Hyperplasia of paratracheal lymph nodes. Hyperplastic and inflammatory processes of the lymph nodes of the neck

Based on the most significant histological features lymphadenopathy, we have developed a classification of this heterogeneous group. This classification is somewhat arbitrary, since some lymphadenopathies have common features that can vary at different stages of the disease. Most often, a biopsy in patients with persistent lymphadenopathy is performed to exclude malignancy.

In such cases Properly taken, well-fixed whole lymph node biopsies are preferred because a number of reactive lymphadenopathy may closely resemble malignant lymphoma.

Follicular hyperplasia is probably the most common type of lymph node reaction, characterized by enlargement of follicles and expansion of reproductive centers. Often these changes are combined with the appearance of plasma cells in the brain cords and interfollicular parenchyma. Reactive follicular hyperplasia is usually associated with the entry of antibodies into the body that stimulate a B-cell response.

Using auxiliary Diagnostic methods make it possible to identify many pathogens. However, in the absence of evidence of infection by microorganisms and no specific histological features indicating an etiology, this reaction is called “nonspecific hyperplasia.” Such nonspecific reactions are more common in children and young people, and are also more often detected in nodes that collect lymph from sites of infection (such as the tonsils, skin and gastrointestinal tract).

In reactive lymphadenopathy, follicles retain a distinct mantle zone consisting of small lymphocytes; in the centers of reproduction, the polarization of centroblasts and centrocytes can be determined. They are usually distributed predominantly in the cortex of the ganglion and often have unequal shape and size. In the reactive centers of reproduction, a large number of mitotic figures and numerous apoptotic bodies are detected, which are often phagocytosed by “macrophages of colored bodies.”

Rheumatoid lymphadenopathy.

Lymphadenopathy in rheumatoid arthritis is not limited to the lymph nodes that collect lymph from the affected joints, but as a component of this systemic disease can often be generalized. Severe follicular hyperplasia develops. Enlarged reproductive centers may contain amorphous PHIK-positive hyaline inclusions; occasionally, follicular hyperplasia may be accompanied by the appearance of sarcoid-like granulomas.

Large quantities plasma cells, often with Russell bodies, infiltrate the medullary cords and can also be detected in the reproductive centers.

Complication of long-term intramuscular injections of drugs colloidal gold in the treatment of rheumatoid arthritis is “golden lymphadenopathy”. Changes in the lymph nodes are similar to those seen in rheumatoid lymphadenopathy.

Lymph node hyperplasia is a serious problem in clinical medicine.

In fact, hyperplasia (Greek - over-formation) is a pathological process associated with an increase in the intensity of reproduction (proliferation) of tissue cells of any type and location. This process can begin anywhere, and its result is an increase in tissue volume. And, in fact, such hypertrophied cell division leads to the formation of tumors.

However, it should be noted that lymph node hyperplasia is not a disease, but a clinical symptom. And many experts attribute it to lymphadenopathy - increased formation of lymphoid tissue, which causes their increase. And lymph nodes are known to enlarge in response to any infection and inflammation.

ICD-10 code

R59 Enlarged lymph nodes

Causes of lymph node hyperplasia

When characterizing the causes of lymph node hyperplasia, it is necessary to clarify that lymphoid or lymphatic tissue (consisting of reticuloendothelial cells, T-lymphocytes, B-lymphocytes, lymphatic follicles, macrophages, dendrites, lymphoblasts, mast cells, etc.) is located not only in the parenchyma of the organs of the lymphatic system : regional lymph nodes, spleen, thymus glands, pharyngeal tonsils. This tissue is also present in the bone marrow, in the mucous membranes of the respiratory system, gastrointestinal tract and urinary tract. And if there is a focus of chronic inflammation in any organ, accumulations of lymphoid tissue cells appear there too - to protect the body from the infection attacking it.

But we are interested in the regional lymph nodes, which ensure the production of lymphocytes and antibodies, filtering lymph and regulating its flow from organs. Today, the causes of lymph node hyperplasia are considered as the reasons for their enlargement, which is an immune response to any pathological process that makes changes both in the dynamics of tissue metabolism of the lymph node and in the ratio of certain cells. For example, in response to genetically distinct cells (antigens) in a lymph node, the production of lymphocytes and mononuclear phagocytes (macrophages) increases; When bacteria and microbes enter the lymph nodes, their waste products and neutralized toxins accumulate. And in the case of oncology, hyperplasia of the lymph nodes can involve any of their cells in the pathological process of proliferation. This causes an increase in size, change in shape and structure of the fibrous capsule of the lymph node. Moreover, the tissues of the lymph nodes can grow beyond the capsule, and in the case of metastases from other organs, they can be replaced by their malignant cells.

