Where the lymph nodes become inflamed during cancer. Damage to the lymph nodes of the neck by metastases of malignant tumors. Axillary lymph nodes in oncology

For some types of lymphoma, one of the first stages of treatment is surgery to remove lymph nodes. Depending on the purpose, lymphadenectomy can be complete (extended) or radical. The latter is often used in diagnostic purposes, allowing you to obtain maximum information about the cause and type of tumor.

The human lymphatic system has complex structure. It includes internal organs, an extensive network of blood vessels and several groups of lymph nodes.

Three large groups are conventionally distinguished:

visceral (near internal organs and tissues);
pariental (located next to the head, neck and in contact with the musculoskeletal system);
mixed (their task is to combine the mentioned organs of the lymphatic system).

There are up to 150 groups of lymph nodes in the human body.

The largest conglomerations:

Heads. Control the outflow of lymphatic fluid from the skin and organs of the head and back of the neck. The group includes deep and superficial nodes behind the ears, in the temples and crown, submandibular and parietal.
Cervical. They are located next to the jugular vein, above the collarbone and behind the larynx. Regulate the cleansing of lymph from the nasopharynx, middle ear, thyroid gland.
Axillary. Divide by 6 separate groups, which are interconnected with nerve endings, large blood vessels. They cleanse lymph flows from the mammary glands, mediastinal organs and esophagus.
Intrathoracic. They include the lymph nodes of the anterior, posterior and middle mediastinum, and control the flow of lymph from the chest organs (heart, lungs, bronchi, stomach).
Inguinal. They lie along femoral artery, taking lymphatic fluid from the genitals and genitourinary system. This includes the popliteal nodes, which control the blood circulation in the lower extremities.
Abdominal. The group includes large number nodes lying along the branches of the abdominal aorta, hepatic and portal veins. They receive lymph from the entire surface of the thick and small intestine, liver, spleen, pancreas.

The main function of lymph nodes is the production of lymphocytes. These blood cells are responsible for immune protection people, stop the spread dangerous infections. When lymph flows through the lymph nodes, the process of its purification and neutralization occurs, and microorganisms remain and are neutralized in the cavity of the node. Therefore, in oncology, they are the first to encounter malignant cells, signaling danger with inflammation, pain, and increased volume.

What is lymphadenectomy and what is its purpose?

Lymphadenectomy or lymph node dissection is a surgical procedure aimed at removing lymph nodes. It proceeds as a standard surgical operation under general anesthesia and requires dissection of the subcutaneous layer and isolation of the lymph system affected by cancer. But most oncologists consider the procedure to be diagnostic methods, which do not affect the quality of life and survival prognosis for the patient.

Such an operation to remove lymph nodes has the following goals:

collection of high-quality biomaterial for further research;
obtaining information about the condition of tissues and organs near a malignant tumor;
determination of the degree of metastasis.

At some stages of lymphoma, removal of lymph nodes can slow down the progression of the disease and improve prognoses during subsequent chemotherapy and radiation therapy. The famous oncologist Donald Morton discovered that in many types of cancer, the first metastases arrive in the nearest node, called the “sentinel”. During the procedure, it must be detected using special dyes that indicate the direction of lymph flow. After removal, it is submitted for research, and the process of spreading metastases is stopped.

This procedure is performed in combination with surgery to remove the main tumor. For stage 1–2 breast cancer, this can cure up to 60% of women without additional drugs.

Indications for lymphadenectomy

In most cases, the reasons for removal of lymph nodes are the appearance of a tumor or metastases. The resulting material is carefully examined in the laboratory, allowing us to find out the type of cells, their structure, and assess the risk for the patient. Based on this, an effective plan for further treatment is drawn up to defeat cancer. lymphatic system.

Indications for the surgical procedure are:

malignant neoplasms of various localizations;
metastasis at certain stages of development of the oncological process;
suspicion of metastases or tumors in organs abdominal cavity, intestines, retroperitoneal space, etc.;
cancer of the nasopharynx, lungs;
bone tissue sarcoma;
removal of lymph nodes during suppuration.

Removal of lymph nodes is effective in the early stages of Hodgkin lymphoma. In the absence of distant metastases, every second patient experiences long-term remission.

Contraindications

The operation to remove lymph nodes in most cases is abdominal and does not differ from standard surgery.

Therefore, it has the following generally accepted contraindications:

tumor growth involving the heart, aorta, coronary vessels;
multiple metastases affecting several groups of lymph nodes;
condition after a stroke;
renal or liver failure;
severe heart pathologies.

With such pathologies, general anesthesia is contraindicated for the patient. In addition, complications after removal of lymph nodes can greatly aggravate the general condition.

