Among general signs A rather extensive range of diseases is noted an increase in lymph nodes in the lungs - pulmonary, roasting bronchopulmonary, peribrous or paratroheal. Since the lymph nodes are considered a mandatory component of the body's immune system, their increase, detected during radiography, CT or MRI of the lungs, suggests one of the clinical indicators of pathologies of infectious or oncological occurrence. An increase in lymph nodes with a temperature is a symptom of pneumonia in an adult.

The disease is often referred to as lymphadenopathy, hyperplasia and syndrome of increased lymph nodes (in the diseased AIDS), however, in each case, the pathology is the same code R59 on the ICD-10, and the subclass of R owned signs and differences from generally accepted measurements, which are found in patients In the process of medical examination.

Pathogenesis

The pathogenesis of growth is partly due to the functions of lymph nodes, which, with the help of macrophages of its own sines and stromas, clean the lymphatic fluid from not very beneficial substances that cause harm to the body.

Depending on the background of the disease and the mechanism of influence on lymphoid fabric distinguish the varieties of this pathology:

• cancer,
• infectious
• reactive.

Thus, in infections with the Lymph current, phagocytes with captured antigens and the cells died from inflammatory necrosis are accumulated and accumulated.

Granulomatous modification of lymph nodes (with the displacement of lymphoid fabric fibrous) is also noticed during sarcoidosis, the reason for which medicine is unknown at these times (despite this, autoimmune and genetic factors of its appearance are not excluded).

In cases of rapid growth prevailing pathological process lies in the high proliferation of their follicles, which is provoked by autoimmune diseases - if the immune system The body produces antigens in spite of healthy cells, in particular, with SLE.

With an increase in malignant nature, lymphomas with abnormal cell proliferation occur. And in metastases, lymphoproliferative pathologies are due to infiltration of healthy tissues with atypical (oncological) cells and their growth, which leads to painful morphological changes.

Causes

Pulmonary lymph nodes are inflamed and increased in the amount due to the occurrence of the disease. No inflammatory process in the lungs passes without affecting lymph nodes. This is due to T and B-lymphocytes, as well as the other protective functions of lymphoid tissue. There are a number of serious diseases associated with breathing pathways and other human bodies in which lymphatic nodes can be infected:

1. Inflammation of lymph nodes in most cases occurs due to infectious infection of the organism by various fungi. Mycoses are developing with bronchopal acute or chronic form, lung disease pneumonia, which is caused by streptococcus and staphylococcal
2. The disease of the lungs of sarcoidosis, as well as pulmonary diseases of chronic type, such as silicosis or pneumoconiosis.
3. Different types and forms of tuberculosis, such as pulmonary and extreme tuberculosis of lymphatic nodes.
4. Red lupus and amyloidosis, which lead to fibrous lung damage.
5. Cancer disease respiratory tract Contribute to inflammation and increase nodes in light.
6. Development of malignant tumor in organs digestive system They lead to the appearance of metastasis in pulmonary lymph nodes.
7. Tumors in the thyroid and mammary glands also lead to the formation of metastasis.
8. Leukemia, and in particular lymphoblastic leukemia in acute form contributes to an increase in lymph nodes in light.

Diseases leaking with increasing and inflammation of lymph nodes in the lungs, a lot. These are the most common of them. But you should not eliminate the possibility of growth and other diseases.

Symptoms

With inflammation of lymph nodes, such symptoms are characteristic:

• feeling fatigue immediately after night sleep;
• sharp differences of forces;
• depression state;
• strong fatigue;
• the disease does not immediately show itself.

Usually the disease has an incubation period. To identify the disease on early stage, you need to know these symptoms of lymphogranulumatosis in adults:

• the temperature of the body increases sharply, chills passes through the body;
• the severity in the chest, the feeling of strong pressure;
• characteristic burning under the blade;
• hurt and whine joints.

There are also several other symptoms that can be detected at the stage of the incubation period. If there are no strong complications in the form of inflamed nodes, the treatment will not cause difficulties.

If these symptoms are present, there will be long therapy for the restoration of the lungs that can pass with complications. The symptoms of pneumonia with a temperature in an adult are accompanied by a long cougium and a vomiting reflex.

One of the visual effects on the human body may be inflammation of muscle tissues, which leads to respiratory symptoms: dry cough, shortness of breath, whistling breathing. Granulomatous lymph nodes of the size of 2 centimeters can cause severe painful sensations.

Lymphogranulomatosis

Lymphognulomatosis (Hodgkin lymphoma) is the oncological disease of the lymphoid system, in which the cells of Berezovsky-Sternberg-Rida are found in lymphoid matter during diagnostics. The name of these cells received in memory of scientists who participated in their invention and the study. Lymphogranulomatosis is often found in children of late adolescence and also has the peaks of morbidity in twenty and fifty years.

