What Causes a Stiff Neck and Swollen Glands?

Peripheral lymphoid organs unique to mammals are composed of lymphocytes. It is bean-shaped and located on the way of lymphatic vessels, and it is one of the important organs that produce immune response.

Lymph gland

Mammal-specific surroundings

The function of lymph glands is from

Lymphatic system

The human body has hundreds

Lymphatics of the arm

Lymphatics of the axillary region

lymph node enlargement

Chronic lymphadenitis

Most of them have obvious infections, and often have localized lymphadenopathy, pain and tenderness. Generally, the diameter does not exceed 2 to 3 cm, and it will shrink after anti-inflammatory treatment. Swollen inguinal lymph glands, especially flat lymph glands that have been present for a long time without change, are of little significance. However, there is no obvious cause of swelling of the lymph glands in the neck and supraclavicular region, which is a sign of systemic lymphoproliferative diseases, which should be paid attention to and further confirmed.

Tuberculous lymphadenitis

Fever, sweating, fatigue, and increased erythrocyte sedimentation are more common in young adults. Often accompanied by tuberculosis, the texture of lymph glands is uneven, and some are lighter (cheese-like), and some are harder (fibrosis or calcification), and they adhere to each other and adhere to the skin, so they have poor mobility. These patients are positive for tuberculin tests and blood tuberculosis antibodies.

Malignant lymphoma

It can also be seen in any age group, and its lymphadenopathy is usually painless and progressive. It can range from soybeans to jujubes with medium hardness. It is generally non-adhesive to the skin, and does not fuse with each other in the early and middle stages, and can move. In the later stage, the lymph glands can grow very large, or they can fuse into large pieces, with a diameter of more than 20cm, which invades the skin and will not heal after ulceration. In addition, it can invade the mediastinum, liver, spleen, and other organs, including the lungs, digestive tract, bones, skin, breast, and nervous system. Definitive diagnosis requires biopsy. Clinically, malignant lymphomas are often misdiagnosed, with superficial lymphadenopathy as the first manifestation, and 70% to 80% are diagnosed with lymphadenitis or lymphadenopathy at the initial diagnosis, which delays treatment.

Giant lymphadenopathy

Is a rare misdiagnosis. Often manifested as unexplained lymphadenopathy, mainly invading the thorax, most of the mediastinum, but also invading the hilum and lung. Other affected areas are the neck, retroperitoneum, pelvic cavity, axilla, and soft tissue. Often misdiagnosed as thymoma, plasmacytoma, malignant lymphoma. Understanding the pathology and clinical manifestations of the disease is extremely important for early diagnosis.

Pseudolymphoma

Masses that often occur outside the lymph glands, such as orbital, gastric pseudolymphomas, and lymphatic polyps of the digestive tract. Generally considered to be a reactive hyperplasia, caused by inflammation.

Lymphoma

Lymph glands are often stiff, uneven in texture, and primary foci can be found. Rarely systemic lymphadenopathy.

Acute leukemia and chronic lymphocytic leukemia also often have lymphadenopathy, especially acute lymphoblastic leukemia common in children, which is clinically acute, often accompanied by fever, bleeding, liver and splenomegaly, sternal tenderness, etc. Diagnosis and bone marrow aspiration can confirm the diagnosis.

Sarcoidosis is rare in China, often invades bilateral hilars, is radial, and is associated with chronic low fever. Lymph glands can swell throughout the body, especially before and after the ear, under the jaw, and near the trachea. It is difficult to distinguish clinically from malignant lymphoma.

Infectious mononucleosis

More common with young men and women, caused by EB virus, but patients are generally in good condition, may have fever and generalized lymphadenopathy, and may also have mild spleen enlargement. Heteromorphic lymphocytes are present in the peripheral blood, and a positive heterophilic agglutination test can confirm the diagnosis.

Serum disease

A disease that occurs after the use of serum products (tetanus antitoxin, rabies vaccine, etc.) on patients. A few patients have lymphadenopathy as the first clinical symptom. However, most of the lymph glands in the injection site and the upper part of the pulley are enlarged first. It can be diagnosed based on injection history and fever, rash, and eosinophilia.