Giant Lymph Node Hyperplasia – Causes, Symptoms, Diagnosis & Treatment

Abstract

Giant lymph node hyperplasia is a rare disorder that commonly involves lymph nodes. Lymph nodes are kidney shaped organs of the lymphatic system and immune system. A large number of lymph nodes are linked together throughout the body via lymphatic vessels. There are 2 major sites of the lymphatic system that are B and T cells. A lymph node is enclosed in a fibrous capsule which is made up of cortex (outer) medulla (inner). They are usually important for the proper functioning of the immune system. There are no detoxification functions, hence they get enlarged or inflamed in various types of throat infections to life threatening cancer.

Lymphadenopathy refers to the glands that are enlarged or swollen when lymph nodes become firm and tender. B cells are mainly found in the outer cortex where there is presence of cluster form, T cells are found in the paracortex. B cells are entering the bloodstream and cells are produced in the bone marrow. Lymph nodes are the most liable structures which are usually large at birth but undergo progessive atrophy throughout life. It acts like a defensive barrier which is virtually present in all systemic infections and in neoplastic conditions. In this topic we are going to study in detail about its causes, types and its ayurvedic management.

INTRODUCTION

Giant lymph node hyperplasia is a rare disorder where benign growths are formed in the lymph node tissues, mainly there is overgrowth of the cells in the body's lymph nodes. It is known as Castleman's disease, angiofollicular lymph node hyperplasia, Hyaline vascular type, Back pain. This disease is usually found at ⅔ of the chest, along the tracheobronchial tree in the mediastinum or in parts of the neck, pelvis etc. Usually Giant lymph node hyperplasia is asymptomatic or has non specific symptoms such as cough, chest pain, respiratory infections, and back pain which is usually due to tracheobronchial compression. Castleman's disease causative factors are human herpesvirus (HHV)-8 also known as kaposi sarcoma which causes degeneration of the inflammatory mediators and interleukin (IL). In castleman's disease there is overproduction of IL-6 and overexpression of IL-6 that further leads to proliferation of B lymphocytes.

FACTS ABOUT CASTLEMAN'S DISEASE

• It is a group of three immunologic disorders that occur in all individuals of all age groups and has microscopic lymph node appearance.
• The signs and symptoms are related to the release of cytokines, mainly interleukin 6.
• About 6600-7700 patients are estimated to suffer from this disease in the United States.
• People suffering from HIV are at major risk of developing HHV 8 associated with Castleman's disease.
• HHV 8 is affecting males more than females at a high rate.
• It affects males and females both in equal numbers and there is no known factor.

PATHOLOGY

Variations in the lymph nodes of patients with this disease lead to 4 histological classifications

• Plasmacytic- increased number of follicles with large germinal centers and plasmacytosis.
• Hyaline vascular- It is a regressed germinal center, follicular dendritic cell, prominent mantle zones with onion-like appearance.
• Hypervascular- It is mainly seen in idiopathic multicentric castle disease which includes the germinal center, follicular dendritic cell with onion-like appearance.
• Mixed- It is usually a combination of hyaline vascular and hypervascular plasmacytic features.

TYPES OF CASTLEMAN'S DISEASE

1. Unicentric Castleman's disease

This affects single or multiple lymph nodes in one region of the body hence it is known as localized Castleman's disease. The causes are unclear.

2. Multicentric Castleman's disease

Here multiple lymph nodes are involved in the body, half of the cases of MCD are involved which is caused by HHV-8 infection mainly in people with HIV infections. It can be related to idiopathic Multicentric disease

• iMCD associated with POEMS (polyneuropathy, organomegaly, skin changes)
• iMCD associated with TAFRO (anasarca, renal dysfunction, thrombocytopenia)
• iMCD, not specified.

CAUSES

The exact cause of Castleman's is not known but some causes involves-

• Human herpesvirus type8 (HHV-8)
• Human immunodeficiency virus (HIV)
• Inflammation
• Weak immune system
• Acquired genetic mutations

SYMPTOMS

Unilateral castleman's Disease includes

• Unintentional weight loss
• Fever
• Fatigue
• Anemia
• Fullness in stomach or chest
• Swollen lymph nodes in the neck, armpit or groin region.