Removal of lymph nodes for cancer

. Removal of breast lymph nodes is performed during mastectomy surgery. A few years ago, doctors recommended dissection of at least 10 nodes located in close proximity to the chest. Today, at stage 2 of carcinoma, it is recommended to excise only the “sentinel” node, which gives full information about the nature of the disease and the need for chemotherapy.
. For thyroid cancer, the removal procedure is performed only in extreme cases, if the inflamed node interferes with the passage of food or normal breathing. Indications are suspicion of a high degree of aggressiveness of the disease. For papillary cancer, surgery can reduce the risk of relapse by 50–60%. Therefore, after removal of the thyroid gland, all lymph nodes are sent for histology for further examination.
Heads and necks. A biopsy after removal of neck lymph nodes is the most common type of lymphadenectomy for oncology. This area is more likely to metastasize in cancers of the lung, thyroid, brain, or larynx. They are located close to the surface of the skin, so the operation is quick with minimal complications for the patient.
. For tongue cancer and oral cavity metastasis begins at stages 3–4. With this type of oncology, it is recommended to remove the lymph node under the jaw, which becomes a “sentinel” when cancer cells spread with the lymph. This reduces the risk of further complications, but does not help in treating the underlying disease: the latter clinical trials proved that 43–45% of patients with tongue cancer have metastases only in the oral cavity.
And . At correct diagnosis Laryngeal cancer is highly treatable. Therefore, during laryngectomy, simultaneously with excision of the affected vocal cords removal recommended submandibular lymph node for histology. This provides complete information about the nature of the tumor and allows doctors to select the most suitable efficient protocol for chemotherapy.
At . With this type of cancer, there is a high risk of metastasis to soft fabrics the patient’s mouth, tongue, and larynx are already at stage 2. Therefore, during the removal of the main tumor, the question of complete removal of a group of regional lymph nodes is raised. Many experts strongly recommend performing a complete lymphadenectomy even in the absence of signs of inflammation.
. Patients at stages 2 and 3 often experience inflammation of the lymph nodes, which can greatly complicate treatment. Many oncologists use a method that involves complete removal iliac lymph nodes after a course of radiation therapy. The operation of extraperitoneal lymphadenectomy is most effective at stages T2N1M0 and T3N1M0, giving a five-year survival prognosis of 80.1% and 52.9%, respectively.
At . The pathology is characterized by a high degree of tumor aggressiveness in the early stages of the disease. Most metastases are diagnosed in regional nodes of the pelvis and peritoneum. Therefore, it is often recommended to remove a lymph node in the groin for histological analysis of the cells. After confirming the diagnosis, the doctor may recommend a repeat operation with complete excision of a group of parts of the lymphatic system to reduce the risk of relapse.
At . It is recommended to remove the retroperitoneal lymph nodes located between the kidney and ureter. During surgery, doctors must observe special caution: in this area there is a risk of damage to the nerve endings that regulate sexual function men. Surgical intervention effective at stages 1–3.
At . The procedure is performed with a radical vaginectomy. Doctors simultaneously remove the inguinal lymph nodes and the affected organ, and remove the uterus and ovaries. This significantly reduces the risk of further spread of the pathological process to the patient’s rectum.
. For operable forms of prostate cancer, oncologists strongly recommend removal of the pelvic lymph nodes. In combination with radiation therapy and chemotherapy, the method increases the prognosis for five-year survival to 50% and ten-year survival to 35–40%.
. To diagnose a tumor, removal of the supraclavicular lymph node is often recommended. In 90% of cases, it acts as a sentinel, participating in the further spread of malignant cells.
. Damage occurs to the submandibular and anglemaxillary lymph nodes in the immediate vicinity of the larynx and thyroid gland. Excision can relieve pain from inflammation of the masticatory muscles, restoring the ability to speak and eat normally.
. With gastric carcinoma, metastasis occurs at stage 3 with damage to the lymph nodes located between the omentums. Often, signs of inflammation are found in the left subclavian region, the peritoneum, with the involvement of the para-aortic group of parts of the lymphatic system.
. For colon cancer, the chances of survival increase markedly if the peritoneal lymph nodes are removed at stages 2–3.
. With this type of cancer, distant metastases in the lymphatic system form on late stages and indicate a worsening situation. Removal inflamed lymph nodes does not affect the quality and duration of life, so it is justified only for histology.
And . In case of the disease, damage to the lymph nodes at the gates of the liver is often diagnosed. Their removal is recommended only if there is a violation of the outflow of bile, which significantly worsens the patient’s well-being.
At . In 95% of cases, bone cancer is secondary, developing against the background of oncological processes in internal organs and systems. In this situation, lymph node removal is rarely used, and the main treatment is chemotherapy and radiation therapy.
At . For skin cancer, it is easy for doctors to obtain biomaterial for histology. If melanoma is diagnosed, malignant cells spread through the circulatory system, affecting the bones and muscles of a person. Removing metastases in the lymph nodes does not make sense.
. If an organ is damaged, further spread of the disease through the lymphatic system is possible. Therefore, removal of lymph nodes in oncology is performed simultaneously with excision of the primary tumor.
. This organ is part of the human lymphatic system, and therefore is often accompanied by damage to groups of lymph nodes in the retroperitoneal space. Doctors do without surgical intervention, preferring chemotherapy.
A. There is a danger of early metastasis to the liver, lungs and mammary gland. Therefore, removal of lymph nodes under the arm is practiced to improve the prognosis and conduct additional research of the affected tissues.
. Lymphosarcoma is characterized by damage to peripheral nodes in any part of the body, impaired lymph outflow, and the appearance of swelling of the limbs, face, and neck. The operation is only advisable for collecting biomaterial.
. Most often when acute leukemia the nodes on the neck practically do not increase in size, but merge into groups. Removal of axillary lymph nodes is not recommended: with effective treatment, lymph outflow is normalized, and the diameter of the formation decreases.
At . The disease is associated with damage to all parts of the lymph system. It is characterized by a simultaneous increase in a large group in groin area, under the arms or on the neck. Removal does not guarantee recovery.