As with non-Hodgkin's lymphomas, the symptom of lymphogranulomatosis in adults, as a rule, is considered to be a significant increase in the size of lymph nodes on the neck, in the axillary depressures or in groin. Unlike infectious diseases, increased lymph nodes do not hurt, their scales are not reduced over time and with antibiotic cure. Due to the fact that the lymphatic fabric placed in the chest, the initial sign of the disease may be the initial sign of the disease or cough due to pressure on the lungs and bronchi.

Purit and tuberculosis

Treatment of pleurite (ICD -10 R09.1) depends directly from the disease, the consequence of which inflammation of the lymphatic node occurred. Often this happens pneumonia, in this case the doctor will register the necessary drugs, which in turn will fight with this disease. With inflammation of lymph nodes, a person has a high temperature, strong headaches, weakness. The doctor with such symptoms can prescribe antipyretic or painkillers. Elimination inflammatory process It begins primarily from the treatment of pleurite (MKB -10 R09.1).

Lymph nodes can be inflamed by various diseases. No exception and lymph nodes with pulmonary tuberculosis. It is necessary to go through all the types of analyzes available in the hospital (blood, urine, antibodies). This will help determine the causative agent of the disease process, and to further cure this disease and forget about it for a long time.

What are the dangerous lymph nodes in the lungs?

In most situations, the results and complications are associated with the flow of the main disease. And complications of the growth of lymph node in the lungs include the development of abscess or phlegmons, the formation of fistula, the development of septicemia.

Growth in the field of mediastinum leads to bronchial or tracheal obstruction, stricture of the eating path, the pathology of blood flow in the upper hollow vein.

The pulmonary infiltration in the field of lymph nodes during sarcoidosis leads to the formation of scars and irreversible fibrosis, severe pulmonary dysfunction and heart failure.

In the case of tuberculous lesion of intragenuous lymph nodes with caseaseous content, they are likely to break and penetrate infection in other mediastinum structures.

With growth, which is caused by cancer, metabolic complications appear: the rapid increase in the amount of uric acid in the blood, the disorder of the electrolyte balance, the functional insufficiency of the kidneys.

Medical therapy

The lesion of lymph nodes in the lungs is pathological statein which the nodes increase significantly. To relieve the inflammatory process, various medical preparations are usually prescribed.

NSAIDs: implemented in lymphatic systemThey prevent the production of prostaglandins, eliminate hyperemia, reduce swelling and soreness, reduce the temperature. NVPS Group medicines are usually used as creams or ointments that are used for 5 days. With longer use, they can irritate the digestive mucosa, causeing internal bleeding. These include:

• "Nimesil";
• "Nimesulid";
• "Diclofenac";
• «Ibuprofen» and so on.

For children, it is preferable to use preparations in the form of candles.

Analgesic

Analgesics are used if the preparations of the previous group are not suitable for the patient's use. In particular, analgesics or agents with paracetamol - "Efferulgan", "Panadol", "Analgin" and so on.

Glucocorticosteroids

Glucocorticosteroids are prescribed at a significant swelling and inflammation of lymph nodes in the lungs. They will stop soreness and clean local reactions. The use of drugs "Dexamethasone", "prednisone" and "hydrocortisone" is recommended. But they independently apply them undesirable, because they can enhance the symptoms of lymphadenitis.

Antibiotics

With lymph nodes in lungs, treatment is carried out by the following antibiotics:

• cephalosporins ("Cedeks", "Zefisim", "Fortaz", "Ceftriakson");
• macrolides ("Sumamed", "Azithromycin", "Clarithromycin");
• fluorochinols (Ciprofloxacin and Ofloxacin).

Penicillin group of doctors prefer to use rarely, since pathogenic microorganisms have recently acquired high resistance.

Antiviral

Antiviral tools are designed to suppress the activity of the virus, contribute to improving the immune status, lead to Papillomavirus remission and herpes. To increase immunity, use antiviral type tools:

• "Cycloferon";
• "Kagole";
• "Amixin";
• "Arbidol", etc.

Viral activity suppress "isoprinozin", "Zoviraks", "acyclovir", "Groprinosin".

Mazi.

Ointments are designed to overlap on lymph node, using for this dressing, bullion and compresses. Widely used ointments "Vishnevsky" and "ichthyol" effectively stop inflammation, possessing powerful antimicrobial effects. Heparinovaya accelerates lymphotok and eliminates the stools. Nonteroidal ointments ("Ketoprofen", "Pyroxikov", "Diclofenak") help eliminate swelling and soreness.

Dressings are not recommended to do at night - when medicine He dried, the affected area should "raise" at least 3 hours, after which you can repeat the procedure. External means should be used after eliminating the inflammatory process and high temperatures.

