What happens if my child has lymph nodes behind his neck?

Children are the cutest angels in the world and treasures in the eyes of their parents. Parents are afraid that the children will melt if they are held in their mouths, and afraid that they will be smashed if they are held in their hands. Parents become worried and at a loss as to what to do if their children have the slightest problem. Recently, many parents have reported to us that their children have lymph nodes on the back of their necks, and they look very scary. So what is the cause of this and what should we do?

1. Causes of disease

Cervical lymph node metastasis is closely related to its anatomical characteristics. The deep cervical lymph nodes are located between the deep cervical investing fascia and the prevertebral fascia. There are 10 groups with about 300 lymph nodes. The lymph nodes are surrounded by the carotid artery, nerves, muscles, and neck organs (Figure 1). The cervical lymph nodes are the collection area of ​​the whole body's lymph, and all the lymph fluid in the body can be drained through here. For example, the nasopharyngeal lymph drainage flows through the lateral retropharyngeal lymph nodes into the upper internal jugular lymph nodes; the oral floor lymphatic vessels enter the submental lymph nodes, and then flow into the submandibular lymph nodes and deep cervical lymph nodes; the thoracic and abdominal cavity fluid flows into the thoracic duct, and then drains to the supraclavicular lymph nodes, etc. Therefore, once cancers throughout the body invade the lymphatic system, they may metastasize to the cervical lymph nodes. Cancer metastasizes to the cervical lymph nodes in three ways:

1. Metastasis from lymphatic vessels, most common.

2. Metastasis through the bloodstream to the lymph node capsule and trabecular blood vessels.

3. Cancer (such as salivary gland and thyroid cancer) directly invades nearby lymph nodes.

2. Pathogenesis

1. Relationship between metastatic lymph nodes and primary lesions Cervical lymph node metastasis of tumors usually first occurs in the sentinel lymph nodes (or the first station lymph nodes), which are often the largest in size. Among them, 95% involve unilateral (usually ipsilateral) lymph nodes. However, tumors of the soft palate and Waldeyer's ring can metastasize to the bilateral cervical lymph nodes, especially nasopharyngeal carcinoma, which has a more obvious tendency.

2. Relationship between pathological type and primary lesion (Table 3)

(1) Metastatic cancer originating from the head and neck: Most are squamous cell carcinomas, especially well-differentiated and moderately differentiated types, mainly from tumors in the oral cavity, paranasal sinuses, larynx, and pharynx. Poorly differentiated carcinomas mainly arise from the nasopharynx, with a few arising from the base of the tongue and the pyriform sinus. Adenocarcinomas are more common in the thyroid gland, often presenting a typical papillary thyroid adenocarcinoma structure. A few may also originate from the salivary glands or nasal cavity. Malignant lymphomas are rare, and most of the primary sites are in the pharyngeal lymph ring areas such as the pharyngeal tonsils, palatine tonsils, and base of the tongue. They may also be the neck manifestation of systemic malignant lymphoma. Malignant melanoma mostly originates from the skin of the head and neck, especially the hairline and scalp, and a few originate from the oral cavity, nasal mucosa or eyes.

(2) Metastatic cancer originating from the chest, abdomen, pelvis, etc.: Most of them are adenocarcinomas, mostly from the breast, stomach, colon, and rectum, and a few originate from the prostate, liver, pancreas, uterus, ovaries, and kidneys. Squamous cell carcinoma is less common and mostly originates from the esophagus and lungs, while small cell carcinoma mainly originates from the lungs.

Parents always treat their children like treasures, which is the most selfless dedication of every parent. However, children are ignorant and they don’t know how to express the pain in their body. Therefore, as parents, we must pay attention to our children at all times to ensure that they can spend their short childhood in health and happiness.