Types of operations

Surgeons remove lymph nodes in two ways:

Selectively - all lymph nodes around the tumor are removed for further histology.
Only one “sentinel” lymph node is removed.

There are several types of lymphadenectomy that are used in the treatment and diagnosis of cancer:

Cervical. Recommended for excision of inflamed lymph nodes for tumors of the salivary glands, cancer of the larynx and nasopharynx. It is carried out when it is necessary to obtain biomaterial in areas of the lymphatic system in the area of the thyroid gland.
Para-aortic. Often, distant metastases affect large veins in the peritoneum, pelvis, and mediastinal area, growing into the coronary aorta. The operation allows you to obtain information about the spread of the disease, helps to select correct treatment for breast, cervical or ovarian cancer. It is often prescribed for tumors in the patient’s intestines.
Inguinal-femoral. This type of intervention is called the Duquesne method. It is recommended if it is necessary to detect metastases in cancer of the testicles, ovaries, and genitourinary system. In many cases, it is diagnostic when the tumor is very widespread in the pelvis.
Retroperitoneal. Used for lesions of the gonads and appendages. It is often used to remove lymph nodes after a course of chemotherapy: it allows specialists to find out how effective the treatment regimen was chosen.
Regional. It is recommended if necessary comprehensive examination and diagnosis of many types of oncology: melanoma, brain or bone marrow cancer, tumors in the lungs or bronchi, neoplasms in the esophagus or stomach.

For some types of cancer at stage 1 or 2, the doctor removes only the “sentinel” lymph node. After confirmation of malignant cells, a decision may be made on the need for further excision of the remaining group of lymph nodes, surgery on the affected area internal organ. If metastases are not detected, oncologists often limit themselves to only a few courses of chemotherapy.

Preparing for surgery

Lymphadenectomy involves the introduction of general anesthesia, so the patient undergoes a thorough examination by a cardiologist, therapist, and oncologist. In addition to standard blood and urine tests, a cardiogram is required to confirm the absence of contraindications. Sometimes a cleansing diet is recommended. Subject to availability chronic diseases It is better to discuss their appointment with the anesthesiologist in advance. For example, using aspirin can cause severe bleeding.

Progress of the operation

On average, lymphadenectomy takes 45–60 minutes. After preparing the patient and administering general anesthesia, the surgeon makes an incision in the skin and subcutaneous layer above the node location. Using a scalpel, the required fragment is excised. If necessary, the doctor takes organ tissue or bone for histology. After removal of the lymph nodes and all manipulations, the wound is sutured with drainage installed.

Cost of the operation

The price for lymphadenectomy depends on many factors:

choice between laparoscopy or abdominal surgery;
specialist qualification;
duration and level of difficulty;
the need for additional histology during surgery.

The most “budget” option is cervical lymphadenectomy, in which removal of the lymph node and collection of pathological tissue is carried out under local anesthesia (from 5000–6000 rubles).

The cost of other methods depends on the complexity:

Inguinal-iliac – from 25,000 to 65,000 rubles.
Retroperitoneal – from 17,000 rubles.
Para-aortic – from 25,000 to 350,000 rubles (for removal of organs and tumors).
Operation using the Krail method on the neck – up to 90,000 rubles.
Duquesne operation in the inguinal-femoral area - up to 105,000 rubles.

The price may increase if additional involvement of a vascular or thoracic surgeon is necessary.

Research regarding the need for lymph node removal

In recent years, new methods of lymphadenectomy have been constantly developed, and the quality of the procedure has been improved. But the question remains: how effective and useful is surgery as a method of treating cancer? In fact, there is no scientifically proven evidence of an increase in length or quality of life after lymph node removal. Therefore, more and more often, oncologists are trying to limit themselves to excision of the “sentinel” node for biopsy, eliminating metastases with the help of a course of chemotherapy.

Complications after removal of lymph nodes in the cervical, inguinal and axillary areas

After surgery to remove lymph nodes, the body requires time for rehabilitation, so swelling, weakness, prolonged inflammation and suppuration of surgical wounds may occur.

Among the complications that patients often encounter during neck surgery are:

damage to nerve endings;
change in voice timbre;
hoarseness;
bleeding.

After removal of the lymph nodes under the armpit, you may experience:

change heart rate(arrhythmia);
severe swelling;
weakness in the hands, tremor;
bloating of veins and phlebitis;
headaches;
temperature rise.

