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What Is A Lymph Node?

Lymph nodes are organized collections of lymphoid tissue located in various places in the body. There are certain locations where lymph nodes are numerous and grouped into clusters, such as the neck, armpit, and inguinal region. They are also located around big blood vessels and lymph ducts inside the thorax and the abdomen. Lymph nodes contain several types of lymphocytes (types of white blood cells). B lymphocytes are responsible for the production of antibodies and T lymphocytes have several different functions. In general, lymph nodes serve to react to foreign infective agents, tumor cells, and other antigens and provide defense from these agents. After skin and local defense mechanisms, lymph nodes provide a second line of defense from foreign antigens.

When Does A Lymph Node Need To Be Removed?

The condition in which lymph nodes are inflamed and enlarged is called lymphadenitis. This happens most commonly due to a reaction to local or generalized infections. Inflammed lymph nodes are often very painful. 

In these cases, the infection should be treated, which will gradually normalize the enlarged lymph nodes and there is usually no need for surgical removal. 

Allergies can also cause enlargement of lymph nodes, which are then painless and occur rapidly after the contact with some allergen. Antihistamines and corticosteroids are used to diminish the effects of an allergy with consequent decrease in size of affected lymph nodes. The most severe causes of enlarged lymph nodes are malignant tumors. Cancer cells originate from primary tumor and enter the bloodstream and lymph ducts. On their way, they get caught by lymph nodes and start reproducing, thus causing enlargement of lymph nodes. There are also primary tumors originating from lymph nodes, called lymphomas.

In cancer treatment, it is necessary to remove all the malignant cells, including those located in the lymph nodes, and therefore, different types of cancer are the most common causes of lymph node removal.

Lymph Node Removal: The Procedure

The procedure of lymph node removal depends on the underlying disease as well as on the localization of the affected lymph nodes. In the case of cancer, besides surgical removal of primary tumor and metastases, the surrounding lymph nodes need to be removed too, as there is a high possibility that they also contain tumor cells. This is a complicated process, because sometimes whole clusters of grouped lymph nodes need to be removed. 

In addition, radiation therapy and chemotherapy are needed to eliminate residual tumor cells.

In case of Hodgkin lymphoma (less severe variant), the affected lymph node is removed and the situation is followed up on regular examinations. Non-Hodgkin lymphomas are more aggressive, metastatic, and they require more intensive approach.

Complications

The usual complications of lymph node removal are no different than in any other surgical procedure. Wound infections, complications of general anesthesia, and bleeding can appear, but they are not very common. If during the removal of lymph nodes the lymph ducts are also damaged, that can prevent normal drainage of lymph through the lymphatic system. This can cause an accumulation of excess lymph fluid in the tissues with damaged drainage, and subsequent swelling which is called lymphedema.

In case you notice an enlarged lymph node or several, you should refer this problem to your doctor. 

Basic laboratory tests can give valuable information which can indicate the cause of the lymph node(s) enlargement.

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