There are sliding bumps on both sides of the neck

Some people have bumps on their necks that slide up and down when touched. You don’t feel anything at ordinary times, but it will be a little painful when you touch it without paying attention. Because it doesn’t cause much trouble, many people don’t pay too much attention to it. However, it is possible that it is swollen lymph nodes caused by inflammation in that area. So how should swollen lymph nodes be diagnosed and treated? Let's take a look at the examination and diagnosis of swollen lymph nodes

examine

1. Blood picture

The total number and classification of peripheral blood leukocytes have certain reference value for determining the cause of lymphadenopathy. Lymphadenopathy accompanied by an increase in total white blood cell count and neutrophilia is common in bacterial infection; lymphadenopathy accompanied by a normal or decreased total white blood cell count and an increase in lymphocytosis is often considered a viral infection; atypical lymphocytes (10% to 20% or more) may be found in patients with infectious mononucleosis; eosinophilia suggests parasitic infection or eosinophilic granuloma; lymphadenopathy accompanied by peripheral blood immature cells is mostly a leukemia.

2. Bone marrow examination

Bone marrow smear cell morphology examination, bone marrow pathology examination, bone marrow flow cytology examination, etc. are of decisive significance for the diagnosis of leukemia and lymphoma.

3. Serological examination

Such as EBV, CMV IgM, antinuclear antibody spectrum, etc.

4. Lymph node puncture needle aspiration smear examination

5. Lymph node pathology examination

6. Tumor marker testing

If a solid tumor is highly suspected, tumor markers can be used to assist in diagnosis.

diagnosis

1. Enlargement of lymph nodes in one area is called localized lymphadenopathy, which is often seen in nonspecific lymphadenitis, lymph node tuberculosis and metastasis of malignant tumors. The primary lesion should be found according to the lymphatic drainage area. If lymph nodes are swollen in more than two areas, it should be considered as systemic lymphadenopathy, which is more common in acute and chronic lymphadenitis, infectious mononucleosis, leukemia, lymphoma, leptospirosis, scrub typhus, brucellosis, serum sickness, connective tissue disease, etc.

2. Associated symptoms can provide important clues to the cause of swollen lymph nodes.

(1) Patients with swollen lymph nodes accompanied by infection foci in the corresponding drainage areas, such as swollen submandibular and submental lymph nodes accompanied by tonsillitis and gingivitis, swollen axillary lymph nodes accompanied by mastitis, swollen postauricular lymph nodes accompanied by scalp infection, and swollen left inguinal lymph nodes accompanied by erysipelas of the left lower limb, can be diagnosed with nonspecific lymphadenitis.

(2) Lymph node enlargement accompanied by pain is usually caused by acute inflammation, often with local redness, swelling, heat and other inflammatory manifestations; while painless lymph node enlargement is common in malignant tumor metastasis, lymphoma, etc. Local lymph node enlargement accompanied by low fever, night sweats, and weight loss may indicate lymph node tuberculosis, malignant lymphoma, or other malignant tumors.

(3) Lymph node enlargement accompanied by periodic fever is often seen in malignant lymphoma; systemic lymph node enlargement accompanied by fever is seen in infectious mononucleosis, leukemia, lymphoma, etc., and occasionally in systemic lupus erythematosus.

(4) Lymph node enlargement accompanied by rash is often seen in certain infectious diseases or allergic diseases, and one should also be alert to lymphoma.