Based on this, lymph node hyperplasia can be of infectious, reactive or malignant origin.

Hyperplasia of lymph nodes of infectious etiology

Hyperplasia of the lymph nodes (in the sense of an increase in their size) is a response to infection in diseases such as lymphadenitis caused by strepto- or staphylococci, rubella, chicken pox, infectious hepatitis, felinosis (cat scratch disease); tuberculosis, HIV, infectious mononucleosis, cytomegaly, tularemia, brucellosis, chlamydia, syphilis, actinomycosis, leptospirosis, toxoplasmosis.

With nonspecific lymphadenitis, depending on the location, hyperplasia of the lymph nodes in the neck, lower jaw or axillary lymph nodes is observed. Enlargement of the axillary lymph nodes has been noted with mastitis, inflammation of the joints and muscle tissue of the upper extremities, brucellosis, felinosis, etc.

Inflammatory processes in the oral cavity and nasopharynx (with actinomycosis, caries, chronic tonsillitis, pharyngitis, bronchitis, etc.) are characterized by hyperplasia of the submandibular, postauricular, preglottic and retropharyngeal lymph nodes. And with infectious mononucleosis, only the cervical lymph nodes become enlarged.

In the case of rubella, toxoplasmosis, tuberculosis, as well as syphilis, doctors note hyperplasia of the cervical lymph nodes. In addition, the symptoms of tuberculosis include hyperplasia of the intrathoracic and mediastinal lymph nodes. At the same time, in the lymph nodes, healthy cells of lymphoid tissue are gradually displaced by necrotic masses of a caseous nature.

Hyperplasia of the mesenteric lymph nodes is also characteristic of tuberculosis. In addition, a significant increase in the lymph nodes of the mesenteric section of the small intestine occurs due to damage by the gram-negative bacterium Francisella tularensis, which causes tularemia, an acute infectious disease transmitted by rodents and arthropods.

Hyperplasia of the inguinal lymph nodes is noted by doctors in infectious mononucleosis, toxoplasmosis, brucellosis and actinomycosis, as well as in all genital infections and HIV.

Symptoms of lymph node hyperplasia

Lymph node hyperplasia, as mentioned above, is a symptom of a wide range of diseases. The most important task is to identify symptoms of lymph node hyperplasia that confirm or refute the malignant pathogenesis of increased cell division.

If the lymph node enlarges quickly (up to 2 cm and a little more), if painful sensations arise when palpating, and the consistency of the node is quite soft and elastic, then there is every reason to say: this lymph node hyperplasia arose as a result of an infectious lesion or inflammatory process. This is confirmed by redness of the skin in the lymph node area.

When the lymph node enlarges slowly, there is no pain during palpation, and the node itself is very dense - there is a high probability that the process is malignant. And with metastases, the enlarged lymph node literally grows into the surrounding tissue and can form “colonies.”

The location of the hypertrophied lymph node is also important. Hyperplasia of the submandibular, cervical and axillary lymph nodes speaks in favor of its benignity. The same cannot be said about hyperplasia of the supraclavicular, mediastinal, retroperitoneal and lymph nodes in the abdominal cavity.

Reactive lymph node hyperplasia

Reactive lymph node hyperplasia occurs as a response of the immune system to pathologies of an immune nature. Such pathologies include:

autoimmune collagenoses (rheumatoid arthritis and polyarthritis, periarteritis nodosa, systemic lupus erythematosus, scleroderma, Hamman-Rich syndrome, Wegener's granulomatosis); - Wagner's disease or dermatomyositis (systemic disease of skeletal and smooth muscles and skin)
storage diseases (eosinophilic granuloma, Gaucher disease, Niemann-Pick disease, Letherer-Sieve disease, Hand-Schüller-Christian disease).

In addition, the reactive form may be accompanied by serum sickness (allergy to the use of immune serum preparations of animal origin), hemolytic anemia (hereditary or acquired), megaloblastic anemia or Addison-Beermer disease (which occurs with a deficiency of vitamins B9 and B12) and chemotherapy and radiation therapy oncological diseases.

Among autoimmune diseases of the endocrine system, lymph node hyperplasia is characteristic of hyperthyroidism (Graves' disease), the cause of which lies in the increased production of thyroid hormones by the thyroid gland. With this pathology, hyperplasia of the lymph nodes is generalized with increased mitosis of lymphatic follicles.

