Lymphofollicular hyperplasia

Hyperplasia is a process of pathological cell proliferation. Lymph-follicular hyperplasia is an increase in the follicular tissue of the mucous/submucous layer. The disease occurs in patients of all age categories, regardless of gender, food preferences, and place of residence.

Lymphofollicular hyperplasia is diagnosed in the endocrine sphere, but most often affects the digestive system. What causes the prevalence of pathology in the gastrointestinal tract? Of course, the number of predisposing factors - chronic digestive system diseases, consumption of a large number of carcinogens, stress level. Hyperplastic changes in endocrine organs are detected against the background of endocrine or systemic disorders. For example, lymphofollicular lesion of the thymus gland is observed with existing pituitary pathology.

[ 1 ], [ 2 ], [ 3 ], [ 4 ], [ 5 ], [ 6 ], [ 7 ]

Causes of lymphofollicular hyperplasia

The occurrence of hyperplasia is associated with various negative effects on tissue, leading to an increase in the number of cells. The pathogenic mechanism can be triggered by accompanying problems - obesity, liver dysfunction, hyperglycemia, etc. Specialists also consider the hereditary factor to be a risk factor.

The following causes of lymphofollicular hyperplasia are distinguished:

• dysfunction of the internal secretion of the gastric mucosa;
• hormonal imbalances;
• disruptions in the functioning of the nervous regulation of the digestive tract;
• the harmful effects of carcinogens that activate pathological cell division;
• the impact of specific tissue decay products;
• blastomogenic influence;
• the presence of chronic, autoimmune, atrophic diseases of the digestive system (often gastritis of these forms);
• presence of Helicobacter pylori bacteria;
• constant nervous disorders and stress;
• herpesvirus infection;
• disorders of gastric and duodenal motility;
• pathologies of an immune nature.

[ 8 ], [ 9 ], [ 10 ], [ 11 ], [ 12 ], [ 13 ], [ 14 ], [ 15 ], [ 16 ]

Symptoms of lymphofollicular hyperplasia

Manifestations of pathogenic symptoms largely depend on the localization of the pathological focus. Generalized signs are considered to be - an increase in temperature, a feeling of weakness, a quantitative increase in lymphocytes and a decrease in the albumin level. It should be noted that often with a benign nature of the lesion, symptoms of lymphofollicular hyperplasia are absent. Negative symptoms are common in advanced and particularly difficult cases of hyperplastic lesions of the gastrointestinal tract, which are characterized by pain in the abdominal region (often in the epigastrium) in the presence of dyspeptic disorders.

The stages of hyperplasia are classified according to the size and distribution of the follicles:

• zero – lymphoid follicles are absent or poorly expressed, are small in size and chaotic in location;
• the first is diffuse, isolated proliferation of small follicles;
• the second is a dense, diffuse distribution without merging into conglomerates;
• the third is the crowding of follicles, sometimes into large colonies, their mucous membrane may be hyperemic;
• fourth - erosive areas, pronounced hyperemia of the mucous membrane with the presence of fibrinous plaque, the mucous membrane is matte in color, an increase in the vascular pattern is observed.

Based on the above features of the formation and course of pathology, we can conclude:

• lymphofollicular hyperplasia of the gastrointestinal tract gives clinical manifestations only at stages 3-4 in the form of intestinal bleeding, pain syndrome of varying intensity in the abdominal region;
• detection of the disease in other cases is a random event, since there are no specific symptoms.

Lymphofollicular hyperplasia of the gastric mucosa

The complex structure of the gastric mucosa is due to the performance of many functions, including secretory activity, protection and participation in the peristalsis process. A healthy mucosa is the key to the proper functioning of the entire digestive system.

Excessive growth of epithelial cells with simultaneous thickening of the mucosal walls is called lymphofollicular hyperplasia of the gastric mucosa. The pathology is often accompanied by the formation of growths or polyps. Neurological and hormonal changes are considered to be the cause of the disease. Lymphofollicular hyperplasia rarely transforms into oncology. The appearance of cancer cells in most cases is facilitated by epithelial dysplasia, in which healthy cells of the mucous layer develop into cells with a pronounced atypical structure. The most dangerous is mucosal metaplasia, characterized by digestive dysfunction and a high probability of developing malignant tumors.

Making a diagnosis and conducting appropriate treatment are the main tasks of a gastroenterologist. Moreover, therapeutic methods are selected individually for each pathology.

Lymphofollicular hyperplasia of the gastric antrum

According to statistics, the cause of damage to the antral region of the stomach in the presence of chronic gastritis is caused not only by a reaction to inflammation (the causative microorganism in this case is Helicobacter pylori), but is a consequence of weakened immunity. Immune changes in combination with gastritis, as practice shows, are detected under the condition of low acidity, which in turn is a prerequisite for the occurrence of autoimmune diseases.

The study of pathology in childhood allowed us to conclude that lymphofollicular hyperplasia of the antral part of the stomach is a consequence of autoimmune rheumatic disease, and not the action of bacteria. Of course, the presence of pathogenic flora and autoimmune deviations increases the risk of hyperplasia several times.

Changes in the mucous membrane often result in the development of polyps, the localization of which in the antral section accounts for about 60% of all cases of stomach damage. Polyps of an inflammatory nature, in other words hyperplastic, occur with a frequency of 70 to 90%, developing from the submucous or mucous layer. They are round, cylindrical, dense formations with a wide base and a flat top.

