Diseases of the lymphatic system

Lymphoid syndrome is a pathological condition developing in the lymphoid formations of the body, which, along with venous, is associated not only anatomically but also functionally (tissue drainage, removal of metabolic products, lymphopoiesis, protective function) due to disease of the lymphatic system. Lymphoid vessels and nodes accompany veins and lymph through ducts equipped with valves is discharged into venous blood.

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Inflammatory diseases of the lymphatic system

Lymphadenitis is a secondary disease that develops as a complication of various purulent-inflammatory processes and specific infections. There are acute and chronic, specific and non-specific.

Primary foci can be abscesses of any localization and etiology. Microflora enters the lymph nodes, which are filters, by lymphogenous, hematogenous and contact routes. Inflammation develops according to the general type. According to the nature of the exudate, serous, hemorrhagic, fibrinous, purulent lymphadenitis are distinguished. The progression of purulent inflammation can lead to destructive changes with the development of an abscess, phlegmon (adenophlegmon), ichorous decay.

In the acute process, pain is observed in the area of the regional nodes, they are enlarged, dense, painful upon palpation, mobile, the skin above them is not changed. When the process turns into a purulent one, the pain becomes sharp, edema appears, the skin above the lymph nodes is hyperemic, palpation causes sharp pain, previously clearly palpated nodes merge with each other, forming packets, become sharply painful upon palpation, immobile. When adenophlegmon forms against the background of extensive infiltrate and hyperemia, foci of softening appear. The general condition changes depending on the type of disease of the lymphatic system.

Chronic non-specific lymphadenitis is formed mainly as a result of a chronic process, when weakly virulent microflora enters the lymph nodes, for example, in tonsillitis, caries, otitis, fungal infections of the feet, etc. The process is proliferative in nature. The nodes are dense, painless or slightly painful, mobile. They remain enlarged for a long time, but as the connective tissue grows, they decrease in size. In some cases, proliferation of lymph nodes can lead to the development of lymphostasis, edema or elephantiasis. Specific lymphadenitis also occurs as chronic: tuberculous, syphilitic, actinomycotic, etc. All forms of chronic disease of the lymphatic system should be differentiated from lymphogranulomatosis and tumor metastases based on the clinical picture and biopsy method.

Lymphangitis is an inflammatory disease of the lymphatic system, complicating the course of various purulent-inflammatory diseases. There are serous and purulent, acute and chronic, reticular (capillary) and truncular (stem) lymphangitis. The development of the disease indicates the aggravation of the underlying pathological process.

With reticular lymphangitis, there is edema and pronounced hyperemia of the skin, reminiscent of hyperemia in erysipelas, but without a clear border, sometimes it is possible to detect a reticular pattern with a more intense or, conversely, pale color. With stem lymphangitis, edema and hyperemia are noted in the form of stripes running from the site of inflammation to regional nodes. In almost all cases, the disease of the lymphatic system is combined with the development of lymphadenitis. Moreover, with lymphangitis of deep vessels, edema is not expressed, but pain and sharp soreness during palpation are noted along the vessels, with the early development of lymphadenitis. Lymphangitis is quite often accompanied by the development of thrombophlebitis.

Tumor diseases of the lymphatic system

Benign tumors - lymphangiomas - are extremely rare, are an intermediate condition between a tumor and a developmental defect, with predominant localization in the skin and subcutaneous tissue, more often in the area of localization of the lymph nodes, in the form of vesicular (thin-walled bubbles up to 0.5-2.0 cm, filled with lymph) and cavernous (soft to the touch tumor-like subcutaneous formations, often with the formation of bubbles on the skin and sharp deformation of the affected areas), cystic (soft, hemispherical, painless formation, not fused with the skin, the skin may be unchanged or have a bluish appearance) forms. Never malignant. Malignant tumors can be of two types: primary with damage initially to one lymph node with subsequent involvement of other nodes in the process (noted only with lymphoma and lymphogranulomatosis); secondary due to metastasis from the primary tumor or with hemoblastoses. A distinctive feature is the development of oncosyndrome. In all cases, the diagnosis must be confirmed by biopsy.