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Persistent generalized lymphadenopathy (PGL) is enlarged, painless, non-tender
lymph nodes A lymph node, or lymph gland, is a kidney-shaped Organ (anatomy), organ of the lymphatic system and the adaptive immune system. A large number of lymph nodes are linked throughout the body by the lymphatic vessels. They are major sites of lymphoc ...
occurring in a couple of different areas for more than three to six months for which no other reason can be found. To expand, the common site where PGL occurs is within the head and neck region; parotid gland alterations and nasopharyngeal lymphatic tissue enlargement are often frequent comorbidities of Persistent generalized lymphadenopathy. Due to lymphoproliferation in the intraglandular lymphoid tissue, obstruction within the epithelium results in cystic expansion, which is the cause of cystic parotid lesions found in PGL.HIV lymphadenopathy: Differential diagnosis and important imaging features : American Journal of roentgenology : Vol. 216, no. 2 (AJR). American Journal of Roentgenology. (n.d.). Retrieved November 18, 2022, from https://www.ajronline.org/doi/full/10.2214/AJR.19.22334?mobileUi=0 This condition frequently occurs in people in the latency period of
HIV/AIDS The HIV, human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system. Without treatment, it can lead to a spectrum of conditions including acquired immunodeficiency syndrome (AIDS). It is a Preventive healthcare, pr ...
. The
lymphatic system The lymphatic system, or lymphoid system, is an organ system in vertebrates that is part of the immune system and complementary to the circulatory system. It consists of a large network of lymphatic vessels, lymph nodes, lymphoid organs, lympha ...
is part of the immune surveillance system. Blood contains
fluid In physics, a fluid is a liquid, gas, or other material that may continuously motion, move and Deformation (physics), deform (''flow'') under an applied shear stress, or external force. They have zero shear modulus, or, in simpler terms, are M ...
and blood cells. The fluid, which may contain suspended foreign material such as
bacteria Bacteria (; : bacterium) are ubiquitous, mostly free-living organisms often consisting of one Cell (biology), biological cell. They constitute a large domain (biology), domain of Prokaryote, prokaryotic microorganisms. Typically a few micr ...
and
virus A virus is a submicroscopic infectious agent that replicates only inside the living Cell (biology), cells of an organism. Viruses infect all life forms, from animals and plants to microorganisms, including bacteria and archaea. Viruses are ...
es, seeps through
blood vessel Blood vessels are the tubular structures of a circulatory system that transport blood throughout many Animal, animals’ bodies. Blood vessels transport blood cells, nutrients, and oxygen to most of the Tissue (biology), tissues of a Body (bi ...
walls into the tissues, where it bathes the body cells and exchanges substances with them. Some of this lymph fluid is then taken up by
lymphatic vessel The lymphatic vessels (or lymph vessels or lymphatics) are thin-walled vessels (tubes), structured like blood vessels, that carry lymph. As part of the lymphatic system, lymph vessels are complementary to the cardiovascular system. Lymph vessel ...
s and passed back to the heart, where it is again mixed with the blood. On its way, the fluid passes through the lymph nodes, small nodular organs located throughout the body but concentrated in certain areas such as the armpits or
groin In human anatomy, the groin, also known as the inguinal region or iliac region, is the junctional area between the torso and the thigh. The groin is at the front of the body on either side of the pubic tubercle, where the lower part of the abdom ...
. These lymph nodes are also known as ''glands'' or ''lymphoid tissue''. If they detect something foreign passing through them, they enlarge. This is called '' lymphadenopathy'' or ''swollen glands''. Usually this is localized (for example, an infected spot on the scalp will cause lymph nodes in the neck on that same side to swell). However, when two or more lymph node groups are involved, it is called '' generalized lymphadenopathy''. Usually this is in response to significant systemic disease and will subside once the person has recovered. Sometimes it can persist long-term, even when no explanation for the lymphadenopathy can be found. PGL is often found in cases of autoimmune disease (where the body is attacking itself). These include diseases such as
rheumatoid arthritis Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects synovial joint, joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and h ...
, lupus and sarcoidosis. Some forms of
cancer Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Po ...
will also cause PGL. Sometimes, despite exhaustive investigation, no cause for PGL is found. For the patient and the physician, this can continue to be a source of concern, but many adults have had PGL all their lives and suffered no ill effects. In others, the PGL may persist for a decade or more and then mysteriously subside. Children often have generalized lymphadenopathy of the head and neck, or even PGL, without the finding of a sinister cause. At
puberty Puberty is the process of physical changes through which a child's body matures into an adult body capable of sexual reproduction. It is initiated by hormonal signals from the brain to the gonads: the ovaries in a female, the testicles i ...
this usually disappears. The
immune system The immune system is a network of biological systems that protects an organism from diseases. It detects and responds to a wide variety of pathogens, from viruses to bacteria, as well as Tumor immunology, cancer cells, Parasitic worm, parasitic ...
of some people may be sensitized by exposure to a living exogenous irritant such as a bacterial or
viral infection A viral disease (or viral infection) occurs when an organism's body is invaded by pathogenic viruses, and infectious virus particles (virions) attach to and enter susceptible cells. Examples include the common cold, gastroenteritis, COVID-19, t ...
, which then results in PGL after the organism has been cleared from the body. In some cases the sensitization is caused by non-living exogenous irritants such as cyclic hydrocarbons (for example, resinous vapours) or
pesticide Pesticides are substances that are used to control pests. They include herbicides, insecticides, nematicides, fungicides, and many others (see table). The most common of these are herbicides, which account for approximately 50% of all p ...
s and herbicides.


References

{{Lymphatic organ disease Lymphatic organ diseases