An increase in inguinal lymph nodes (inguinal lymphadenopathy) is an overgrowth of lymphoid tissue in the groin with the formation of palpable nodes more than 1 cm in diameter. The symptom occurs with various genitourinary infections, inflammatory diseases of the genital organs, malignant neoplasms. To clarify the cause of inguinal lymphadenopathy, an ultrasound examination and a biopsy of the lymph nodes, laboratory tests are performed. In order to reduce pain, analgesics, anti-inflammatory drugs are prescribed.
Urinary tract infections
Lymphadenopathy in infectious diseases is due to increased stimulation of the inguinal nodes, enhanced differentiation of lymphocytes. An increase in lymph nodes is determined at the beginning of the disease as a reactive reaction. Sometimes patients themselves identify "bumps" or nodes in the groin, painful on palpation. Lymphoid formations have an elastic consistency, are not soldered together and are not attached to the skin. Over the lymph nodes, reddening of the skin, an increase in local temperature are determined. The most common causes of lymphadenopathy are:
- Genital herpes . The increase in inguinal lymph formations occurs against the background of fever, general malaise. With significant hyperplasia of the lymph node tissue, patients independently palpate seals located in the upper lateral parts of the pubic zone. Then, on the skin of the perineum, multiple small blisters with transparent contents appear, bursting with the formation of erosions.
- Primary syphilis . With this disease, there is a unilateral increase in lymphoid formation, which can reach the size of a walnut. The node is painless on palpation, sometimes a dense band is found coming from the lymph node, which is an inflamed lymphatic vessel. A couple of weeks before lymphadenopathy, a red fleshy erosion, a chancre, appears on the skin of the genital organs.
- Chlamydia . Bilateral inguinal lymphadenopathy with chlamydia infection is more often diagnosed in men, since their infection often occurs in an acute form. Enlarged lymph nodes are sensitive to palpation, the skin over them, as a rule, is not changed. The symptom is accompanied by pain in the lower abdomen and mucopurulent discharge from the urethra. In women, a slight increase in lymph nodes without other manifestations is possible.
- Gonorrhea . Increased antigenic stimulation causes increased differentiation of lymphocytes and an increase in the volume of lymphoid formations in the groin. The defeat of the lymph nodes is often bilateral, the formations are sensitive to palpation, a slight hyperemia of the skin is determined above them. With gonorrhea in men, lymphadenopathy is combined with dysuric disorders, purulent urethral discharge in the morning.
- Ureaplasmosis and mycoplasmosis. Moderate enlargement of lymph nodes without signs of local inflammation is possible in both men and women, but an acute course with severe clinical symptoms is more typical for males. Against the background of inguinal lymphadenopathy, pain and cramps are felt during urination, mucopurulent discharge from the urethra is noted. With intense inflammation, the skin over the lymph nodes noticeably turns red.
The high frequency of inflammatory processes in women is due to the anatomical features of the genital organs, the proximity of the entrance to the vagina and urethra, which contributes to the spread of pathogenic microorganisms. Exacerbation of inflammation is provoked by hypothermia, stress, non-compliance with personal hygiene. The increase in inguinal lymph nodes occurs as a reaction of the lymphoid tissue to the inflammatory process, resulting in increased production of mature T- and B-lymphocytes in the antigen-dependent zones of the follicles. Inguinal lymphadenopathy in women is caused by:
- Vulvit . The acute variant of inflammation is manifested by an increase in lymph nodes, itching and burning in the perineum, moderate pain during urination. Lymphadenopathy develops a few days before the rest of the symptoms of vulvitis, lymphoid formations are painless, so many women do not notice this symptom in time. Then the outer labia turns red and swells, viscous mucus or pus is released from the vagina.
- Abscess of Bartholin's gland . With massive purulent inflammation, there is a significant increase in the inguinal lymph node on the side of the lesion. With self-examination, a woman can palpate a large painful “bump”. A typical sign of the disease is the appearance of a formation several centimeters in diameter in the area of the labia, which, when palpated, is disturbed by sharp pains in the perineum.
