axillary lump
Introduction
Introduction The neck, armpits, and groin (thigh root) are the three major lymphatic areas. The subgingival mass of the upper extremity or the mammary gland can cause swollen axillary lymph nodes, which are red, swollen, hot, and painful, and can cause suppurative infection.
Cause
Cause
It can be seen in lymphadenitis, which causes lymphadenitis caused by bacteria invading the lymph nodes along the lymphatic vessels. However, not everyone will develop lymphadenitis when they encounter bacterial infections. This disease is only likely to occur when the body's resistance is reduced. Long-term malnutrition, anemia, and other chronic diseases can cause lymphadenitis after infection with bacteria.
Examine
an examination
Related inspection
General photo inspection
Can be seen in chronic lymphadenitis, most of the underarm masses have obvious infections, and often localized lymphadenopathy, pain and tenderness, generally no more than 2 ~ 3cm in diameter, will shrink after anti-inflammatory treatment. Inguinal lymphadenopathy, especially long-standing and unchanged flat lymph nodes, is of great significance. However, the neck and supraclavicular lymph nodes are enlarged without obvious cause, which marks the systemic lymphoproliferative disease. The underarm mass should be taken seriously and further examined and confirmed.
If the upper limbs or breast inflammation occurred in the past (the medical history has been ten years), and then the mass appeared, this time mainly showed the characteristics of inflammation, then the possibility of acute exacerbation of chronic lymphadenitis is large. However, inflammation usually does not have neoplasms. If there is a local "cauliflower-like" neoplasm, the pain is not serious, then it is basically a malignant tumor. The source of the mammary gland is very likely, especially in the lateral mammary gland. When touching a hard mass bump. Of course, local necrosis and rupture of tumors can also have inflammatory manifestations, but the range is generally limited to necrotic areas, which can have stench.
Diagnosis
Differential diagnosis
Identification of symptoms that are easily confused with ankle mass :
Chronic lymphadenitis: Most of them have obvious infections, and often have localized lymphadenopathy, pain and tenderness, generally no more than 2 to 3 cm in diameter, and will shrink after anti-inflammatory treatment. Inguinal lymphadenopathy, especially long-standing and unchanged flat lymph nodes, is of great significance. However, there is no obvious cause of swelling of the neck and supraclavicular lymph nodes, which marks the systemic lymphoproliferative disease, which should be taken seriously and further examined and confirmed.
Tuberculous lymphadenitis: fever, sweating, fatigue, increased blood sedimentation, more common in young adults. Often accompanied by tuberculosis, the lymph nodes are uneven in texture, some are lighter (cheese-like), some are hard (fibrosis or calcification), and adhere to each other, and adhere to the skin, so the activity is poor. This type of patient is tuberculin test and blood tuberculosis antibody positive.
Malignant lymphoma: also seen in any age group, its lymphadenopathy is often painless, progressive swelling, from large soybeans to jujube, medium hardness. Generally, it has no adhesion to the skin, and does not fuse with each other in the first and middle stages. In the later stage, the lymph nodes can grow to a large size, and can also be fused into a large piece, the diameter of which is more than 20cm, invading the skin, and it will not heal after rupture. In addition, it can invade the mediastinum, liver, spleen and other organs, including the lungs, digestive tract, bones, skin, breast, nervous system and so on. The diagnosis requires a biopsy. Clinically, malignant lymphoma is often misdiagnosed, with superficial lymph node enlargement as the first manifestation, 70% to 80% of patients diagnosed with lymphadenitis or lymph node tuberculosis at the time of initial diagnosis, resulting in delay in treatment.
Giant lymph node hyperplasia: a rare disease that is easily misdiagnosed. Often manifested as unexplained lymphadenopathy, mainly invading the chest, with the most mediastinum, but also invading the hilar and lungs. Other affected sites include the neck, retroperitoneum, pelvis, armpits, and soft tissue. Often misdiagnosed as thymoma, plasma cell tumor, malignant lymphoma. Understanding the pathology and clinical manifestations of this disease is extremely important for early diagnosis.
Pseudolymphoma: A site that often occurs outside the lymph nodes, such as the eyelids, the pseudolymphoma of the stomach, and the lymphatic polyps of the digestive tract. It is generally considered to be a reactive hyperplasia caused by inflammation.
Lymph node metastasis: Lymph nodes are often hard and uneven in texture, and the primary lesion can be found. Very few systemic lymphadenopathy.
Acute leukemia and chronic lymphocytic leukemia: also often have lymphadenopathy, especially acute lymphocytic leukemia common in children, clinically acute, often accompanied by fever, hemorrhage, liver and splenomegaly, sternal tenderness, etc., blood Learning and bone marrow puncture can confirm the diagnosis.
Sarcoidosis: rare in China, often invading the bilateral hilar, radial, accompanied by long-term low fever. The lymph nodes of the whole body can be swollen, especially before and after the ear, under the jaw, and next to the trachea. It is clinically difficult to distinguish from malignant lymphoma.
Infectious mononucleosis: more common with young adults, caused by Epstein-Barr virus, but patients are generally in good condition, may have fever and systemic lymphadenopathy, may also have mild swelling of the spleen. There are atypical lymphocytes in the peripheral blood, and the positive heterophilic agglutination test can confirm the diagnosis.
Serum disease: A disease that occurs after the patient has used serum products (tetanus antitoxin, rabies vaccine, etc.). A small number of patients with lymphadenopathy as the first clinical symptoms. However, most of the lymph nodes on the injection site and the pulley are swollen first. According to the history of injection and fever, rash, eosinophilia, etc. can be diagnosed.
Can be seen in chronic lymphadenitis, most of the underarm masses have obvious infections, and often localized lymphadenopathy, pain and tenderness, generally no more than 2 ~ 3cm in diameter, will shrink after anti-inflammatory treatment. Inguinal lymphadenopathy, especially long-standing and unchanged flat lymph nodes, is of great significance. However, the neck and supraclavicular lymph nodes are enlarged without obvious cause, which marks the systemic lymphoproliferative disease. The underarm mass should be taken seriously and further examined and confirmed.
If the upper limbs or breast inflammation occurred in the past (the medical history has been ten years), and then the mass appeared, this time mainly showed the characteristics of inflammation, then the possibility of acute exacerbation of chronic lymphadenitis is large. However, inflammation usually does not have neoplasms. If there is a local "cauliflower-like" neoplasm, the pain is not serious, then it is basically a malignant tumor. The source of the mammary gland is very likely, especially in the lateral mammary gland. When touching a hard mass bump. Of course, local necrosis and rupture of tumors can also have inflammatory manifestations, but the range is generally limited to necrotic areas, which can have stench.