Folk Methods

Treat inflammation and increase lymph nodes with folk Medicine stands together by S. medical preparationsSince such inflammation of nodes in the lungs occurs subsequently serious diseases. Folk treatments favorably contribute to the recovery of the patient.

Lymph nodes are increasing due to the development of infection. Best tool Against this symptom will be anti-inflammatory fees, decoctions and infusions.

Useful infusion can be prepared from the bark and leaves of the flavory. To prepare it, you need to take one big dimensional spoon of a dry mixture of the flaw and pour it with one faceted glass of water, which only boiled. Insstruct about half an hour and take, strain by infusion, before taking food on a quarter of a cup.

You can purchase the finished tincture of Echinacea in the pharmacy and take it twenty drops, spreading in an incomplete glass with water several times a day. It is an excellent antiseptic for the body.

Also in the pharmacy you can purchase ready-made herbal fees that are used to destroy the inflammatory process in the body and reduce lymph nodes. The method of preparing such fees is specified on the packages. Like herbal collection You can cook yourself, connecting the black head, linen, the chamber, the root of Valerian, the soul, St. John's wort, the road, Air, the leaves of birch and raspberries. All plants must be dry. To collect two spoons of each mix, only Valerians take one teaspoon. From the resulting dry mixture you need to take 2 tablespoons and brew on the night daily in liter boiling water. Drink at a time. The course of treatment with such a decoction is long, not less than a month.

The field hat must be brewed in a glass of boiling water, taking it one big dimer. Take it necessary within two to three weeks.

Very good in the fight against the increase in lymph nodes various compresses. They remove swelling and painful sensations. You can use fresh mint for the preparation of the compress. Its leaves are needed to grind, having received Cashitz and juice. The resulting mass is imposed on increased lymph nodes and warm. This will reduce swelling and pain. Walnut (three parts), mistletoe (one part) and chamomile (five parts), or rather, their leaves are also very effective. They need them to cook a decoction. Compress to do with the help of gauze or bandage, mamming it in the brave, and apply to a sore place for a couple of hours.

The course of treatment is long. To speed up recovery and reduce swelling, you can massage the patient with light and smooth movements every day.

Inflammation of lymph nodes in the lungs may have an infectious or non-infectious nature. In the second case, we are talking about tumor neoplasms of benign or malignant (leukemia, Hodgkin's lymphoma, sarcoma). I am striking both young people (from 20 to 40 years old) and older people. Until now, it is accurately not studied that it is provokeing the occurrence of pathology, but specialists allocate several of the most likely factors, which will be discussed below. Next, consider the features of lymph nodes in the lungs, the causes of inflammation, clinical manifestations, as well as methods of diagnosis and treatment.

Irregular lymph nodes are localized around the mediastinum organs. On average, their number varies from 20 to 40, and the size is up to 5 mm. Some of them are so small, but they are not even visualized on the X-ray.

Click to enlarge

Depending on the location and the function performed, visceral and intumencoal lung lymph nodes are isolated. Priest lymph nodes include several small lymphough formations on the front and rear wall. breast cavity. These include supplementary, intercostal and ocal-shaped lymph nodes. Through viscerals, lymph passes from the tracheoobronchial tree, lungs, heart, esophagus and soft mediastinal tissues. They, in turn, are also divided into groups:

1. Paratracal (Owlish).
2. Tracheobronchial, which are localized along the edges of the trachea and bronchi.
3. Bifurcation are in the field of trachea separation on the right and left bronch.
4. Bronchopulmonal, located near the roots of the lungs, around the main bronchi, and provide drainage fluid from the lung tissue.

The lymphatic system is part of immune and designed to protect the body from infectious agents, as well as from mutation of own cells in cancer.

Why lymphatic nodes are inflamed in the lungs

Inflammation of lung lymph nodes occurs for reasons that can be divided into 3 groups:

1. Infectious. The organism includes pathogenic microorganisms (viruses, bacteria, fungi), provoking such diseases such as tuberculosis, pneumonia. Acute I. chronical bronchitis, pleurite. The same group includes a systemic red lupus and amyloidosis, causing fibrous lesions of pulmonary fabrics. When infected with the Mushrooms of the Histoplasma Capsulatum group (histoplasmosis), the mold mushroom Aspergillus Fumigatus (Aspergillosis), a yeast-like blastomyces dermatitidis (pulmonary blastomycosis) mushroom (pulmonary blastomycosis).

1. Chronic pulmonary diseases, such as pneumoconiosis, also provoke an inflammatory process of lung lymph nodes. Pneumoconiosis is also called "Shakhtar's disease", as it strikes people who have worked for many years at coal mines.
2. Noncommunicable reasons. Dangerous group of diseases, as it includes tumor neoplasms of malignant nature: it is Hodgkin's lymphoma, sarcoma, leukemia, adenocarcinoma, paraganglioma, as well as metastases in the lungs with other types of cancer.
3. The hereditary factor also affects the occurrence of sarcoidosis, as well as the pathology of the immune system.