- Colpitis . An increase in lymph nodes with inflammation of the vagina is combined with subfebrile body temperature, discomfort in the perineum. Inguinal lymphadenopathy with colpitis is characterized by a bilateral lesion, a small size of the formations and mild pain during their palpation. Women note dysuric phenomena, moderate pain in the lower abdomen with irradiation to the groin, then vaginal discharge joins.
Diseases of the male genital organs
Inflammatory processes of the reproductive system occur in men of different ages and are of great importance, since without treatment they cause severe complications and disrupt the quality of intimate life. Inguinal lymphadenopathy is a typical symptom of andrological pathology, regional lymph nodes increase due to antigenic stimulation of paracortical and follicular zones. Hyperplasia of the inguinal nodes occurs in diseases such as:
- Balanitis . With inflammation of the head of the penis, an increase and soreness of the inguinal lymph nodes are usually detected on both sides, sometimes unilateral lymphadenopathy develops. A day or two after the onset of the symptom, the man begins to feel pain and burning in the area of the head and the outlet of the urethra. With the spread of the inflammatory process to the foreskin, balanoposthitis develops.
- Orchitis . With inflammation of the testicles, inguinal lymphadenopathy is unilateral, manifests itself 2-3 days before the main symptoms, lymphatic formations reach a size of 1.5-2 cm. An increase in lymph nodes is accompanied by general malaise, myalgia, and fever. The man pays attention to the swelling and hyperemia of the scrotum, which are more pronounced on one side. There are sharp pains, aggravated by walking.
- Gangrene of the penis . Destructive inflammation proceeds relatively slowly, so sometimes the lymph nodes have time to reach the size of a walnut. When probing, the lymphoid formations are compacted, not adherent to the skin and tissue, and moderately painful. Against the background of an increase in the inguinal lymph nodes, specific changes in the penis are revealed - its skin dries out, turns black, the process gradually captures the entire organ.
Perhaps explicit images of the genitals are hidden here Are you 18 years old? yes no Enlarged inguinal lymph nodes in a man
Oncological pathology
Usually, metastatic lesions of the inguinal lymph nodes are associated with malignant tumors of the organs of the reproductive system, which is due to the peculiarities of the lymph outflow. Lymphatic formations are not painful, immobile, differ in woody density. Patients complain of discomfort when wearing tight underwear, jeans. More often, patients discover lymphadenopathy on their own. Inguinal lymph node metastasis is also specific for anal cancer and perineal skin neoplasia. With inguinal lymphadenopathy proceed:
- Neoplasms of the female genital area . Inguinal lymph nodes are the most common site of primary metastasis of malignant cells, since lymph from the pelvic organs passes through them. Lymphadenopathy, accompanied by frequent vaginal bleeding and pain in the lower abdomen, is typical of uterine carcinoma and fallopian tube cancer. Enlargement and thickening of the lymph nodes are found in vulvar melanoma, vaginal sarcoma.
- Testicular cancer . This tumor is characterized by early metastasis with damage to the inguinal lymphoid formations. More often there is unilateral lymphadenopathy, which corresponds to the affected testicle, with advanced neoplasia, the process becomes bilateral. Formations are dense, motionless. In the early stages, men notice asymmetry and swelling of the scrotum, then a dense, tuberous neoplasm appears.
- Cancer of the penis . An increase in inguinal lymph nodes is pathognomonic for the edematous form of neoplasia. Lymphoid tissue is affected on both sides, the formations are very dense to the touch, do not move during palpation. The primary tumor is often localized on the head of the penis: patients first notice a wart, a long-term non-healing ulcer or erosion with a bloody or purulent discharge. When the form is running, phimosis occurs.
- germ cell tumors. Neoplasms develop from the germ cells of the reproductive system and can affect both men and women. Inguinal lymph nodes increase and thicken with the progression of the disease, general lymphadenopathy indicates a massive lymphogenous spread of tumor cells. Patients report urination disorders, in women the menstrual cycle is disturbed.