Lymphofollicular hyperplasia of the ileum

The lower part of the small intestine is called the ileum, lined from the inside with mucous with an abundance of villi. The surface is supplied with lymphatic vessels and capillaries, participating in the absorption of nutrients and useful substances. Thus, fats are absorbed by the lymphatic sinus, and sugars with amino acids are absorbed by the bloodstream. The mucous and submucous layers of the ileum are represented by circular folds. In addition to the absorption of necessary substances, the organ produces special enzymes and digests food.

Lymphofollicular hyperplasia of the ileum is formed as a consequence of immunodeficiency and proliferative processes of the intestinal wall. Disturbances are detected in a specific reaction to external irritation of the lymphoid tissue of the intestinal sections. Clinical manifestations of the pathological condition:

• loose stools (with frequent urges up to 7 times per day);
• inclusion of mucus/blood in the stool;
• abdominal pain;
• sudden weight loss;
• increased gas formation, bloating and rumbling in the abdomen;
• a noticeable decrease in the body's defenses.

Blood, urine, and stool tests, as well as fiberoptic endoscopy examinations, help differentiate the disease. As a rule, lymphofollicular hyperplasia is diagnosed exclusively in the terminal zone of the ileum, which indicates that the pathological process is secondary and does not require therapeutic intervention. A strict diet with restrictions on a number of food products may be recommended as therapeutic and preventive measures. If we are talking about serious inflammation, suspected cancer or Crohn's disease, then medication or surgical intervention is used.

Diagnosis of lymphofollicular hyperplasia

The difficulty of early detection of the pathological condition of the mucous membrane is the asymptomatic course of the disease in the early stages of its formation. Often, lymphoid follicles are detected accidentally during colonoscopy for other indications. Unfortunately, patients begin to seek help with the appearance of intestinal bleeding or unbearable abdominal pain, which corresponds to the last stages of the disease.

The increase in the mucous layer in the stomach and intestines can be examined using endoscopic technologies, which include colonoscopy, FGDS and rectoscopy. Lymphatic follicular hyperplasia is also diagnosed using radiography with contrast agents. X-ray examination helps to assess the extent of the spread of newly formed cells, and endoscopic examination allows obtaining biological material for histology.

Confirmation of the diagnosis of lymphofollicular hyperplasia indicates the need for constant monitoring of the condition in view of the possible development of abnormal areas into malignant tumors.

[ 17 ], [ 18 ], [ 19 ], [ 20 ], [ 21 ], [ 22 ]

Treatment of lymphofollicular hyperplasia

Lymphofollicular hyperplasia of the mucous membrane, occurring with obvious signs of a pathological process, is treated by reducing the acidity of the stomach and suppressing the activity of Helicobacter. The therapeutic regimen for suppressing Helicobacter flora with the obligatory elimination of gastritis takes two weeks, includes taking medications (including antibiotics) and following a diet.

The presence of malignant tissues makes surgical intervention necessary. Hyperplasia of the digestive system may require gastric resection or excision of a section of the intestine. The rehabilitation period depends on the severity of the disease, the success of the operation and the general condition of the patient. An important point after surgical manipulation is constant monitoring to exclude relapses and complications.

The detection of a pathological focus in the endocrine or hematopoietic system with signs of a malignant process requires long-term combined treatment, combining surgical techniques and chemotherapeutic effects.

Treatment of benign lymphofollicular hyperplasia is generally not performed.

Prevention of lymphofollicular hyperplasia

Considering the fact that lymphofollicular hyperplasia in most cases is asymptomatic, it is possible to detect pathology at the stage of its origin only through regular examinations. Therefore, regular visits to a medical institution for the purpose of undergoing a preventive examination are mandatory.

Prevention of lymphofollicular hyperplasia includes general recommendations: healthy and nutritious nutrition, adherence to a daily routine, moderate physical activity, time for rest and relaxation, minimization of stressful situations, and abstinence from addictions to tobacco/alcohol/narcotics.

It should be noted that those who like to self-medicate with drugs or folk remedies are at risk, since pronounced symptoms of hyperplasia occur only in the late stages of the pathology. Advanced processes are difficult to treat, develop into chronic forms of diseases, require complex surgical interventions, and can transform into malignant neoplasms.

Prognosis of lymphofollicular hyperplasia

The number of patients with chronic diseases of the digestive system is steadily growing. Such pathologies are increasingly detected in childhood, leading to severe consequences and even disability. The presence of Helicobacter pylori in the gastrointestinal tract is associated with the development of autoimmune gastritis, which in turn is provoked by the herpes virus. As, for example, in mononucleosis caused by Epstein-Barr infection, there is damage to the epithelium of the digestive organs with obvious signs of lymphofollicular hyperplasia.

For high-quality treatment of chronic autoimmune gastritis, early diagnosis remains the determining factor. Autoimmune gastritis has a pre-atrophic form, corresponding to the immune response that provokes lymphofollicular hyperplasia.

The prognosis of lymphofollicular hyperplasia is better the earlier the disease is detected. By means of complex therapy, including a treatment regimen for chronic gastritis (a combination of interferon with immunocorrection and valacyclovir), the pathological focus of the gastric mucosa is stopped, the body's defenses are normalized and stable remission is achieved.

The diagnosis of lymphofollicular hyperplasia must be confirmed by clinical, morphological, endoscopic, virological and immunological data. Only after the listed studies can high-quality and effective treatment be prescribed.