Symptomatics

Inflamed lymph nodes of the bronchi and lung have nonspecific clinical manifestations:

1. Increase body temperature. For infectious diseases Hyperthermia reaches 38-40 degrees, with oncological - long subfebilite, not exceeding the figure of 37.5.
2. Weakness, fast fatigue, drowsiness.
3. The depressed state, apathy, so on. Long ailment negatively affects the state of the nervous system.
4. Sweating, fever, chills, especially when acute disease and high temperature.
5. Pain in the chest, the feeling of pressure, tingling and burning under the blades. Localization of pain depends on which group of lymph nodes is inflamed.
6. The difficulty of breathing (dipNoe), which arises due to squeezing the nerve endings. Patients complain about the difficulties of inhalation of air and pain when exhaling.
7. Swallowing disorders. In this case, enlarged lymph nodes in the chest squeeze the esophagus and prevent the normal passage of food on it.
8. The severity in the muscles and joints.
9. Cough with sputum, sometimes with blood.
10. Pulsation of the cervical veins due to impaired blood circulation and lymph.

These symptoms are common, appear regardless of the specific disease. The order of manifestation and how brightly they are expressed, depends on the stage of inflammation.

Stay 3 stages:

• in the initial, intragenic lymph nodes are affected;
• next on the radiograph, fibrosis of pulmonary fabrics is detected;
• at the third stage, not only the pulmonary, but also the heart system is completely affected.

Diagnostics

Since inflammation of lymph nodes in the lungs can be caused by an extensive group of diseases, then the diagnosis should be complex and comprehensive.

Among general laboratory studies, a general and biochemical analysis of blood and urine is carried out. If the lymph nodes are inflamed of the lungs, then in the analysis of blood increased ECD, lymphocytes and leukocytes are detected.

Next is a radiograph of the chest, as well as an MRI or CT, fluorography (by appointing the attending physician). These studies show localization and size of inflammation, whether fibrosis or tissue necrosis has. When suspicion of tuberculosis, Mantu test is performed.

The punctural thin game biopsy of the inflamed lymph node is used in the insufficiency of the above studies, if there are still questions in the diagnosis, as well as in suspected oncological process.

Treatment

The treatment of pulmonary pathologies is engaged in several narrow specialists, depending on the diagnosis.

Various types of malignant processes treats oncologist; Therapist or pulmonologist - infectious uncomplicated lung diseases in which lymph nodes (bronchitis, pneumonia) can be infected. The surgeon is involved in the development of complications that require surgical intervention, and the phthisiar - with tuberculosis. In some cases, infectiousness is shown, for example, when infected with the Epstein Bar virus.

The treatment strategy also depends on the diagnosis and the truth cause of the inflammatory process.

In the case of infectious leaving, antibacterial, antiviral drugs are used, as well as means for stimulating immunity. A special place in this case is removed by expectorant and antitussive drugs. Widely applied in the case of bronchitis and pneumonia physiotherapy.

Under tuberculosis are used strong antibiotics, as well as antimicotic drugs (from fungi). It is shown in addition to the use of immunomodulators.

In cancer processes, treatment is more complex and serious - surgical intervention, chemo, radio, radiation therapy, taking antibiotics, immunostimulants, vitamins, etc.

Robin Smithuis.
Radiology Department of The Rijnland Hospital in LeiderDorp, The Netherlands

This update of Article 2007, in which the division of regional lymph nodes for Mountain-Dresler (1) was used to address the lung cancer (MD-ATS).
In order to harmonize the differences used in Naruke and MD-ATS classifications, in 2009, the International Study Association light cancer (IAslc) proposed the classification of regional lymph nodes.
This article presents illustrations and CT images for a better understanding of this classification.

Classification of regional lymph nodes IASLC 2009

Included lymphatic nodes
1 lower cervical, pressed and lymph nodes of sternum cutting (left and right).
They are located on both sides of the middle line of the trachea in the lower third of the neck and the test areas, the upper limit is the bottom edge of the hand-shaped cartilage, the bottom - the clavicle and the jugular cutting of the sternum handles.