Removal of the uterus, ovaries and lymph nodes in the groin area is fraught with the following complications:

swelling of the lower extremities;
leg pain;
lymphostasis;
the appearance of a vascular network;
fatigue with minimal physical activity.

During healing, patients long time experience discomfort and pain after lymph node removal. Against the background of a weakening of the lymphatic system, immunity decreases, and frequent colds and ARVI.

Lymphedema after lymph node removal

One of the most serious complications after lymph node removal is lymphedema. This is a condition in which large amounts of fluid accumulate in a limb. In this case, the venous outflow and nutrition of soft tissues are disrupted, and high blood pressure on bones and joints.

moderate exercise;
following a special diet;
pneumocompression course;
therapeutic massage.

If there is no effect, it is carried out reoperation with suturing of lymphatic vessels to blood veins.

Rehabilitation period after lymphadenectomy

The consequences of lymph node removal will be less pronounced if you adhere to the following rules during rehabilitation:

until the wounds heal, refrain from any load on the operated area;
use an elastic bandage to bandage the limbs;
Perform light self-massage daily to improve microcirculation;
refuse to take a lying bath.

During the rehabilitation period, it is necessary to reduce the consumption of salty foods, which provoke fluid retention in the tissues. To speed up wound healing, it is necessary to avoid exposure to the sun and attend physical procedures.

Nature has endowed our body with a unique protective system, which is rightly called the permanent guardian of health. This is the lymphatic system, which has its representation in every, even the most microscopic part of the body. It is represented by three components: lymphoid tissue, a network of lymphatic vessels and lymphatic fluid circulating through them. The role of the lymphatic system in the formation of oncology is no less important, since it is through the lymph that cancer cells spread throughout the human body.

The lymphatic system protects health

Lymphoid tissue is distributed throughout the body, located in every organ and in every anatomical region in the form of nodal accumulations - lymph nodes. They are located both superficially, under the skin, and more deeply - between layers of muscles, along blood vessels, near organs, in body cavities, and are connected to each other by lymphatic vessels. The role of lymphoid tissue is the production of protective cells: plasma cells, macrophages; B- and T-lymphocytes coming from the bone marrow, the main protective cells, mature and multiply in it.

The network of lymphatic vessels begins with the finest capillaries, millions of which are located everywhere. Tissue intercellular fluid (body fluid) enters these capillaries. It washes the tissue cells of various organs, muscles, bones, skin, etc., and is absorbed into the lymphatic capillaries, forming lymph. Pathogens, tumor cells, and toxins enter this lymph. The capillaries connect into small lymphatic vessels, and they into larger ones and are sent to the nearest lymph nodes. Passing through them, the lymph is neutralized by protective cells and moves further through the vessels to more distant lymph nodes, and the same thing happens there.

As a result, all the lymph, already purified, is collected in the large thoracic lymphatic duct, which flows into the superior vena cava and goes to the heart.

How and why do cancer metastases form in the lymph nodes?

A cancerous tumor of any location metastasizes to the lymph nodes. How does this happen? When a malignant tumor grows and becomes looser (starting from stage 2), its cells are washed out by tissue fluid and enter the lymphatic capillaries. From there, the lymph is sent through the lymphatic vessels to the nearest lymph nodes. Such nodes located closer to the tumor are called sentinel nodes.

There, cancer cells settle, are partially neutralized, and some of the cells multiply and form a secondary tumor focus - metastasis to the lymph node. It gradually grows and for some time, protective cells surrounding it prevent cancer cells from advancing further. That is, the malignant process is localized for a while. This can last from several months to several years, depending on the grade of the tumor. When the metastasis grows and becomes loose, its cells enter the lymph and the passing lymphatic vessel, heading to the next lymph collector - a more distant lymph node. And there the cancer is localized for a while, forming a metastasis, which after a certain time spreads the cancer cells through the vessels to the large central lymph nodes located along large vessels, in the retroperitoneal space, in the mediastinum.

What is the protective function of lymph nodes against cancer?

If there were no lymph nodes on the path of movement of lymphatic fluid containing cancer cells, they would immediately enter the thoracic lymphatic duct, from there into the bloodstream, and would be carried with the blood to organs, forming distant metastases there. That is, the cancerous tumor would immediately go into the 4th, metastatic stage, and patients would have little chance of it being effective.

It is the lymph nodes that are more or less long period hold tumor process, providing the opportunity to “win time” during which you can spend effective treatment and prevent the transition of cancer to an advanced metastatic stage.

There is a direct relationship with the size of lymph nodes in cancer.

According to global cancer statistics:

12% of patients had metastases to the lymph nodes with a tumor up to 2 cm in size,
in 32% - with a tumor of 2 to 3 cm,
in 50% - with a tumor diameter of 3-4 cm,
in 65% - with a tumor size of 4-6 cm,
in 90% of patients with tumors larger than 6 cm.

How is the stage of a cancer tumor determined by metastases in the lymph nodes?

