![]() The glands on either side of the neck, under the jaw, or behind the ears commonly swell when you have a cold or sore throat.Which lymph nodes are swollen can help identify the problem. Lymph nodes often swell in one location when a problem such as an injury, infection, or tumor develops in or near the lymph node. Most lymph nodes in the body cannot be felt. ![]() Lymph nodes generally are not tender or painful. Groups of lymph nodes can be felt in the neck, groin, and underarms. And they may be as small as the head of a pin or as large as an olive. Lymph nodes may be found singly or in groups. The lymph nodes filter lymph fluid as it flows through them, trapping bacteria, viruses, and other foreign substances, which are then destroyed by special white blood cells called lymphocytes. The lymph system is an important part of the immune system, the body's defense system against disease. ![]() They are part of the lymph system, which carries fluid (lymph fluid), nutrients, and waste material between the body tissues and the bloodstream. In two patients, SPECT/CT lymphoscintigraphy did not reveal any pathological findings after the disappearance of the cervical swelling, 2 and 3 weeks after the onset of the episode, respectively.Lymph nodes are small, bean-shaped glands throughout the body. In all three scans performed at the time of the acute event, tracer accumulation was visualized in the left cervical region. Single-photon-emission computed tomography (SPECT)/CT lymphoscintigraphy was performed in five patients, with three out of five scans performed during the acute episode ( Fig. All vascular structures appeared patent, there was no evidence of a thrombosis. Furthermore, we noted lymphadenopathy in all patients, mediastinal involvement in seven patients and pleural fluid in five patients. In two patients, the cervical part of the thoracic duct appeared to be wide. The larynx, thyroid gland, proximal trachea and esophagus were slightly deviated to the right in seven patients. In three patients, retropharyngeal edema extending up to level C2 was noted. 1A and B), with the edema extending to the left cervical region in seven. Computed tomography (CT) of the neck and chest showed edema of the supraclavicular fossa in all patients ( Fig. Ultrasound with echo-color Doppler revealed subcutaneous edema in all patients and thoracic duct dilatation in four patients. Patient 1 had a minor elevation of D-dimers and Patient 4 had long-standing anemia, which were considered not to be related to the cervical edema ( Table 2). The laboratory results did not reveal abnormalities in six patients. The clinical characteristics are summarized in Table 1. The edema extended to the left cervical region over the course of the episode in seven patients. Clinical examination revealed left-sided, non-tender and non-pitting edema of the supraclavicular fossa in all patients. The most frequently reported associated symptoms include a cervical pressure sensation, shortness of breath and general malaise. Physical activity, including jogging and gardening, and warm weather conditions were reported as eliciting factors. The mean duration of episodes in patients with symptom-free intervals was 3.8 days. Seven patients reported having multiple episodes in the past. All episodes had an acute onset of the supraclavicular fossa swelling. ![]() Five out of 8 patients were perimenopausal or menopausal at the time of diagnosis. CASE SERIESĪll patients ( n = 8) were female with a mean age of 56 (38–82) at presentation. In this case series, we report on the epidemiology, clinical presentation and imaging findings in the spontaneous cervical swelling syndrome (SCSS). Over the past few years, eight patients consulted our tertiary care facility because of a spontaneous, atraumatic swelling of the left supraclavicular fossa. The pathogenesis remains to be fully elucidated, but a transient obstruction of the thoracic duct is suspected to be the cause, which may account for the extravasation of chyle during the acute event and normalization of lymphatic transport in the in-between episodes. were the first to report on this syndrome as a distinct clinical entity. In the past, several terms have been used to refer to patients with spontaneous, atraumatic swelling of the left supraclavicular fossa, including ‘benign supraclavicular tumorous lymphangiectasia’ and ‘recurrent lymphangiectasia of the left supraclavicular fossa’.
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