it possible to stop cell growth and reduce the volume of overgrown tissues only with the help hormonal drugs, do without surgical intervention.
First, let's look at the standard approach to treating this type of disease as glandular hyperplasia. Treatment in most cases involves curettage of the uterine cavity, which is both a diagnostic and therapeutic procedure. Hormonal therapy for the disease glandular hyperplasia consists of prescribing combined contraceptive drugs (medicine Regulon) or gestagens. It has been established that glandular hyperplasia responds well to the gestagenic drug Duphaston. Treatment is often limited to the prescription of this drug alone, and it lasts at least three months. Contraceptives are prescribed in courses of 21 days, with control examinations carried out in between.
Cystic hyperplasia and glandular cystic hyperplasia are treated according to the same scheme. Often, in the absence of obvious abnormalities, cystic hyperplasia and glandular cystic hyperplasia are considered to be the same disease.
Simple hyperplasia is a tissue growth in which atypical cells are not found in them. Simple hyperplasia is a benign process with a positive prognosis. Simple hyperplasia, when treated promptly, is often successfully treated with hormones.
Atypical diffuse hyperplasia is a uniform proliferation of endometrial cells. Atypical focal hyperplasia is the proliferation of cells in a limited area of the uterine cavity.
Both diffuse hyperplasia and focal hyperplasia of an atypical nature are considered precancerous conditions; in most cases they require surgical intervention - either the entire uterine cavity is curetted if diffuse hyperplasia is diagnosed, or a separate altered area if focal endometrial hyperplasia is observed. Read more about drug treatment for endometrial hyperplasia. Regulon is usually prescribed to women of childbearing age - up to 35 years of age and to teenage girls with complaints of irregular or heavy menstruation. As already mentioned, the drug is taken in the standard course - 21 days. To stop uterine bleeding, the patient is prescribed to take 2-3 Regulon tablets per day. If the bleeding does not stop, curettage of the uterus is performed.
Duphaston for such a disease as benign endometrial hyperplasia is prescribed to women both during childbearing age and during menopause. The drug is taken in courses of 3-6 months, from days 16 to 25 of the menstrual cycle.
Women during premenopause can be prescribed the drug Buserelin. The medicine inhibits ovarian function. This process is reversible (the ovaries return to normal after 2-3 weeks), but such side effects, as menopausal manifestations are usually poorly tolerated by patients from a psychological point of view, so women are more early age try not to prescribe Buserelin.
Except hormone therapy a woman with endometrial hyperplasia needs to undergo restorative treatment. Vitamins, iron supplements, medications with a sedative effect are usually prescribed, acupuncture and physiotherapy are practiced.
If hyperplasia does not respond to surgical and hormonal treatment, and after a while it appears again, the woman is advised to have the uterus removed.
In order to prevent such serious consequences, it is necessary to undergo regular examination by a gynecologist and be sure to apply for medical assistance if the following signs of endometrial hyperplasia are detected:
To begin with, it should be noted that prostatic hyperplasia is always a benign process. At timely detection disease and adequate treatment can prevent the degeneration of adenoma (the second common name for BPH) into a malignant neoplasm.
Therefore, a man should pay attention to the following signs of hyperplasia:
Benign prostatic hyperplasia in the initial stage is amenable to drug treatment. There are two types of medications used to treat BPH:
Surgery on the prostate is resorted to if the following signs of hyperplasia are detected:
In addition, resection of the prostate gland is indicated for patients with benign prostatic hyperplasia if they have kidney stones, scar processes in the pelvis, neurogenic disorders, acute inflammation lower urinary tract, as well as hypersensitivity to drugs.
The functioning of the thyroid gland is regulated by the endocrine system. Hyperplasia of this organ begins when its function deteriorates, when the gland stops producing thyroid hormones. This often occurs due to iodine deficiency in food and water.
The growth of thyroid tissue can be different, but most often patients are treated about the appearance of nodules in the gland.