In the international classification of cancer by stages, in addition to the size of the tumor, an important criterion is the degree of involvement of lymph node metastases.

This feature is denoted by the symbol N (in Latin nodus - node):

for stage 1 cancer no metastases are detected in the lymph nodes, this is designated N0;
for stage 2 cancer: single metastases in the nearest lymph nodes - N1;
for stage 3 cancer: several metastases in regional (nearest) lymph nodes - N2;
for stage 4 cancer: both regional and distant lymph nodes are affected by metastases - N3.

These are general ideas, but for each type of cancer there are options, depending on the anatomy and the number of groups of lymph nodes near the diseased organ (N2a, N2b, etc.). The symbol Nx in the diagnosis means that there is no specified data on damage to the lymph nodes.

The main groups of lymph nodes that have diagnostic value in oncology

There are a huge number of lymph nodes in our body - from the smallest to large ones located everywhere. But it is the lymph collectors, into which metastases spread through the lymphatic vessels, that are divided into groups according to anatomical principles. In general, all lymph nodes are divided into superficial, located almost under the skin, and deep, located deep in the muscle layers, in the body cavities - the chest, abdominal and pelvic cavity.

Among the superficial lymph nodes, the following groups are of primary importance:

cervical;
axillary;
inguinal

Deep lymph nodes include:

intrathoracic;
abdominal nodes;
pelvic cavity nodes;
retroperitoneal.

These are large lymph collectors, where metastases are always found when cancer spreads; they are called regional, that is, located near the organ affected by cancer. If cancer is suspected, the doctor will mandatory refers the patient to diagnostic examination to identify lymph nodes with cancer using ultrasound, CT or MRI.

Cancer and cervical lymph nodes

In the neck area, the lymph nodes are located in several layers and groups: superficial, located subcutaneously, deep, located under the fascia and along the sternocleidomastoid muscles, posterior cervical, located behind these muscles, and supraclavicular.

Sources of metastases to cervical lymph nodes

The following tumors form metastases in the lymph nodes of the neck:

Symptoms of metastases in the cervical lymph nodes

Normally, the cervical lymph nodes are not visible externally and cannot be palpated. With cancer of the lymph nodes in the neck and metastases, one or more round or oval formations are visually determined, with unchanged skin above them. To the touch they are dense, limitedly displaceable, often painless, the size can vary from 2 to 8 cm in diameter, with lymphogranulomatosis they can represent a conglomerate of enlarged nodes, reaching large sizes. With increasing deep cervical nodes they are not contoured subcutaneously, but asymmetry and thickening of the neck appear.

With any enlargement of the lymph node in the neck, it is necessary to undergo examination, because sometimes metastasis appears earlier than the primary tumor itself. Determining the symptoms of pathology is one of the main tasks of doctors conducting.

Cancer and axillary lymph nodes

In the axillary region there is large cluster lymphoid tissue in the form of 6 groups of nodes, some of them are adjacent to the walls armpit, others are located more deeply, along the vessels and nerves.

The following tumors can metastasize to the axillary or axillary lymph nodes:

Usually the first symptom of enlarged axillary lymph nodes is a feeling foreign body under the armpit, as if something was interfering. Pain occurs when the lymph node is located near the nerve; numbness of the arm and tingling of the skin may also occur. When the blood vessels are compressed, swelling of the hand appears. Externally, you can notice a lumpiness in the axillary region when you raise your arm up, and the nodes are also easily palpable.

Cancer and inguinal lymph nodes

The inguinal group of lymph nodes is located in the upper thighs and lower abdomen along the inguinal fold. Surface nodes located in subcutaneous tissue, group deep nodes located under the fascia near the femoral vessels.

The inguinal lymph nodes are affected by the following types cancer:

for testicular cancer;
for cancer of the external genitalia;
for cervical cancer;
for prostate cancer;
for bladder cancer;
for rectal cancer;
for skin cancer in the lower limb, gluteal, lumbosacral, and groin areas;
for lymphogranulomatosis and non-Hodgkin's lymphomas.

Cancer in the lymph nodes of the abdomen and pelvis

A large number of lymph nodes in the abdominal cavity are located everywhere: parietally along the peritoneum, along the vessels, in the mesentery and along the intestine, in the omentum, there are many of them at the gates of the liver and spleen. Pelvic lymph nodes are also located parietally and along the iliac vessels, in the tissue surrounding the organs - the bladder, uterus, prostate, rectum.

Cancer cells from tumors of all organs of these cavities spread into these lymph nodes:

stomach cancer;
liver cancer;
bowel cancer;
pancreatic cancer;
uterine and cervical cancer;
ovarian cancer;
bladder cancer;
prostate cancer.