Experts emphasize that reactive lymph node hyperplasia is characterized by significant proliferative activity and, as a rule, affects the lymph nodes in the neck and lower jaw.

From the point of view of cytomorphology, the reactive form has three types, the most common of which is the follicular form.

Follicular lymph node hyperplasia

Histological studies have shown that a feature of follicular hyperplasia of the lymph nodes is the size and number of secondary follicles that form antibodies, significantly exceeding the norm of lymphoproliferation, as well as the expansion of their reproduction centers (the so-called light centers). These processes occur in the cortex of the lymph nodes. At the same time, secondary follicles behave quite aggressively, displacing other cells, including lymphocytes.

Follicular hyperplasia of the lymph nodes in the neck is diagnosed as a characteristic symptom of angiofollicular lymphoid hyperplasia or Castleman's disease. In the localized form of this disease, only one lymph node is enlarged, but this is manifested by periodic pain in the chest or abdomen, weakness, weight loss, and bouts of fever. Researchers associate the cause of Castleman's disease with the presence of the herpes virus HHV-8 in the body.

Malignant lymph node hyperplasia

Lymph node hyperplasia of malignant etiology can affect regional nodes throughout the body. Primary ones include lymphomas.

Long-term enlargement of the supraclavicular lymph nodes may indicate cancer of the esophagus, stomach, duodenum, intestines, kidneys, ovaries, testicles.

Hyperplasia of the cervical lymph nodes is observed with tumors of the maxillofacial localization, with melanoma in the head and neck area. In patients with tumors of the lungs or mammary glands, oncopathology will certainly manifest itself as hyperplasia of the axillary lymph nodes. In addition, it occurs with blood cancer.

Hyperplasia of the cervical and mediastinal lymph nodes is characteristic of sarcoidosis (with the formation of epithelioid cell granulomas and their subsequent fibrosis).

With leukemia, with malignant neoplasms in the pelvic organs, metastases of prostate, uterine, ovarian, and rectal cancer, hyperplasia of the lymph nodes in the abdominal cavity and inguinal lymph nodes is usually observed.

With Hodgkin's lymphoma, as a rule, there is a persistent enlargement of the cervical and supraclavicular nodes, as well as hyperplasia of the retroperitoneal and lymph nodes of the abdominal cavity. The significant size of the latter causes dysfunction of the intestines and pelvic organs. In the case of non-Hodgkin's lymphoma, against the background of anemia, neutrophilic leukocytosis and lymphopenia, hyperplasia of the cervical and intrathoracic lymph nodes (in the area of the diaphragm), as well as nodes in the elbow and popliteal folds, is detected.

Diagnosis of lymph node hyperplasia

Diagnosis of lymph node hyperplasia must take into account and correctly evaluate all the factors that led to the occurrence of this syndrome. Therefore, a comprehensive examination is necessary, which includes:

general blood analysis,
biochemical blood test (including for toxoplasmosis and antibodies),
blood immunogram,
analysis for tumor markers,
general urine analysis,
throat swab for the presence of pathogenic flora,
serological tests for syphilis and HIV,
Pirquet and Mantoux test for tuberculosis,
Kveim test for sarcoidosis,
X-ray (or fluorography) of the chest,
ultrasound examination (ultrasound) of lymph nodes,
lymphoscintigraphy;
biopsy (puncture) of the lymph node and histological examination of the biopsy.

In half of the cases, accurate diagnosis is possible only with the help of histological examination after taking a tissue sample from the lymph node.

When treating tuberculosis or another specific infection, treatment is prescribed according to regimens developed for each specific disease.

In the case of a diagnosed autoimmune disease that has resulted in lymph node hyperplasia, or the malignant nature of the proliferation of lymph node cells, no compresses or antibiotics will help. Keep in mind that in the case of lymph nodes and pathological proliferation of their tissues, self-medication is absolutely unacceptable!

Prevention of lymph node hyperplasia - timely examination and treatment, and in case of incurable pathologies - implementation of all recommendations of experienced and knowledgeable doctors. Then it is possible not to take the disease to extremes, when hypertrophied tissues turn into a malignant neoplasm.

The name of the disease has Greek roots and, literally translated, sounds like “over-education.” Therefore, hyperplasia is called an increase in the elements of tissue structure due to their excessive formation. An increase in the number of cells leads to an increase in the volume of an organ or tumor. At the same time, rapidly developing processes of hyperplasia lead to a decrease in the volume of the cells themselves, i.e. to disruption of their structure.