Upper median lymphatic nodes 2-4
2L The left upper paratraheal is located along the left wall of the trachea, from the upper edge of the sternum handle to the top edge of the aortic arc.
2r. The right upper paratroheal is located along the right wall of the trachea and in front of the trachea to its left wall, from the level of the upper edge of the sternum handle to the lower wall of the left shoulder vein in the crossbar zone with the trachees.
3A. Prevascular lymph nodes are not adjacent to the trachea as nodes 2 groups, and the klyoni from the vessels are located (from the back of the sternum, to the front wall of the top hollow vein on the right and the front wall of the left sleepy artery left)
3P. Properebral (Retrotracheal) are located in rear mediastone, do not adjoin the trachea as nodes of 2 groups, and the post from the esophagus is localized.
4r. The lower paratraheal from the intersection of the lower edge of the shoulder vein with the trachees to the lower boundary of the unpaired vein, along the right wall of the trachea to its left wall.
4L Lower paratraheal from the upper edge of the aortic arc to the top edge of the left major pulmonary artery

Aortic lymph nodes 5-6
5. Subiutal lymph nodes are located in aortopulmonary window, lancerly arterial ligament, they are not located between the aorta and the pulmonary barrel, but the lancer.
6. Parapoortal lymph nodes lie in front and side of the ascending part of the arc aorta

Lower mediastinal lymph nodes 7-9
7. Picarin lymphatic nodes.
8. Parasezophageal lymph nodes. Lymphatic nodes are below the Karina level.
9. Light bundles. Lying within a ligament.

Root, equity and (sub) segmental lymph nodes 10-14
All these groups refer to N1 lymphatic nodes.
Knots easy root Located along the main bronchus and vessels of the root of the lung. On the right, they spread from the lower edge of the unpaired vein to the field of dividing on equity bronchi, on the left - from the upper edge of the pulmonary artery.

Systematization of lymph nodes of lungs and mediastinum

1. Capture lymphatic nodes
This group includes lower cervical, pressed and lymph nodes of tenderloin sternum.
Upper border: the bottom edge of the rigid cartilage.
Lower border: Clavicle and jugular cutting arms of sternum.
The middle line trachea is the boundary between the right and left groups.

2R Right upper paratroheal lymph nodes
Located to the left wall of the trachea.

Nizhny Edge: intersection of the lower edge of the shoulder vein with a trachea.

2L. Left upper pararaheal lymph nodes
Upper border: Top edge of sternum handles.
Lower edge: the upper edge of the aortic arc.

The image of the left shows 2 lymph nodes of the Kepenti from the trachea, that is, 2r, the small prevasory lymphatic group 3a is also visible.

3. Praise and promerebral lymph nodes
Lymph nodes 3 groups are not adjacent to the trachee, unlike the lymph nodes of 2 groups.
They will be divided into:
3a Kepened from Vessels
3r behind the esophagus / transverse
They are not available at mediastinoscopy. 3P Group can be accessible with percussion echocardiography.

In the image on the left 3a node in the prevasional space. Please note the same paratrohelnial nodes on the left-to-4r group.

4r. Right bottom paratraheal lymph nodes
Upper border: The intersection of the lower edge of the left braceball vein with the trachea.
Lower border: bottom edge of the unpaired vein.
4R nodes apply to the left edge of the trachea.

4L. Left bottom paratraheal lymph nodes
4L nodes located on the left of the left wall of the trachea, between the horizontal lines spent on the upper wall of the aorta arc and the line passing through the left master bronchus at the level of the upper edge of the topless bronchi. They include pararaheal nodes located Knutri from the arterial ligament.
The nodes of the group 5 (aortopulmonal window) are located the dust from the arterial ligament.

The image of the left above the level of the carina. To the left of the trachea 4L nodes. Please note that they are located between the pulmonary barrel and the aorta, but not in the aortopulmonal window, because they lie medially arterial ligament. Limph nodes lateral of the pulmonary trunk belong to the 5th group.

5. Subashtal lymphatic nodes
The subaportal or aortopulmonal window is located in the front of the arterial ligament and proximal to the first branch of the left pulmonary artery and lies within the mediastinal pleura.

6. Parapoortal lymph nodes
Parapoortal lymph nodes are a kleon and the duck from the upstream of the aorta and between the upper and lower edges of the aortic arc.

7. Picarinal lymph nodes
These lymph nodes are below the bifurcation level of the trachea (karyna), but do not belong to the Lower Earth bronchi and artery. On the right, they are caudally the bottom wall of the intermediate bronchus. On the left they are caudal than the upper wall of Ly Drug Bronchus.
On the left, the lymphatic knot 7 of the group to the right of the esophagus.

8. Parasezophageal lymph nodes
These lymph nodes are below the subcarching lymph nodes and extend caudal to the diaphragm.
On the image left below the level of the karyna to the right of the esophagus marked the lymphatic node 8 of the group.

On the Pat image to the left shows the accumulation of 18r-deoxyglucose in the group 8 node. The corresponding CT image shows that this lymphatic node (blue arrow) is not increased. The likelihood that in there is a metastatic lesion of this node is extremely high, since the specificity of PET is higher than the measurement of the size of the lymph nodes.

9. Lymph ligament nodes
These lymph nodes are underway within the ligament, including in the course of the lower pulmonary vein. The pulmonary bundle is represented by the duplicature of mediastinal pleura covering the root of the lung.