Multicentric castleman's disease includes

• Fever
• Stomach pain
• Nerve damage
• Enlarged liver or spleen
• Appetite loss
• Night sweats
• Vomitings.

DIAGNOSIS

• Blood test
• Urine test
• CT Scan (Computed tomography)
• MRI
• PET (positron emission tomography)
• Lymph node biopsy

COMPLICATIONS

Unicentric Castleman's disease usually affects only one lymph node and when that lymph node is removed it usually does well, but in multicentric castleman's disease it may lead to multiple organ failure and lead to life-threatening infections.

TREATMENT

In unicentric castleman's disease - The affected lymph node is surgically removed.

In multicentric castleman's disease- It requires various medications and therapies to control the cell overgrowth.

• Immunotherapy
• Chemotherapy
• Corticosteroids
• Antiviral drugs

AYURVEDIC MANAGEMENT

In Ayurveda Giant lymph node hyperplasia is due to imbalances of the tridoshas and due to dushti of rasvaha srotas. Rasa Vaha srotas are the channels of the body which are formed by digestion of food in the stomach and intestines, these juices get circulated through the circulatory system which is pumped to the heart and different parts of the body. This further nourishes all the tissues and organs of the body and supports the life process. Rasavahini dhamani carries their nutritive juices to every part of the body. The contamination of rasa transport channels are rasa pradoshaja rogas (contamination of rasa dhatus).If there is blockage and destruction of digestive fire leads to the formation of ama.

Rasavaha srotas

1. Mula- heart and great vessels
2. Marga- venous and lymphatic systems
3. Mukha- arteriole, venous junction in capillaries. Rasa Vaha srotas are the main srotas that supply the whole body and provide poshana to rasa dhatu and rakta dhatu. The dhatus are structural components an increase or decrease in quantity indicates abnormal metabolism and lowering of immunity. This dhatu travels the whole body through dhamanees and nourishes tissue, organs, doshas, malas.

FACTORS CAUSING VITIATION

• Guru ahara (heavy food)
• Cold foods
• Excessive consumption of oily food
• Excessive thinking (stress)

MANAGEMENT

HERBS USEFUL FOR GIANT LYMPH NODE HYPERPLASIA

1. TULSI

Tulsi ( Ocimum sanctum) reduces the ill effect of radiotherapy which is due to cancer. Tulsi has katu (pungent) and tikta (bitter) taste, katu vipaka, and has ushna veerya. It usually balances vata and kapha dosha. Tulsi has antimicrobial properties, improves digestion and controls repeated hiccups. For itching or any skin disease tulsi paste is helpful, in kidney and bladder stones tulsi plays an important role.

2. HARIDRA

Haridra ( Curcuma longa) is a famous herb administered through nose, oral applications. Haridra is helpful in retarding facial hair growth, cures diabetes, urinary tract disorders, due to its ushna veerya, ruksha guna it removes the all blockage present in the blood vessels and makes nutrition easy, it cleanses and detoxifies the rasa dhatu, hence restores the all normal body functions. Haridra has antioxidant properties, eliminating all toxins out of the cell.

3. GILOY

Guduchi ( Tinospora cordifolia) is used extensively for the treatment of fever, urinary tract disorders, and cardiac disorders. Giloy has tikta (bitter), kashaya (astringent) taste. It balances tridoshas, so helpful in relieving the burning sensation (it has madhura vipaka and coolant in nature), improves digestion power and helps in gout arthritis. Giloy has anti-aging and rejuvenating properties.

4. BHUMI AMLA

Bhumi amla ( Phyllanthus niruri) is a liver protecting herb so helpful in inflammation of spleen and liver, and jaundice. Bhumiamla has tikta (bitter), madhura (sweet) taste, and has sheetal veerya. Bhumiamla balances vitiated kapha and pitta dosha. Helpful in bleeding disorders, heavy periods, excessive thirst. It has antispasmodic and analgesic properties. Bhumi amla is helpful in kidney stones, venereal disease, hypertension, and gonorrhoea.

