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Swollen Glands – Causes

swollen glandsSwollen glands. Spleen and lymph nodes are a part of the peripheral immune system. Swollen glands can meet in various infectious diseases, auto immune diseases, endocrine and metabolic diseases, neoplasia and most hematological diseases.

The discovery of an enlarged lymph node in a current medical practice raises serious suspicion of suffering, but it often proves that the etiology (cause) of these is benign, frequent infections.

Most patients can be diagnosed based on a strict case history and a thorough objective clinical examination.

Lymphadenopathy (swollen glands) located require the investigation of the adjacent regions and examination of other groups of nodes to exclude a generalized lymphadenopathy, which puts it in a serious condition and requires an additional investigation from the beginning.

In general it takes into consideration a node which has dimensions bigger than 1 cm.

The following questions arise:

  1. There are local signs or symptoms suggesting an infection or a neoplasm with a specific location?

  2. Are present general signs such as fever, weight loss, fatigue, night sweats, suggesting tuberculosis, lymphoma, and collagen?

  3. There are some epidemiological arguments (occupational exposure, recent travel, risky behaviors) suggesting a specific pathology?

  4. The patient is taking a medical treatment that could cause the adenopathy?

Medicines that can cause enlarged lymph: Allopurinol, Atenolol, Captopril, Carbamazepine, Cephalosporin, Gold salts, Hydralazine, Penicillin, Phenytoin, Pyrimidine, Pyrimethamine, Quinidine, Sulfonamides, Sulindac.

Pathological significance of adenophaty according of the location:

  • submandibular: infections of the head and neck, scalp, throat, ears, sinuses, lymphomas;

  • submental (chin): mononucleosis, cytomegalovirus infection, toxoplasmosis;

  • jugular: rubella, throat infections;

  • posterior cervical (neck back): TB, lymphoma, cancers of the head and neck;

  • BTE (behind the ear): local infection;

  • preauricular (in front of the ear): local infection;

  • supraclavicular right: lung cancer, retroperitoneal, gastrointestinal cancer, lymphomas;

  • supraclavicular left: lymphoma, thoracic cancer, retroperitoneal, bacterial or fungal infections;

  • axillary: infections, cat scratch disease, lymphoma, breast cancer, melanoma, brucellosis;

  • epitrohlear (elbow): infections, lymphoma, sarcoidosis, tularemia, secondary syphilis;

  • Inguinal: leg infections, warts, lymphoma, pelvic neoplasm.

Clinical study of adenopathy must be completed more often with CBC (complete blood count), bone marrow examination, bacteriological examination, serological tests for viral infections, inflammation tests, immunological tests, x-rays, abdominal ultrasound, and computerized tomography.

As a last resort open biopsy should be performed and its histological study.

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