10. Lymphatic light root nodes
The lymphatic nodes of the root are located proximal than the equity nodes, but distal than the mediastinal duplication and intermediate bronchi nodes on the right.
All lymph nodes of 10-14 groups are N1 nodes, as they are outside the mediastinum.

Group of lymph nodes on axial computer tomograms

1. Lymphatic knots tenderloin sternum are visible only at this level and above
2. Upper paratroheal lymph nodes: below the clavicle, to the right above the intersection of the lower edge of the left shoulder barrel and trachea, and on the left above the arc aorta
3. Prevascular and retrotechnal: Kepende from vessels (3a) and excellent (3P)
4. Bottom paratraheal: Below the upper edge of the aortic arc to the level of the main bronchi
5. Subiutal (aortopulmonal window): Limph nodes of the dust from the arterial bundle or the duck from the aorta or the left pulmonary artery.
6. Paraolartal: nodes lying kpeed and duck from the ascending aorta and aortic arcs under the top edge of the aortic arc.
7. Subcarinal lymph nodes.
8. Parasezophageal lymph nodes (below karins).
9. Lymph nodes of the ligament: lie within a ligament.
10-14 Lymph nodes N1

Mediastinoscopy and Expiratory Ultrasound
Lymphatic nodes available for biopsy with mediastinoscopy: upper paratroheal nodes 2L and 2R groups, right and left lower paratraheal lymph nodes 4R and 4L groups, reinforced lymph nodes 7 groups. 1 group is located above the supervised clippings and is not available for routine mediastinoscopy.

Extended mediastinocopy
The tumors of the left upper share can be metastable to subortal (5 groups) and para-orthal lymph nodes (6). These nodes are not available for biopsy during routine mediastinoscopy. Extended mediastinoscopy is an alternative for parasal mediastinotomy. This procedure is used less frequently due to the higher risk of complications.

Continuous aspiration biopsy under the control of ultrasound
It can be used for all lymph nodes of available ultrasound visualization from the esophagus. In particular, access to the lymph nodes of the lower mediastinum (7-9 groups) is provided. In addition, with this form of research, the left proportion of the liver and the left adrenal gland is available for visualization.

Lymphatic system

Arterial blood for powering the lung fabric and the walls of the bronchi enters the lungs through the bronchial branches from the thoracic part of the aorta. Blood from the walls of the bronchial over the bronchial veins is subject to the inflows of pulmonary veins, as well as in the unpaired and semi-park veins.

On the left and right pulmonary arteries in the lungs deoxygenated bloodwhich as a result of gas exchange is enriched with oxygen, gives carbon dioxide and becomes arterial.

Arterial blood from the lungs on the pulmonary veins is subject to the left atrium.

Light lymph vessels fall into bronchopal, lower and upper tracheobronchial lymph nodes.

The innervation of the lungs is carried out of the vagus nerve and from the sympathetic barrel, the branches of which in the field of the root of the lung form pulmonary plexusplexus. pulmonalis. The branches of this plexus on bronchoms and blood vessels penetrate the lung. In the walls of large bronchi there are plexuses of nerve fibers in Adventization, muscle and mucosa.

The paths of the outflow of lymphs from the right and left lungs, their regional lymphatic nodes.

On the path of lymphatic vessels The lungs are bronchopile lymph nodes. Intorganic bronchopulmonary nodes are located in each light in the places of branching of the main bronchus to the equity and equity on segmental, and the extraorganas (root) are grouped around the main bronchus, near the pulmonary artery and veins. The standing lymphatic vessels of the right and left bronchopullenses are directed to the lower and upper tracheobronchial lymph nodes. Sometimes they fall directly in the chest duct, as well as in the prejudicial nodes (right) and distortionocarotide (left).

Lower tracheobronchial(bifurcation) lymphaticknots, nodi. lymphatici. tracheobronchiales. inferiores., lie under the bifurcation of the trachea, and top tracheobronchial (right and left) lymph nodes,nodi. lymphatici. tracheobronchiales. superiores. dextri. et. sinistri.are located on the side surface of the trachea and in the tracheoobronchial corner formed by the lateral surface of the trachea and the upper semicircle of the main bronchus of the corresponding side. These lymph nodes are sent to the bronchopulating knots lymphatic vessels, as well as other visceral and parietal nodes of the chest cavity. The reduced lymphatic vessels of the right upper tracheobronchial nodes are involved in the formation of the right bronchostered trunk. There are also ways of lymph outflows from the right upper tracheobronchial lymph nodes toward the left venous angle. The luminous lymphatic vessels of the left upper tracheosobronchial lymph nodes fall into the chest duct.