The symptoms of intracavitary metastases will depend on their location. For example, nodules in the mesentery of the intestine can cause intestinal colic, constipation and even intestinal obstruction. Metastases at the portal of the liver, compressing the portal vein, cause portal hypertension syndrome - congestion venous blood in organs and lower extremities, edema, ascites (accumulation of fluid in the abdomen), dilation of the veins of the stomach and esophagus, which can give dangerous bleeding because of high pressure in the portal vein system. However, usually only large metastases manifest themselves, compressing organs and blood vessels. Small lymph nodes affected by cancer may not show themselves for a long time and can only be detected using special research methods.

It is important to understand that it depends on which part of the body the pathology has spread to, as well as on how the patient feels. It is noteworthy that the cost of procedures is often 26% lower than in hospitals in Europe or the USA.

A malignant tumor of the lymphatic system (lymph node cancer) is a systemic cancer that forms in the lymph nodes and affects the entire body. This pathology looks like an autoimmune process and begins in the cells of lymphoid tissue, mutating it. The tumor affects both superficial and deep lymph nodes. But most often there are lymphomas with the following localization: in the axillary region, on the elbows, above the collarbone.

Lymph nodes are a group of oval formations with a diameter of 0.5 to 10 mm. They pass next to the venous and lymphatic channels. This allows the lymph nodes to be a shield against all diseases.

Classification of lymphomas

Oncology of the lymph nodes is divided into many (about 30) types of neoplasms, and among them there are two main ones:

1 species covers about 1/3, the remaining 2/3 are non-Khodzhin neoplasms.

The following are considered signs of non-Hodgkin's pathologies:

Peripheral lymph nodes undergo changes in volume;
Associated tissues and organs are crushed;

Lymphomas are also divided into simple, benign and malignant. Downtime appears when there is an increased load on the body’s immunity and stagnation of lymphoma with chronic inflammation of tissues and organs. Malignant lymphomas among children occupy 3rd place in the list of cancer diseases.

Leading clinics in Israel

Benign lymphoma borders between simple and malignant.

The peculiarity of benign lymphoma is manifested in slow growth in one area. Does not affect other organs. How to distinguish from a malignant tumor:

It is mobile, has no connection with tissues and organs;
On palpation, the tumor hurts and discomfort is felt;
If the tumor is internal, your health worsens and sleep is disturbed;
A tumor on the skin and mucous membranes may bleed.

If the level of lymphocytes in the blood is exceeded and the proliferation of mature lymphocytes in the affected organ is accelerated, it is necessary to begin treatment for a benign tumor.

Over time, benign lymphoma disrupts the balance of the body and treatment should be started promptly.

One of the diseases of derivative lymphoma is tonsil cancer, which begins at the root of the tongue, tonsil, back of the throat and soft area of the palate. It is divided into cancer of the cervical and head regions.

Every adult should know one of the common types of cancer - adenocarcinoma or. It originates from the glandular cell. This disease most affects the stomach, lungs, intestines and mammary glands. A blood test can determine glandular cancer, because in the primary stages it does not appear.

One of dangerous species These pathologies are a small cell type of lymphoma. Small cell lymphoma develops from small cells of the bone marrow. In the early stages of the disease, the pathology cannot be determined; the first symptoms appear in the later stages.

Causes of lymph cancer

Lymph nourishes cells and helps flush toxins from the body, which puts a lot of stress on the lymph system. And if the immune system does not have time to cope, then we can assume the occurrence of cancer. It is very important to identify signs of oncology in advance, namely, enlargement of the lymphatic channels passing in the neck, armpits and groin.

The increased size of lymphoma is due to the rampant accumulation of “tumor” blood cells, on which immunity is built. Normal operation the body is disrupted when these cells accumulate in organs and tissues. As a result, uncontrolled cell division and the continued accumulation of tumor lymphocytes, which gives rise to the development of cancer, that is, lymphoma.

Reasons that accelerate the possibility of cancer associated with cancer of the lymphatic system:

Age. As you age, your risk of getting sick increases;
Race. The Caucasian race is more susceptible frequent illness lymph nodes than others;
Imbalance of the entire immune system;
In women - late or difficult labor;
Bad heredity;
Long-term exposure to chemicals, paint, radiation.

Symptoms

The lymphatic system is expressed by enlarged cervical, axillary and inguinal lymph nodes, lack of appetite, fatigue and weakness. These symptoms may include:

Excessive sweating (especially at night);
Swelling of veins in the neck area;
Shortness of breath;
Constant itching.

IN in rare cases pathology is observed with swelling of the lymph nodes near the aorta. Therefore, the patient may feel pain in lumbar region, this is especially true at night.

Sometimes cancer occurs in a rather extreme form. The first signs of this:

The patient's temperature rises quickly;
Body weight is significantly reduced;
Lymph nodes quickly increase in size.

These symptoms indicate a negative prognosis for cancer.

As lymphoma progresses, tumors multiply at high speed. The resulting infected cells are concentrated in the lymph nodes. This is characterized by swelling of the lymphatic system in the neck, and there is also damage to the lymphatic system in the abdominal region. Paracaval lymph nodes are also subject to oncology. The paracaval lymph node passes behind the peritoneum.