Hyperplasia can develop in various organs and have significant complications.

In medical practice, there are cases of cell proliferation in the mammary, prostate and thyroid glands, placenta and other organs. Hyperplasia can develop during pregnancy, or during the premenstrual period in the mammary glands, in the form of the mucous membrane of the stomach, uterus, and nose.

Hyperplasia often develops with certain types of infection, with acute anemia in the form of growth of hematopoietic tissue outside the bone marrow.

Causes of hyperplasia

The causes of hyperplasia are various processes leading to cell proliferation.

Such processes include disorders of the nervous regulation of cell metabolism and growth. Hyperplasia often develops due to an increase in tissue function under the influence of growth stimulants. This can occur under the influence of carcinogens or tissue decomposition products.

The cause of hyperplasia may be a violation of relationships in organs with internal secretion.

Hereditary factors and concomitant diseases, such as mastopathy, liver dysfunction, and other diseases can also cause hyperplasia.

Main symptoms of hyperplasia

The symptoms of the disease depend on the location of the area with growing tissues.

The main signs of hyperplasia include an increase in the volume of the organ, thickening of the affected layer, pain at the site of localization. Hyperplasia is often accompanied by nausea, vomiting, chills and increased body temperature.

A variety of forms of hyperplasia

In medicine, there are several types of hyperplasia.

Pathological and physiological hyperplasia is divided into:

Physiological hyperplasias include tissue proliferation that is temporary or functional in nature. These include, for example, mammary gland hyperplasia during pregnancy or lactation.
Pathological hyperplasias include tissue proliferation due to provoking factors.

In addition, hyperplasia can be focal, diffuse or polypous:

In the focal form, there is a clear localization of the process in the form of separate areas.
Diffuse hyperplasia affects the surface of the entire layer.
The polypous form is characterized by uneven growth of connective tissue elements and provokes the development of cysts and low-quality formations.

Diffuse hyperplasia of the thyroid gland

This type of hyperplasia occurs as a compensatory reaction of the liver to iodine deficiency.

The term diffuse hyperplasia reflects an increase in the overall volume of the liver due to the proliferation of its cells to support the secretion of thyroid hormones, which promote metabolism, maintain energy levels and enhance oxygen absorption.

Iodine is needed by the thyroid gland to maintain its hormonal activity. The absence or deficiency of iodine leads to the proliferation of gland cells and its dysfunction.

In addition, a hereditary predisposition can lead to the development of diffuse hyperplasia of the thyroid gland.

Eating goitrogenic substances (preventing the consumption of iodine for the production of hormones) can also cause hyperplasia of the thyroid gland. Such provoking agents include sweet potatoes, cauliflower and white cabbage, corn, lettuce, horseradish, and turnips.

A similar form of hyperplasia can occur with the use of certain medications or helminthic infestation.

Reactive lymph node hyperplasia

An increase in the volume of lymph nodes that occurs as a response of the body to an inflammatory process, a generalized infection or the pathology of autoimmune processes is called reactive lymph node hyperplasia.

Enlarged lymph nodes can be caused by metastases of cancer tumors, so it is necessary to differentiate reactive lymph node hyperplasia from metastases of malignant tumors. In the reactive form, in contrast to oncological processes, there is pain, enlargement and elastic consistency of the inflamed nodes. This form is characterized by localization of hyperplasia in the submandibular, axillary and cervical lymph nodes.

Benign prostatic hyperplasia

After about age fifty, about 85% of men suffer from benign prostatic hyperplasia (prostate adenoma). The disease is characterized by the formation of a small nodule (or several) on the prostate, which, as it grows, puts pressure on the urethra and causes problems with urination. Benign prostatic hyperplasia does not cause metastasis, which distinguishes this disease from oncological disease, that is, prostate cancer. That is why it is called benign hyperplasia. The disease has no clear cause and is usually associated with male menopause.

Breast hyperplasia

When the mammary gland enlarges by more than half, mammary gland hyperplasia is diagnosed, the severity of which is determined by its increase in height and in the anterior projection. The disease can be unilateral or bilateral. With unilateral hyperplasia, echographic diagnosis is necessary to exclude oncology.

Dyshormonal diffuse hyperplasia of the mammary gland can be expressed by an increase in the volume of the ductal epithelium as a result of an increasing number of cell layers of the duct walls and an increase in terminal tubular branches. In addition, diffuse dyshormonal hyperplasia can occur due to connective tissue sclerosis.