Such seemingly simple symptom as an increase in lymph nodes (LU), it may be a sign of not at all banal diseases. Some of them are just unpleasant, others can lead to severe complications and even a tragic outcome. Diseases leading to the appearance of this symptom are not very much, but they all require thoughtful diagnosis and careful, sometimes very long treatment.

What is the lymph nodes

Lymph nodes are small clusters of lymphatic tissue scattered throughout the body. Their main function is the filtering of lymphs and a kind of "storage" of the elements of the immune system attacking alien substances, microorganisms and cancer cellsFinding in lymph. The nodes can be compared with the military bases, where in peacetime there are troops, ready to speak immediately to combat the "enemy" - the causative agent of any disease.

Where are the lymph nodes

Lymph nodes are a kind of collectors collecting lymph with certain areas of the body. This fluid flows to them via vessels. There are superficial lymph nodes and domestic, located in the cavities of the human body. Without the use of instrumental visualization methods, it is impossible to detect the increase in the latter.

Among the superficial, depending on the location of the location, the lymph nodes of the following localizations are isolated:

• pathdled, located on the rear surface of the knee joints;
• surface and deep inguinal, localized in inguinal folds;
• towers - in the field of neck transition to the skull;
• ear and parole, located in front and rear from the ear shell;
• submandibular, lying around in the middle of the branches of the lower jaw;
• chin, located in several centimeters behind the chin;
• the network of cervical lu, thick scattered on the front and side surfaces of the neck;
• elbow - on the front surface of the scene of the same name;
• the axillary, one group of which is adjacent to the inner surface of the pectoral muscles, and the other is located in the thickness of the axillary region.

Thus, places where you can identify an increase in lymph nodes, quite a lot and attentive doctor necessarily pursue them in order to obtain additional information about the possible disease.

Causes of increasing lymph nodes

Natural causes of increasing lu does not exist. If they become more, it means that some pathology must be in the body. The appearance of this feature indicates an occurrence:

With different diseases, lymph nodes increase differently. In addition to sizes, such indicators may change as:

• the structure of the surface that can remain smooth or become a buggy;
• mobility - in some diseases, Lou sold out with each other or with surrounding tissues;
• consistency - dense, soft;
• the condition of the skin above them - when inflammation Lu, the skin can become edema, redden.

And now it makes sense to consider an increase in lymph nodes in binding to diseases most often causing this symptom.

Lymphadenit

This disease is characterized by the brightest symptomatics from the outside, which are significantly increased in size, becoming sharply painful, fixed. The skin is blushing over them, the local swelling is observed. As the disease progressing, the temperature is increasingly rising, chills appears, increasing the phenomena of intoxication.

Most often, lymphadenitis is preceded by any purulent disease of the relevant area:

• carbuncle;
• phlegmon;
• felon;
• abscess;
• infected wound;
• ryg, etc.

Microbes from the focus of infection on lymphatic vessels fall into the lymph node, provoking in it inflammatory reaction, initially catarrhal (without pus), and then purulent. The extreme degree of development of lymphadenitis is adenoflemmon - in fact, the complication of this disease. At the same time, the pussy impresses the surrounding lu fat fiber.

Other complications of purulent lymphadenitis are purulent thrombophlebitis, pulmonary thromboembolism, sepsis.

About lymphadenitis in children tells the pediatrician:

Treatment of lymphadenitis

With catarral lymphadenitis, the main purulent disease is treated primarily. With timely interference, there is a high chance of subsitting acute process in lymph node.

With the development of purulent lymphadenitis or adenoflemons, surgery is required - the opening of the ulotnik, cleaning it using antiseptics and antimicrobial agents, drainage of the abscess cavity.

Respiratory diseases

This group of diseases is the most frequent cause Increased lymph nodes. Brighter than this symptom manifests itself with various forms of tonsillitis (angina). Along with the increase in LU, high fever is noted, during swallowing, pronounced weakness and indisposition.

Several less often lymph nodes increase in size when inflammation of the pharynx - pharyngitis. The symptoms of this disease is similar to the clinical picture of tonsillitis, although he is inferior to it in the brightness of manifestations.

In respiratory infections, Lou becomes dense to the touch, moderately painful, their mobility is preserved during palpation.

Treatment of respiratory infections

Tactics of treatment depends on the type of pathogen who caused the disease. So, with the bacterial nature of pathology use antibiotics wide spectrum Actions, with viral - symptomatic therapy, with fungal - specific antimicrobial means. In parallel, secrets are carried out with simultaneous intake of immunomodulators.

Specific infections

Most often, the increase in lymph nodes is accompanied by such specific infections such as tuberculosis and syphilis.

Tuberculosis defeat

With the tuberculosis of the lungs, intragenuous lymph nodes are amazed at first. Without special research methods, it is impossible to identify their increase. In the absence of treatment, the tuberculosis process can spread through the body, affecting the surface Lou:

• sublimatic;
• cervical;
• axillary;
• inguinal;
• elbow.