HERBAL REMEDIES BY PLANET AYURVEDA FOR GIANT LYMPH NODE HYPERPLASIA

Ayurvedic medicines help to relieve diseases, and maintain a healthy lifestyle without any side effects. Planet ayurveda is a natural brand that is serving humanity. All the medications prepared are free from any preservatives, colors, dye. The formulations made are from planet extract and 100% vegetarian. The medications prepared reduce the risk of recurrence and they are prepared under strict surveillance of the experts team. So many remedies are provided by planet ayurveda for Giant lymph node hyperplasia which we are going to discuss in detail.

PRODUCTS LIST

1. TULSI CAPSULES
2. GILOY CAPSULES
3. IMMUNE BOOSTER
4. KANCHNAAR GUGGUL
5. BOSWELLIA CURCUMIN

PRODUCTS DESCRIPTION

1. Tulsi Capsules

Tulsi capsules are single herbal capsules formulated by planet ayurveda using ingredients Tulsi ( Ocimum tenuiflorum). These capsules are beneficial in patients suffering from allergy, diabetes and provide immunity to fight against infections. It usually maintains immunity and ojas, malas (excreta), and body energy. Tulsi capsules are helpful in respiratory disorders, abdominal upsets therefore balance all doshas of the body.

Dosage - 1-2 capsules twice daily with plain water after meals.

2. Giloy Capsules

Giloy Capsules are single herbal capsules formulated by planet ayurveda using ingredients like Giloy ( Tinospora cordifolia). Giloy capsules have antipyretic, anti-inflammatory, and are excellent blood purifiers so useful in skin problems, anemia, jaundice, and all types of cancers. This capsule has the ability to kill macrophages and protects the stomach from increasing production of mucin. Giloy capsules are helpful in stomach ulcers, and in condition ITP (idiopathic thrombocytopenic purpura) which further increases blood platelet count.

Dosage - 1-2 capsules twice daily with plain water after meals.

3. Immune Booster

Immune booster are poly herbal capsules formulated by planet ayurveda using ingredients such as Grape seed ( Vitis vinifera), Go- Piyush ( Bovine colostrums), Amalaki ( Emblica officinalis). These capsules throw out the toxins and further cleanses it, protecting from recurrent infections. Immune booster prevents development of particular disease and defends against germs and microorganisms. This capsule has cow colostrums which help in building and provide strength and guard against diseases as it contains minerals, proteins.

Dosage - 1-2 capsules twice daily with plain water after meals.

4. Kanchnaar Guggul

Kanchnaar guggul are herbal tablets formulated by planet Ayurveda using ingredients like Guggul ( Commiphora mukul), Kachnaar ( Bauhinia variegata). This preparation is helpful in reducing the chance of PCOS so helpful in balancing kapha dosha, improves the function of ovaries. Kachnaar Guggul reduces the fat accumulation so it is helpful in reshaping the body and controls excessive weight, in endometriosis it removes the blockage and controls the movement of vata thus reducing its symptoms.

Dosage - 1-2 tablets twice daily with plain water after meals.

5. Boswellia Curcumin

Boswellia Curcumin are polyherbal capsules formulated by planet ayurveda using ingredients like Shallaki ( Boswellia serrata), Curcumin ( Curcuma longa). This capsule has an inflammatory effect useful in conditions like cervical spondylitis, chronic colitis, and brain tumors. This capsule has turmeric in it so turmeric has an antioxidant rich formula that has neuroprotective activity and maintains a healthy cardiovascular system.

Dosage - 1 capsule twice daily after meals with plain water.

CONCLUSION

Giant lymph node hyperplasia is a rare disorder that commonly involves lymph nodes. Lymph nodes are kidney shaped organs of the lymphatic system and immune system. It is known as Castleman's disease, in Ayurveda Giant lymph node hyperplasia is due to imbalances of the tridoshas and due to dushti of rasvaha srotas. Planet Ayurveda provides many remedies for Giant Lymph Node Hyperplasia which is very effective in this disease without causing any side effects.