What are the causes of swollen clavicular lymph nodes?

Enlarged clavicular lymph nodes can be divided into different types, so we need to treat them correctly based on these symptoms instead of blindly using medication. The classifications include chronic lymphadenitis, malignant lymphoma, and giant lymph node hyperplasia.

1. Chronic lymphadenitis

Most of them have obvious infection foci, and often localized lymph node enlargement, pain and tenderness. The diameter usually does not exceed 2 to 3 cm, and will shrink after anti-inflammatory treatment. Inguinal lymphadenopathy, especially long-standing, unchanged, flat lymphadenopathy, is usually of no significance. However, unexplained enlargement of the cervical and supraclavicular lymph nodes indicates a systemic lymphoproliferative disease and should be taken seriously and further examined and confirmed.

Tuberculous lymphadenitis is characterized by fever, sweating, fatigue, and increased erythrocyte sedimentation rate, and is more common in young and middle-aged people. It is often accompanied by pulmonary tuberculosis. The texture of the lymph nodes is uneven, with some parts being lighter (caseous change) and some being harder (fibrosis or calcification). They are adhered to each other and the skin, so they have poor mobility. These patients have positive tuberculin tests and blood tuberculosis antibodies.

2. Malignant lymphoma

It can also be seen in any age group. The lymph node enlargement is often painless and progressive, ranging in size from soybean to jujube, and of medium hardness. Generally, there is no adhesion to the skin, and they do not fuse with each other in the early and middle stages, so they are movable. In the later stages, the lymph nodes may grow very large or fuse into large masses with a diameter of more than 20 cm, invading the skin and taking a long time to heal after rupturing. In addition, it can invade the mediastinum, liver, spleen and other organs, including the lungs, digestive tract, bones, skin, breast, nervous system, etc. Diagnosis requires biopsy. Clinically, malignant lymphoma is often misdiagnosed. Among patients with superficial lymphadenopathy as the first symptom, 70% to 80% are diagnosed as lymphadenitis or lymphadenopathy tuberculosis at the initial visit, resulting in delayed treatment.

3. Giant lymph node hyperplasia

It is a rare disease that is easily misdiagnosed. It often manifests as unexplained lymphadenopathy, which mainly invades the chest cavity, most commonly the mediastinum, but can also invade the hilum and lungs. Other sites of involvement include the neck, retroperitoneum, pelvis, axilla, and soft tissue. It is often misdiagnosed as thymoma, plasmacytoma, malignant lymphoma, etc. Therefore, understanding the pathology and clinical manifestations of this disease is extremely important for early diagnosis.

Pseudolymphoma often occurs in areas outside the lymph nodes, such as pseudolymphoma of the eye sockets and stomach and lymphoid polyps of the digestive tract, all of which can form lumps. It is generally considered to be a reactive hyperplasia caused by inflammation.

4. Lymph node metastasis

The lymph nodes are often hard and uneven in texture, and the primary lesion can be found. It is rarely systemic lymphadenopathy.

Acute leukemia and chronic lymphocytic leukemia also often have swollen lymph nodes, especially acute lymphocytic leukemia, which is common in children. Clinically, the disease develops rapidly and is often accompanied by fever, bleeding, enlarged liver and spleen, sternal tenderness, etc. Hematological and bone marrow puncture examinations can confirm the diagnosis and differentiation.