Diffuse dyshormonal hyperplasia, which develops against the background of connective tissue sclerosis, leads to severe premature degeneration of the mammary gland, the formation of cysts and tissue fibrosis.

Fibrous hyperplasia of the mammary gland, better known as fibrocystic mastopathy, is formed due to various dyshormonal disorders in the mammary gland. In this case, benign tumors appear in the breast.

The reasons why fibrous hyperplasia of the mammary glands can form are associated with the presence of gynecological and endocrine diseases in the body, may be a consequence of an abortion or the result of systemic diseases.

Fibrous hyperplasia of the mammary glands is characterized by the formation of connective tissue.

All forms of hyperplasia require accurate diagnosis and identification of the true cause of tissue proliferation.

The proliferation of tissue due to the formation of new cells, or hyperplasia, is not a disease, but a pathological process. It can accompany a variety of diseases. In the body, epithelial cells - the surface layer of the skin, mucous membranes, and glands - divide most intensively. Therefore, diseases of the gastric mucosa, endometrium, prostate, and thyroid gland are often observed.

The development of neoplasms is often caused by hormonal reasons. An example is the glandular form of endometrial disease, associated with excessive stimulation of uterine tissue by estrogen. In this case, a dysfunction of the corresponding organ occurs. Thus, benign pathology of the prostate gland leads to difficulty urinating, pain in the perineum, and decreased sexual activity.

These diseases are dangerous because when cells divide excessively, genetic mutations accumulate in them. This means that they can develop into cancer.

Causes and symptoms

The following causes of hyperplasia can be distinguished:

dysregulation of cell reproduction under the influence of hormonal factors or other biologically active substances;
hereditary predisposition;
chronic diseases of relevant organs;
metabolic pathology in the body - obesity, diabetes.

Signs of hyperplasia are an increase in volume and dysfunction of the affected tissue. For example, the development of endometrial disease in women is accompanied by thickening of the uterine mucosa, heavy menstrual bleeding, and intermenstrual bleeding. With a long course of the pathology, infertility, failure to carry a pregnancy, and transformation into cancer are possible. To diagnose and treat the disease, curettage and hormonal therapy are used. Curettage is necessary to exclude a malignant process.

Often, for quite a long period, any form of the disease is not accompanied by symptoms, and the patient learns about the pathology only in advanced cases. Therefore, regular preventive examinations by doctors of various specialties are important.

Classification of the disease

This condition can be physiological (normal) and pathological. For example, during pregnancy, the number of muscle cells in the uterus increases. Often the disease is combined with hypertrophy - an increase in cell mass and volume.

Classification of hyperplasia:

by place of origin - endometrium, prostate, gastric mucosa, and so on;
by cell type - glandular form, glandular-cystic and others;
by prevalence - focal, diffuse, with the formation of polyps;
benign and atypical (precancer).

The development of disorders is most often mediated by hormonal disorders. Thus, excess estrogen causes endometrial pathology and bleeding. Therefore, research for such pathology includes not only a biopsy of the affected tissue, but also determination of the level of relevant hormones. Based on these data, drug therapy or surgery is prescribed.

Endometrial hyperplasia

This condition is associated with the growth of the inner lining of the uterus. Endometrial hyperplasia manifests itself in several variants (glandular, polyps, atypical). Atypical is the most dangerous for the body, since it can be accompanied by the formation of cancer cells.

The main cause of the pathology is an excess of estrogen with a deficiency of progesterone. The disease is accompanied by heavy menstrual bleeding, intermenstrual discharge and infertility. The course of pregnancy is also accompanied by disturbances.

For diagnosis, curettage of the uterus is prescribed. In combination with hormonal therapy, curettage is a fairly effective treatment method.

Prostatic hyperplasia

Prostate hyperplasia is the most common urological disorder in men. The cause of the disease is hormonal changes that occur in the male body with age, in particular, an increase in the level of testosterone in the gland.

Prostatic hyperplasia is accompanied by its enlargement. This formation compresses the urethral canal, leading to urination disorders. An active sex life is also difficult. In the later stages of the disease, the kidneys are irreversibly damaged.

Every man over 50 years of age should regularly visit a urologist. If necessary, the disease is diagnosed. It includes ultrasound and prostate-specific antigen testing to rule out malignancy.

At an early stage of the disease, it can be managed with the help of medications. If they are ineffective, surgical intervention is performed.