At the initial stage, their increase and moderate pain occur. As the inflammatory process, the lymph nodes are soldered between themselves and with the tissues surrounding them, turning into a dense conglomerate, which is then caught up, forming a long-fiscal fistula.

Treatment

Since the increase in Lu here is caused by the main disease - tuberculosis, then they are treated. Special anti-tuberculosis preparations are used according to special reception schemes.

Syphilis

In the event of syphilisu syphilis, it is grown in size only a few days after the appearance of primary syphilide, known as solid Shankr. Due to the fact that the prevail the place of the occurrence of Shankra is the genitals, the inguinal nodes are most often increasing.

However, with Shankragdalite (syphilitic angry), for example, a symptom can manifest itself from the side of submandibular or snoofing nodes.

Important: When syphilisu can reach the size of the nut, while maintaining their consistency, while remaining painless and not soldered with tissues. Often simultaneously with this, lymphangit occurs - inflammation of lymphatic vessels that are tight in the form of heavy, sometimes with thickening at its length.

Treatment

Syphilis at any stage well gives up antibiotic therapy. The preparations of the penicillin row are used. When developing complications, treatment of infection can significantly delay.

Rubella

With a rubella, this symptom appears one of the first, ahead of the occurrence of rash for several hours. Most often, the occipital, cervical, paroles are increasing, becoming painful, however, without saving with surrounding tissues.

The rash with the uncomplicated flow of rubella may remain the only bright symptom, although along with it sometimes there are fever (moderate) and runny nose.

Treatment

Sore rubella isolate and prescribed if necessary symptomatic treatment. Serious events are held only in the development of complications. For example, under the lesions of the joints, anti-inflammatory agents are prescribed, and with encephalitis - corticosteroids, diuretic, anticonvulsant drugs, etc. It should be noted that rubella refers to relatively benign infections and in most cases it takes place at all without treatment.

HIV infection

At this darous disease Lymph nodes of all localizations may increase. Often, this particular symptom causes the doctor to suspect HIV infection, which for a long time can not show himself anything.

When moving the disease in the AIDS stage, the increase in Lu becomes constant, their inflammation is joined.

Treatment

It is well known that methods that allow us to finally cure HIV-infected, does not exist. All efforts doctors are directed to suppressing the activity of the virus, for which special antiretroviral drugs are used. In parallel with this, concomitant infections are treated, the development of which is most often caused by the death of people patients with AIDS.

Lymph nodes with autoimmune diseases

An autoimmune process is a group of diseases under which the immune system ceases to consider "their" cells of various organs. Taking them for a foreign substance, the body activates the protective mechanisms in order to destroy the "aggressor". One of the manifestations of this activity is the increase in regional LU.

An autoimmune process may affect almost any organ, starting with the joints and ending with the glands of internal secretion and even nervous system. Such diseases are distinguished by a long, chronic flow and are quite seriously treated, bringing patient to disability, and sometimes to death.

Treatment

In the treatment of autoimmune diseases, drugs are used, overwhelming the excessive activity of the immunity system - immunosuppressors and means blocking some chemical reactions in the cells of the lymphocytic system.

Increased lymph nodes in cancer pathologies

Oncologists use this symptom as one of the diagnostic criteria of the tumor process. Lu increase only when malignant tumors In the case when cancer cells are separated from the site of the primary focus and with the current of the lymphs fall into the node. Here they are subjected to an "attack" from the protective forces of the body, seeking not to give the process to "break out on the expanses" of the body. The appearance of this symptom is an unfavorable sign indicating the spread of the tumor process.

However, there are also malignant onco-scabers who affect the very lymphatic system itself:

• hodgkin lymphoma, otherwise called lymphogranulomatosis;
• non-Hodgkinsky lymphoma are a group of over 80 types of tumors derived from lymphatic tissue and having large differences both during the disease and for the reasons for its development mechanisms.

Treatment

In the fight against oncological pathology, several methods are used immediately:

1. cytostatic chemotherapy with drugs that stop tumor growth;
2. irradiation of lymph nodes by the flow of ionizing radiation:
   • x-rays;
   • gamma and beta radiation;
   • neutron beams;
   • the stream of elementary particles;
3. immunosuppressive therapy with powerful hormone means.

Special schemes have been developed for the use of complexes of various types of treatment, allowing to suppress the tumor process and extend the life of the patient.

Note: It must be remembered that the increase in lymph nodes is only a symptom various diseases. So engage in self-medication, and even more so folk Methods, instead of consulting a doctor - is unacceptable. Delegation in the diagnosis and treatment of certain diseases may cost the patient's life.

More information O. possible reasons You can get inflammation of lymph nodes by viewing this review:

Volkov Gennady Gennadyevich, Medical Observer, A ambulance doctor.