There are also lymph nodes on the face. They are located on the cheeks, chin, cheekbones and under the jaw. Lymph facial area It flows through the lymphatic channels into the cervical lymph nodes. If rashes appear on the face in the form of yellowish-gray nodules, then you need to consult a doctor for timely detection of the pathology.

Stages of the disease

To determine the level of spread of cancer of the lymphatic system, there is a classification of diseases.

4 degrees of lymph node cancer:

Stage 1. Only one lymph node is affected;
Stage 2. The pathology involves two or more lymph nodes on one side of the diaphragm;
Stage 3. Pathology of the entire diaphragm;
Stage 4. , lungs, etc. In this case, the lymph nodes may not be affected by the pathology, this is due to the characteristics of the patient’s body.

Diagnosis of the disease

If the above symptoms appear, you should urgently consult a specialist and find out how to check for oncology. He will prescribe the procedure necessary for this case, namely:

Taking a blood test to determine oncology;
Biopsy, in which a sample of the affected tissue is taken with a thin needle and histology is performed;
An ultrasound is performed;
Radiography;

For on . A tumor marker is a specific substance that is secreted by healthy cells of the body to resist cancer. This is B2 - microglobulin, a protein substance whose synthesis occurs in almost all cells of the body. When a tumor marker is examined in venous blood. An increase in the concentration of B2 microglobulin indicates the need for detailed diagnostics of the patient’s body.

You need to know how to diagnose the primary symptoms of cancer of the axillary lymph nodes, namely:

Upon visual inspection, the armpits look slightly swollen; upon touching, a tubercle is felt;
The swollen area is itchy;
Observed constant temperature not higher than 37.5 degrees;
A person sweats a lot, especially at night.

Treatment and prognosis

Expect complete recovery with malignant formations lymphoma is quite difficult. Treatment is aimed at stopping the symptoms of the disease.

What treatment methods for lymph node cancer exist today:

The prognosis after treatment for cancer of the lymphatic system depends on at what stage of the disease the diagnosis was made. It is difficult to say whether lymph node cancer can be cured or not. This depends on many factors:

Stage of the disease (80% survival rate for stages 1 and 2);
Age of the patient;
Surgical intervention;
General condition of the patient;
Spread of pathology outside the lymph nodes.

The better the indicators, the more favorable the prognosis for recovery.

Valery Zolotov

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The first diagnosis was made in beginning of XXI centuries. Since then, the number of cases of this cancer has doubled. Young people over 30 years of age are increasingly becoming ill. Women are more susceptible to the disease, men suffer four times less.

Malignant ones more often affect the male half. In the general system of oncological diseases, the percentage of thyroid cancer is small, slightly more than 1.5%, but among young people it is in the lead.

Located in the front of the neck, not visible in normal condition. When the vital functions of an organ are disrupted, a goiter is formed, and in the presence of a benign and malignant tumor, nodes are detected. The malignant node begins to absorb the iodide element, and thyroid hormones are released. Malignant nodes begin to degenerate into thyroid cancer.

Etiology of thyroid cancer

The normal functionality of all organs depends on proper functioning endocrine system. Causal factors for enough. Among them, the most important reasons stand out:

ionizing radiation in the head or neck area;
inflammatory processes or tumor formations in the female reproductive system or in the mammary glands;
pregnancy, lactation, menopause caused by hormonal imbalance;
irradiation of the tumor in thymus gland or tonsils;
lack of iodine elements in the body, hypothyroidism, and at the same time increased TSH level pituitary gland;
long-term use of thyreostatics, for example, thiamazole, provokes diseases;
functionality of the endocrine gland, morphological structure;
appearance different forms goiter, adenoma, thyroiditis;
professional activities related to heavy metals and chemical fumes;
combination with neoplasms in nearby organs.

Malignant tumors of the thyroid gland are caused by highly complex modification structures, in particular, gene activity is disrupted and mutational oncogenes develop.

Symptoms

Any disease gives signals that can be used to understand the pathological picture. The most important and first sign of the appearance of a tumor is a visual enlargement of the gland. The doctor, after collecting anamnesis, will completely fill out the clinical picture:

pain radiating to the ears;
proliferation of lymph nodes in the neck;
sensation of a “lump” in the throat when swallowing or breathing;
the voice loses its timbre and becomes hoarse;
cough of unknown etiology that does not go away even at night.

Classification of malignant neoplasms

According to International classification thyroid tumors, you should:

Epithelial formation is due to:

– spindle cell formation;
– giant cell;
– small cell;

squamous form.

Non-epithelial formation:

fibrosarcoma;
other.

Mixed form:

carcinosarcoma;
malignant lymphoma;

Secondary education.

Unclassifiable tumor.

Papillary cancer and its features

One of the most common types of cancer of the endocrine system. Diagnostics confirms its presence in 80% of cases. Develops over several years and is characteristic a large number tiny nodules in the lobes of the gland.

Strikes more often female body, middle aged. After healthy cells are damaged by genetic changes, the disease begins its long journey. More often, with timely diagnosis and initiation of treatment in the initial stage, the prognosis is encouraging.