Uterine hyperplasia

Typically, this condition refers to endometrial hyperplasia of the uterus. This disease is caused by the proliferation of mucous membranes with an increase in the level of sex hormones - estrogens. The pathology is accompanied by heavy menstruation, dysfunctional bleeding, anovulation, and infertility. Changes in the properties of the endometrium can lead to its malignant degeneration.

For diagnosis, ultrasound, hysteroscopy, curettage and examination of the resulting tissue under a microscope are used. If the pathology is benign, the woman is prescribed hormonal medications. An effective method of treatment is the introduction of a spiral containing gestagens (Mirena) into the uterine cavity.

Hyperplasia of the thyroid gland

The main problem with this condition is differential diagnosis with a tumor. Hyperplasia of the thyroid gland can be diffuse or accompanied by the formation of nodes. It is usually associated with iodine deficiency in the body or excess synthesis of thyroid-stimulating hormone and is necessary to maintain normal synthesis of thyroid hormones. Patients are often unaware that they have this condition.

A significantly pronounced benign tumor is accompanied by compression of the trachea and esophagus, impaired breathing and swallowing.

Treatment of the pathology is carried out with medications or surgery to remove the tissue of the node.

Focal hyperplasia

One form of pathology is focal hyperplasia. This is a limited area of the mucous membrane in which cell proliferation occurs. The disorder can occur in any part of the mucosa. For example, gastric pathology occurs as a result of its erosion and may be accompanied by the formation of polyps.

When the balance of estrogens and gestagens is disturbed in women of reproductive age, focal pathology of the endometrium develops. It is often accompanied by obesity and diseases of the mammary glands. For diagnosis and treatment, curettage under hysteroscopy control is prescribed.

Symptoms of pathology

Signs of the pathological condition depend on the affected organ. Symptoms of prostate hyperplasia - urination problems, kidney damage. Thyroid pathology increases the risk of hormonal disorders.

Symptoms of endometrial pathology are caused by the excessive effect of estrogens on the uterine mucosa. These include heavy menstruation, irregular bleeding and infertility in women. Atypical endometrial hyperplasia can cause uterine cancer. In this case, the process is accompanied by abundant mucous discharge and pain.

Diagnosis of the disease is based on examination of tissue preparations under a microscope. To obtain them, a biopsy method is used.

Treatment of the disease

The development of the disease is accompanied by symptoms characteristic of the pathology of the corresponding organ. How to treat hyperplasia is determined by the doctor in each individual case.

Treatment of hyperplasia is carried out after a thorough diagnosis aimed at excluding malignant degeneration of cells. Histological examination of tissue obtained by biopsy or curettage is used. Endoscopy and ultrasound are used to assess the thickness and other characteristics of the mucosa.

Treatment of endometrial pathology depends on the age of the patient and the course of the disease. Hormonal agents and surgical treatment are used.

Treatment of the glandular form of the disease in women of reproductive age, in whom pregnancy is desired in the future, is treated with combined oral contraceptives or progesterone preparations. If pregnancy is not yet desired, an intrauterine device with levonorgestrel (Mirena) is used. To stop bleeding, a curettage procedure is used.

Treatment of glandular pathology of the endometrium in menopause includes gestagens, and if they are ineffective, removal of the uterus. For the atypical form, the main treatment method is hysterectomy. The issue of removing the ovaries is decided individually.

For prostate disease, medications are prescribed to reduce the volume of its tissue. If ineffective, gentle surgical techniques or complete removal of the gland are used.

For thyroid disease, treatment depends on hormonal levels. If hormone levels are normal, only observation is indicated; in other cases, medications are prescribed. If the size of the gland increases significantly, part of it is removed surgically.

An increase in tissue volume or proliferation is called hyperplasia or metaplasia. Metaplasia is a tumor growth of cells with signs of malignancy.

Hyperplasia is the same cell growth, but it is distinguished by the benign nature of the process: the overgrown tissues have the correct intracellular structure and chromosomal composition. Only if hyperplasia is started will the process become malignant.

Treatment of hyperplasia can be medication or surgery. The method is selected depending on the type of hyperplasia, its location, and stage.

The article will discuss treatment methods for the most common types of disease, such as endometrial hyperplasia, benign prostatic hyperplasia, thyroid hyperplasia, and lymphoid hyperplasia.

Types and methods of treatment of endometrial hyperplasia

The endometrium in a healthy state consists of a base (stroma) and a gland. Therefore, depending on which endometrial tissue grows, the following types of disease are distinguished:

glandular hyperplasia;
cystic hyperplasia;
glandular cystic hyperplasia;

In addition, a new classification of the disease was recently adopted: simple hyperplasia and atypical. Atypical, in turn, is divided into two forms: diffuse hyperplasia and focal hyperplasia.