Nodular hyperplasia of the thyroid gland is dangerous because the resulting nodules often degenerate into tumors. The most dangerous is considered to be nodular hyperplasia of the gland, in which solitary (single) nodes are formed.
Signs of thyroid hyperplasia are an increase in size of the organ (which is first felt upon palpation, and some time later is easily determined visually), pain, difficulty swallowing and breathing, and hoarseness. All these symptoms are explained by the fact that the gland, increasing, compresses the nerves, blood vessels, and respiratory organs.
As we have already said, nodular hyperplasia is a fairly serious disease, therefore, the sooner the endocrinologist makes a diagnosis, the better the prognosis for hyperplasia. First, nodular hyperplasia is determined by ultrasound - thanks to this examination method, nodules in the gland can be seen. The malignancy of the process can be excluded only after a biopsy - the gland is pierced with a thin needle, the contents of the node(s) are taken and sent for laboratory histological examination.
In addition, a person who is diagnosed with nodular hyperplasia must undergo a gland scanning procedure with radioactive iodine. Such an examination makes it possible to identify “cold” nodules that are prone to degeneration into cancerous tumors.
With timely contact with an endocrinologist and the absence of “cold” nodes, nodular hyperplasia can be successfully treated with drugs containing thyroid hormones.
Nodular hyperplasia of the thyroid gland, which provokes the appearance of “cold” nodes, is subject to surgical treatment. The operation is also indicated if, as a result of histological examination of the contents of the nodes, poor or questionable results are obtained.
If we are talking about surgery, a patient diagnosed with nodular hyperplasia is first prescribed only removal of the nodes. During the operation, an additional histological examination of the gland tissue is performed, and if cancerous (atypical) cells are found in them, it is completely removed, along with the nearby lymph nodes.
Prevention of a disease such as nodular hyperplasia of the thyroid gland is the daily use of iodine. The daily iodine intake for adults is 200 mcg, for children – 100 mcg, for pregnant and lactating women – 250 mcg.
Lymphoid hyperplasia is a pathological proliferation of lymphocytes in the lymph nodes. Lymph nodes perform protective function– they suppress the growth of viruses, bacteria, and the spread of malignant processes. Most often, the enlargement of nodes is a response to inflammation, but in some cases the lymph nodes themselves are involved in the inflammatory process - this is lymphoid hyperplasia.
The location of enlarged lymph nodes can often indicate the presence of serious diseases. For example, hyperplasia of the lymph nodes in the groin can be caused by cancerous tumors in the legs or cancerous metastases in the external genitalia. Pathologically enlarged nodes in the neck appear due to tumors on the face or in the jaw bones.
Lymphoid hyperplasia is treated comprehensively. First, a full examination is carried out to identify the cause of such severe inflammation of the nodes. Based on the results, conservative or surgical treatment. Conservative treatment of the disease lymphoid hyperplasia is selected depending on the location of the inflamed nodes.
If the stomach is affected, I can prescribe probiotics, hepatoprotectors; if the adenoids are inflamed, desensitizing drugs, antiseptics, as well as laser therapy, vibroacoustic therapy, and ultraviolet irradiation are prescribed.
If lymphoid hyperplasia is caused by intestinal disease, corticosteroids may be prescribed. Thus, we can conclude that conservative treatment The disease lymphoid hyperplasia is aimed at relieving inflammation. If this does not produce results and the growth of lymph node tissue does not stop, surgery is prescribed to trim or remove nodes and other affected tissues or organs.
First of all, it should be remembered that lymphoid hyperplasia is still a benign process, and symptoms such as enlarged nodes, their pain, persistent high temperature require medical attention. Surgery and complications in the form of degeneration of overgrown tissue into cancerous tumors can be avoided if you undergo a timely examination.
The same can be said about all types of hyperplasia that are described here. In most cases, you can get by with taking medications and stopping the pathological processes that occur in the body under the influence of external factors, due to poor nutrition, increased trauma, etc.
