What Causes Swollen Lymph Nodes in the Groin?

Inguinal lymphadenopathy is very common clinically, and often indicates that there are lesions in the tissues and organs around the lymph nodes, that is, the reproductive system around the groin, various organs in the abdominal cavity, and systemic diseases.

Basic Information

Visiting department

General surgery

Common locations

groin

Common causes

Caused by chronic lymphadenitis, tuberculous lymphadenitis, malignant lymphoma, etc.

Common symptoms

Lymphadenopathy

Causes of inguinal lymphadenopathy and common diseases

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. Inguinal lymphadenopathy, especially flat lymph nodes that are long-standing and unchanged, is not significant.

2. Tuberculous lymphadenitis

In addition to inguinal lymphadenopathy, tuberculous lymphadenitis also has symptoms such as fever, sweating, fatigue, and increased erythrocyte sedimentation, which are more common in young adults. Often accompanied by tuberculosis, the texture of lymph nodes is uneven, some are lighter (cheese-like), some are harder (fibrosis or calcification), and adhere to each other, and adhere to the skin, so poor mobility. These patients are positive for tuberculin tests and blood tuberculosis antibodies.

3. Malignant lymphoma

Malignant lymphoma can be seen in any age group, and its inguinal lymphadenopathy is usually painless and progressive, ranging 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 nodes 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, malignant lymphomas can invade the mediastinum, liver, spleen, and other organs, including the lungs, digestive tract, bones, skin, breast, and nervous system. Definitive diagnosis requires biopsy.

Differential diagnosis of inguinal lymphadenopathy

Nonspecific lymphadenitis

Lymphadenopathy of the corresponding drainage area caused by acute and chronic infection of local tissue is called nonspecific lymphadenitis. In general, the enlarged lymph nodes are painful and tender during acute inflammation, and the surface is smooth with strict limitations. Sometimes the "red line" caused by lymphangitis can be seen from the original focus to the enlarged lymph nodes. Local skin may have inflammation symptoms of redness, swelling and hot pain, often accompanied by fever and increased white blood cells, and lymph nodes often shrink after treatment. Chronic non-specific lymphadenitis is usually the result of chronic inflammation in the corresponding area. The enlarged lymph nodes are of medium hardness, and there is often no acute inflammation of local swelling and pain. Acute nonspecific lymphadenitis is characterized by the coexistence of local infection and lymphadenopathy in the corresponding area. Inguinal lymphadenopathy is caused by lower limb and perineal infections. The most common site of chronic nonspecific lymphadenitis is the submandibular lymph node, which is more common in people with nasopharyngeal or oral infections in the past, followed by inguinal lymph nodes, caused by chronic inflammation of the lower limbs and reproductive organs.

2. Specific infectious lymphadenopathy

(1) There are two types of lymph node tuberculosis : primary and secondary tuberculosis. Primary lymph node tuberculosis is found if there is no other primary tuberculosis; secondary lymph node tuberculosis occurs after chest, lung, abdomen or genital lesions. . The best place for lymph node tuberculosis is the cervical lymph node group. Most of the tuberculosis bacilli are invaded by tonsil caries to form primary lymph node tuberculosis. A few are secondary to pulmonary or bronchial tuberculosis. Multiple lymph nodes on one or both sides of the neck are swollen in different sizes, and initially swollen and painless. Further development of adhesion and fusion between the lymph nodes and the skin and lymph nodes forms clumps, forming hard-to-move clumps. The cold abscess ulcerated. Chronic ulcers have scars after healing, and more severe cases may have symptoms of systemic tuberculosis toxicity such as low fever, night sweats, and weight loss.

(2) Filial lymphangitis and lymphadenitis Candida filariasis and Malaria filariasis can cause chronic lymphangitis and lymphadenitis. The clinical symptoms vary depending on the location of the disease. It is most commonly found in inguinal lymph nodes. If it is accompanied by lower extremity lymphatic reflux Obstruction can cause rubber swelling in the lower limbs.

(3) STD lymphadenopathy

1) Genital pain ulcers caused by Haemophilus ducrey (Streptococcus lividans), the surface is covered with green necrotic exudate, the inguinal lymph nodes on one or both sides are obviously enlarged, and the pain and tenderness are easy. Septic festering. A large number of Streptococcus muscoli can be found in ulcerated basal pus smears or inflammatory lymph node puncture pus smears.

2) The main lesions of venereal lymphogranuloma caused by the serotypes of C. trachomatis L1L2 and L3 can be painless papules or ulcers in the lymphoid tissues at the external genital anorectum, etc., which will heal after a few days. Thereafter, the inguinal lymph nodes became enlarged, painful, and ulcerated, and multiple fistulas may appear. Lymph node lesions in women are mostly around the rectum, and later stage lymph node fibrosis. Differentiation mainly depends on medical history, pathology and etiological examination.

3) Inguinal granuloma is a painless granulomatous ulcer of the genitals and nearby parts caused by the granulomatous Dono-vania bacillus. Identification mainly relies on tissue smears to find (Dono-vania) bodies.

4) Syphilitic lymphadenopathy is infected with syphilis for about 3 weeks. Symptoms of inguinal lymphadenopathy often occur in the genital area about 1 week after the genitalia has a hard chancre. The diagnosis is mainly based on history. , History of lower sores, rash and serology.

5) AIDS (AlDS) lymphadenopathy is prone to deadly conditional infections such as Pneumocystis carinii pneumonia, and tumors can occur during the course of the disease, such as Kaposi's sarcoma. Some people develop chronic lymph node syndrome with systemic lymphadenopathy Inguinal lymphadenopathy is the most obvious. The diagnosis is mainly based on medical history and serological examination.

Examination of inguinal lymphadenopathy

Superficial lymph nodes of normal human body are only the size of rice grains, soft, smooth and movable, without tenderness, and generally not easy to touch. It is characterized by smooth lymph nodes, clear borders, good mobility, medium or soft texture. If the lymph nodes become swollen, painful, hardened, not smooth, stick to the surrounding tissues, or become soft, touch the sense of fluctuations, or even rupture, all are "alarms" issued by lymph node disease.

Treatment of inguinal lymphadenopathy

Lymph node swelling is mostly nonspecific lymphadenitis, which may be caused by fatigue, inflammation of the lower limbs or perineum, and rest and antibiotic treatment are effective. Broad-spectrum antibiotics such as penicillin and streptomycin can be used first. People who are allergic to penicillin and streptomycin can use erythromycin or metronidazole. Western medicine has a short treatment cycle, which is effective and can relieve symptoms. However, the swelling caused by chronic stimuli is often difficult to completely resolve, and the disease cannot be completely cured. If you have tonsillitis, dental caries, finger infections, athlete's foot, and scabies, you should also timely antibacterial and anti-inflammatory or do appropriate treatment to control the infection. If it is caused by sexually transmitted diseases, relevant treatment is required.