The standard treatment regimen for endometrial hyperplasia is a combination of surgery and hormonal therapy. But since we are talking about a disease of the most important reproductive organ, the woman’s age is also taken into account. If the stage and type of hyperplasia make it possible to stop cell growth and reduce the volume of overgrown tissues only with the help of hormonal drugs, surgical intervention is avoided.

First, let's look at the standard approach to treating this type of disease as glandular hyperplasia. Treatment in most cases involves curettage of the uterine cavity, which is both a diagnostic and therapeutic procedure. Hormonal therapy for the disease glandular hyperplasia consists of prescribing combined contraceptive drugs (medicine Regulon) or gestagens. It has been established that glandular hyperplasia responds well to the gestagenic drug Duphaston. Treatment is often limited to the prescription of this drug alone, and it lasts at least three months. Contraceptives are prescribed in courses of 21 days, with control examinations carried out in between.

Cystic hyperplasia and glandular cystic hyperplasia are treated in the same way. Often, in the absence of obvious abnormalities, cystic hyperplasia and glandular cystic hyperplasia are considered to be the same disease.

Simple hyperplasia is a proliferation of tissues in which atypical cells are not found in them. Simple hyperplasia is a benign process with a positive prognosis. Simple hyperplasia, when treated promptly, is often successfully treated with hormones.

Atypical diffuse hyperplasia is a uniform proliferation of endometrial cells. Atypical focal hyperplasia is the proliferation of cells in a limited area of the uterine cavity.

Both diffuse hyperplasia and focal hyperplasia of an atypical nature are considered precancerous conditions; in most cases they require surgical intervention - either the entire uterine cavity is curetted if diffuse hyperplasia is diagnosed, or a separate altered area if focal endometrial hyperplasia is observed. Read more about drug treatment for endometrial hyperplasia. Regulon is usually prescribed to women of childbearing age - up to 35 years of age and to teenage girls with complaints of irregular or heavy menstruation. As already mentioned, the drug is taken in the standard course - 21 days. To stop uterine bleeding, the patient is prescribed to take 2-3 Regulon tablets per day. If the bleeding does not stop, curettage of the uterus is performed.

Duphaston for such a disease as benign endometrial hyperplasia is prescribed to women both during childbearing age and during menopause. The drug is taken in courses of 3-6 months, from days 16 to 25 of the menstrual cycle.

Women during premenopause can be prescribed the drug Buserelin. The medicine inhibits ovarian function. This process is reversible (the ovaries return to normal after 2-3 weeks), but side effects such as menopausal symptoms are usually poorly tolerated by patients from a psychological point of view, so they try not to prescribe Buserelin to younger women.

In addition to hormonal therapy, a woman with endometrial hyperplasia must undergo restorative treatment. Vitamins, iron supplements, medications with a sedative effect are usually prescribed, acupuncture and physiotherapy are practiced.

If hyperplasia does not respond to surgical and hormonal treatment, and after a while it appears again, the woman is advised to have the uterus removed.

In order to prevent such serious consequences, it is necessary to undergo regular examinations by a gynecologist and be sure to seek medical help if the following signs of endometrial hyperplasia are detected:

menstrual irregularities;
heavy and/or painful menstruation;
pain in the lower abdomen;
infertility;
intermenstrual bleeding or spotting.

Benign prostatic hyperplasia (BPH)

To begin with, it should be noted that prostatic hyperplasia is always a benign process. With timely detection of the disease and prescribing adequate treatment, it is possible to prevent the degeneration of adenoma (the second common name for BPH) into a malignant neoplasm.

Therefore, a man should pay attention to the following signs of hyperplasia:

frequent urge to urinate, incl. at night time;
the stream of urine becomes intermittent or weaker than usual;
urination begins with difficulty;
urine drips for a long time at the end of urination;
after urination there is a feeling of incomplete emptying of the bladder.

Benign prostatic hyperplasia in the initial stage is amenable to drug treatment. There are two types of medications used to treat BPH:

such that they reduce the size of an enlarged prostate;
such that they relax the smooth muscles of the prostate, urethra and bladder neck.

Surgery on the prostate is resorted to if the following signs of hyperplasia are detected:

serious urinary retention - when even catheterization does not help, or there is no way to use it;
renal failure secondary to BPH;
recurrent urinary tract infection developing against the background of BPH.