Hemoblastoses
An increase in axillary, cervical, inguinal lymph nodes is detected in myeloproliferative processes - leukemia, chronic lymphocytic leukemia. Lymphoid formations are dense, mobile, up to several centimeters in size. Generalized lymphadenopathy is accompanied by sweating, spontaneous bleeding. With a decrease in immunity, infectious diseases manifest. An increase in lymph nodes is characteristic of T-cell lymphomas: Cesari's syndrome, mycosis fungoides. The symptom is also observed in autoimmune lymphoproliferative syndrome.
Parasitic infestations
The increase in lymphoid formations is caused by an increase in local immune reactions in response to the penetration of the pathogen. An isolated lesion of the inguinal nodes is possible with local parasitic infections of the perineum, generalized lymphadenopathy is characteristic of protozoal diseases. The most common reaction from the lymphatic system is observed in pathologies such as:
- Worm infestations . When a person is infected with tropical biohelminths, a group of helminthiases similar in clinical picture may occur: filariasis, wuchereriosis, brugiasis. The reaction of the inguinal lymph nodes is caused by the direct pathogenic action of pathogens. Lymphoid formations can increase in diameter up to 1 cm, the outflow of lymph from the lower extremities is disturbed, there is a pronounced swelling of the scrotum in men, elephantiasis.
- Toxoplasmosis. For the acquired form of infection, generalized lymphadenopathy is pathognomonic, with a predominant lesion of the inguinal and axillary lymph nodes. The formations are moderately dense, mobile, painful on palpation. The symptom is accompanied by the appearance of spotty or nodular rashes on the skin of the body, an increase in the liver and spleen. In chronic toxoplasmosis, the mesenteric lymph nodes are involved.
- Pediculosis . The defeat of the inguinal lymphoid structures is noted in the pubic form of the disease. The enlargement of the lymph nodes is bilateral, the formations have an elastic consistency, up to 2 cm in size. Patients feel intense itching, especially at night, small bluish spots and scratches are found on the skin of the pubis. A common form of pubic pediculosis must be differentiated from adult pruritus.
Survey
Diagnostic search with an increase in inguinal lymph nodes is aimed at identifying other signs of pathology, establishing the root cause of lymphadenopathy. Different specialists can be involved in the examination, depending on the leading clinical syndrome. An isolated change in the lymph nodes is the reason for contacting a hematologist. The most valuable in diagnostic terms are the following instrumental and laboratory methods:
- Ultrasound . Ultrasound of the lymph nodes is prescribed to determine the size of lymphoid formations, visualize their morphological structure. Sonography helps to differentiate lymphadenopathy from cysts, hidradenitis, and benign tumors. To clarify the diagnosis, ultrasound of the pelvic organs is often used.
- Biopsy study . A biopsy of an enlarged lymph node is performed to study its cytological composition. A large number of lymphocytes indicates reactive inflammation of the lymphoid tissue. The presence of atypical cells indicates metastases of malignant tumors or oncological diseases of the blood system.
- Blood study . A general blood test for inguinal lymphadenopathy is necessary to quickly detect signs of an inflammatory process. Severe pancytopenia or a significant change in the ratio of individual cell populations are typical for developing hemoblastosis. Additionally, biochemical analysis is carried out.
- Serological reactions . Lymphoid hyperplasia can be caused by various infectious diseases of the genitourinary tract. Therefore, to exclude them, ELISA, RSK are produced, which determine specific antibodies against the most common pathogens. In some cases, PCR diagnostics is performed to confirm the diagnosis.
Ultrasound examination of the inguinal lymph nodes
Symptomatic therapy
Inguinal lymphadenopathy usually does not require specific treatment, unpleasant manifestations disappear some time after the treatment of the underlying disease that caused the enlargement of the lymph nodes. To relieve pain, analgesics, anti-inflammatory drugs are used. With hemoblastoses and other oncological pathologies, a longer and more serious therapy is required. When detecting dense formations in the inguinal folds, you should immediately contact a specialist, since early diagnosis significantly increases the likelihood of a complete recovery.