Features are numerous rudiments and a large degree. Thyroid cancer sometimes manifests itself as the only clinical symptom of papillary cancer. Neoplasms of papillary cancer reach from the most microscopic to quite large sizes, at which the neoplasm completely engulfs the organ.

During hardware diagnostics, the morphological structure of cancer varies. It is completely decorated with papillary projections consisting of cylindrical and cubic epithelial cells. In addition to papillary structures, follicular formations and, less often, entire cell fields are found.

Follicular cancer

More common at the age of 45 years. Metastases appear in the skeletal system and the apexes of the lungs. Damage to healthy cells in distant organs is rare.

Cytological picture of cancer

The neoplasm tissue consists of follicles. Cellular papillary structures are absent. The peculiarity of this form of cancer is its growth into the walls vascular system. Due to its structure, follicular cancer is considered a malignant adenoma.

Medullary cancer

Aggressive hormonal and active neoplasm. It increases the production of thyrocalcitonin several tens of times. The symptomatic picture is added by diarrhea. A node forms in the gland, and in some patients there are metastases. The affected cellular structures are surrounded by a fibrous wall.

Undifferentiated cancer

The pathological picture is very severe and aggressive. The prognosis of the disease is unfavorable. Metastases affect nearby tissues and organs. Very rarely metastasize to distant systems and tissues.

Most often they are affected by follicular and account for about 23%. Papillary cancer gives slightly more than 8% of metastases, papillary-follicular - 18%, medullary - 37%.

Metastases are distinguished between single and multiple. This form of cancer promotes metastases to the skull, chest, ribs, pelvic bones and into the trunk of the spine.

Diagnostics

Diagnostics are carried out through a complete collection of tests and hardware examination, in particular, ultrasound and x-rays. A blood test can help detect thyroid cancer. An ultrasound will determine the size of the tumor, its uniformity along the edges, and the number of nodes formed.

Carrying out a biopsy - necessary element complex diagnostics. A biopsy is performed using needle aspiration. Computed tomography determine the stage of the disease. Puncture of the nodular tumor will show the cytological structure of the cells.

Ultrasound diagnosis of thyroid cancer

As is known, in the first stages of the development of the disease, the symptoms are vague and rarely observed. Clinical features of a malignant nature gradually begin to emerge. In this case, all signs can be classified into three groups.

Correlation with developing neoplasm in the thyroid gland:

a very rapidly developing tumor node;
the filling is dense, lumpy to the touch and has uneven edges.

Correlation with the tumor growing into nearby tissues:

- low mobility of the node;
hoarse voice, nerve paralysis;
difficulty swallowing and breathing movements;
compression of veins in the chest area.

Near and distant metastasis in the last stage of thyroid cancer:

nearby lymph nodes thicken, enlarge and limit their mobility (in the jugular fossa, in the anterior-superior mediastinum, in the cervical regions);
distant metastases to the lungs (in the form of a scattering of coins on x-ray), in the form of round shadows in lower parts lungs, reminiscent of tuberculosis;
metastasis to the bones of the pelvis, skull, spine, sternum, ribs;
penetration of affected cells into the brain and other internal organs.

Treatment

Operation and removal cancerous tumor not so scary after timely treatment. It will prevent tumor growth. Life does not stop when the gland is removed. Patients take hormones that the gland previously produced. Extended treatment is prescribed with a course of chemotherapy, radioactive iodine, medicines and completion with surgery.

The patient receives injections of radioactive iodine. Using a special camera, the affected areas of the gland tissue are scanned. Areas with existing cancer cells cannot absorb iodine, which means they are cancer cells.

In patients with papillary, follicular and medullary forms of cancer, 1, 2, 3 and are noted. The presence of one form or another predicts the outcome of recovery. All forms anaplastic cancer belong to stage IV, the most severe.

The prognosis after surgical treatment depends on the age and gender of the patient, the number of enlarged lesions. If the tumor is microscopic, then surgery will not be required and the organ will be preserved.

The recovery period takes place under the constant supervision of an endocrinologist. The body is scanned for evidence of metastases. A synthetic hormone, thyroxine, is mandatory. It is recommended to do an ultrasound of the neck and organs associated with the tumor annually.

Prediction regarding cancer type

Forecast for complete treatment quite favorable. How long a patient can live after stages 1 and 2 of cancer depends on the form of treatment. Only 12% of patients may experience relapses, but they are not life-threatening. Any new nodes are removed during the operation.

How long patients diagnosed with thyroid cancer live depends on many indicators, ranging from mutation processes in cells. Papillary cancer gives a favorable life rate of up to 85%, of which up to 60% live more than 10 years.

Follicular cancer is less rosy. How long patients will live depends on the start of complex treatment. It gives up to 75% survival rate.

Medullary thyroid cancer often carries a very poor prognosis. High probability metastatic formations to other organs. The question of how long a sick person will live can be answered, no more than 50% until 10 years after surgery. Other species are very dangerous; only a few survive for no more than 3-5 years.

Thyroid adenoma: symptoms and treatment