In addition, resection of the prostate gland is indicated for patients with benign prostatic hyperplasia if they have kidney stones, scar processes in the pelvis, neurogenic disorders, acute inflammation of the lower urinary tract, as well as hypersensitivity to drugs.

Hyperplasia of the thyroid gland

The functioning of the thyroid gland is regulated by the endocrine system. Hyperplasia of this organ begins when its function deteriorates, when the gland stops producing thyroid hormones. This often occurs due to iodine deficiency in food and water.

The growth of thyroid tissue can be different, but most often patients are treated about the appearance of nodules in the gland.

Nodular hyperplasia of the thyroid gland is dangerous because the resulting nodules often degenerate into tumors. The most dangerous is considered to be nodular hyperplasia of the gland, in which solitary (single) nodes are formed.

Signs of thyroid hyperplasia are an increase in size of the organ (which is first felt upon palpation, and some time later is easily determined visually), pain, difficulty swallowing and breathing, and hoarseness. All these symptoms are explained by the fact that the gland, increasing, compresses the nerves, blood vessels, and respiratory organs.

As we have already said, nodular hyperplasia is a fairly serious disease, therefore, the sooner the endocrinologist makes a diagnosis, the better the prognosis for hyperplasia. First, nodular hyperplasia is determined by ultrasound - thanks to this examination method, nodules in the gland can be seen. The malignancy of the process can be excluded only after a biopsy - the gland is pierced with a thin needle, the contents of the node(s) are taken and sent for laboratory histological examination.

In addition, a person who is diagnosed with nodular hyperplasia must undergo a gland scanning procedure with radioactive iodine. Such an examination makes it possible to identify “cold” nodules that are prone to degeneration into cancerous tumors.

With timely contact with an endocrinologist and the absence of “cold” nodes, nodular hyperplasia can be successfully treated with drugs containing thyroid hormones.

Nodular hyperplasia of the thyroid gland, which provokes the appearance of “cold” nodes, is subject to surgical treatment. The operation is also indicated if, as a result of histological examination of the contents of the nodes, poor or questionable results are obtained.

If we are talking about surgery, a patient diagnosed with nodular hyperplasia is first prescribed only removal of the nodes. During the operation, an additional histological examination of the gland tissue is performed, and if cancerous (atypical) cells are found in them, it is completely removed, along with the nearby lymph nodes.

Prevention of a disease such as nodular hyperplasia of the thyroid gland is the daily use of iodine. The daily iodine intake for adults is 200 mcg, for children – 100 mcg, for pregnant and lactating women – 250 mcg.

Lymphoid hyperplasia

Lymphoid hyperplasia is a pathological proliferation of lymphocytes in the lymph nodes. Lymph nodes perform a protective function - they suppress the growth of viruses, bacteria, and the spread of malignant processes. Most often, the enlargement of nodes is a response to inflammation, but in some cases the lymph nodes themselves are involved in the inflammatory process - this is lymphoid hyperplasia.

The location of enlarged lymph nodes can often indicate the presence of serious diseases. For example, hyperplasia of the lymph nodes in the groin can be caused by cancerous tumors in the legs or cancerous metastases in the external genitalia. Pathologically enlarged nodes in the neck appear due to tumors on the face or in the jaw bones.

Lymphoid hyperplasia is treated comprehensively. First, a full examination is carried out to identify the cause of such severe inflammation of the nodes. Based on the results, conservative or surgical treatment may be prescribed. Conservative treatment of the disease lymphoid hyperplasia is selected depending on the location of the inflamed nodes.
If the stomach is affected, I can prescribe probiotics, hepatoprotectors; if the adenoids are inflamed, desensitizing drugs, antiseptics, as well as laser therapy, vibroacoustic therapy, and ultraviolet irradiation are prescribed.
If lymphoid hyperplasia is caused by intestinal disease, corticosteroids may be prescribed. Thus, we can conclude that conservative treatment of lymphoid hyperplasia is aimed at relieving inflammation. If this does not produce results and the growth of lymph node tissue does not stop, surgery is prescribed to trim or remove nodes and other affected tissues or organs.

First of all, it should be remembered that lymphoid hyperplasia is still a benign process, and symptoms such as enlarged nodes, their pain, and persistent high temperature require medical attention. Surgery and complications in the form of degeneration of overgrown tissue into cancerous tumors can be avoided if you undergo a timely examination.

The same can be said about all types of hyperplasia that are described here. In most cases, you can get by with taking medications and stopping pathological processes that occur in the body under the influence of external factors, due to poor nutrition, increased trauma, etc.