Swollen lymph nodes – Symptoms & causes

Overview

Swollen lymph nodes usually occur as a result of infection from bacteria or viruses. Rarely, swollen lymph nodes are caused by cancer.

Your lymph nodes, also called lymph glands, play a vital role in your body’s ability to fight off infections. They function as filters, trapping viruses, bacteria and other causes of illnesses before they can infect other parts of your body. Common areas where you might notice swollen lymph nodes include your neck, under your chin, in your armpits and in your groin.

Lymph node locations

Your lymph nodes play a vital role in your body’s ability to fight off infections. Common areas where you might notice swollen lymph nodes include your neck, under your chin, in your armpits and in your groin.

Swollen lymph nodes

One of the most common places to find swollen lymph nodes is in the neck. The inset shows three swollen lymph nodes below the lower jaw.

In some cases, the passage of time and warm compresses may be all you need to treat swollen lymph nodes. If an infection causes swollen lymph nodes, treatment depends on the cause.

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Symptoms

Your lymphatic system is a network of organs, vessels and lymph nodes situated throughout your body. Many lymph nodes are located in your head and neck region. Lymph nodes that frequently swell are in this area, as well as in your armpits and groin area.

Swollen lymph nodes are a sign that something is wrong somewhere in your body. When your lymph nodes first swell, you might notice:

• Tenderness and pain in the lymph nodes
• Swelling that may be the size of a pea or kidney bean, or even larger in the lymph nodes

Depending on the cause of your swollen lymph nodes, other signs and symptoms you might have include:

• Runny nose, sore throat, fever and other indications of an upper respiratory infection
• General swelling of lymph nodes throughout your body. When this occurs, it may indicate an infection, such as human immunodeficiency virus (HIV) or mononucleosis, or an immune system disorder, such as lupus or rheumatoid arthritis
• Hard, fixed, rapidly growing nodes, indicating a possible cancer or lymphoma
• Fever
• Night sweats

When to see a doctor

Some swollen lymph nodes return to normal when the underlying condition, such as a minor infection, gets better. See your doctor if you’re concerned or if your swollen lymph nodes:

• Have appeared for no apparent reason
• Continue to enlarge or have been present for two to four weeks
• Feel hard or rubbery, or don’t move when you push on them
• Are accompanied by persistent fever, night sweats or unexplained weight loss

Seek immediate medical care if you’re having difficulty swallowing or breathing.

Causes

Lymph nodes are small, round or bean-shaped clusters of cells. Inside lymph nodes are a combination of different types of immune system cells. These specialized cells filter your lymphatic fluid as it travels through your body and protect you by destroying invaders.

Lymph nodes are located in groups, and each group drains a specific area of your body. You may be more likely to notice swelling in certain areas, such as in the lymph nodes in your neck, under your chin, in your armpits and in your groin. The site of the swollen lymph nodes may help identify the underlying cause.

The most common cause of swollen lymph nodes is an infection, particularly a viral infection, such as the common cold. Other possible causes of swollen lymph nodes include:

Common infections

• Strep throat
• Measles
• Ear infections
• Infected (abscessed) tooth
• Mononucleosis
• Skin or wound infections, such as cellulitis
• Human immunodeficiency virus (HIV) — the virus that causes AIDS

Uncommon infections

• Tuberculosis
• Certain sexually transmitted infections, such as syphilis
• Toxoplasmosis — a parasitic infection resulting from contact with the feces of an infected cat or eating undercooked meat
• Cat scratch fever — a bacterial infection from a cat scratch or bite

Immune system disorders

• Lupus — a chronic inflammatory disease that targets your joints, skin, kidneys, blood cells, heart and lungs
• Rheumatoid arthritis — a chronic inflammatory disease targeting the tissue that lines your joints (synovium)

Cancers

• Lymphoma — cancer that originates in your lymphatic system
• Leukemia — cancer of your body’s blood-forming tissue, including your bone marrow and lymphatic system
• Other cancers that have spread (metastasized) to lymph nodes

Other possible but rare causes include certain medications, such as the anti-seizure medication phenytoin (Dilantin) and preventive medications for malaria.

Complications

If infection is the cause of your swollen lymph nodes and isn’t treated, an abscess may form. Abscesses are localized collections of pus caused by infections. Pus contains fluid, white blood cells, dead tissue, and bacteria or other invaders. An abscess may require drainage and antibiotic treatment.

Swollen lymph nodes – Symptoms & causes

Overview

Swollen lymph nodes usually occur as a result of infection from bacteria or viruses. Rarely, swollen lymph nodes are caused by cancer.

Your lymph nodes, also called lymph glands, play a vital role in your body’s ability to fight off infections. They function as filters, trapping viruses, bacteria and other causes of illnesses before they can infect other parts of your body. Common areas where you might notice swollen lymph nodes include your neck, under your chin, in your armpits and in your groin.

Lymph node locations

Your lymph nodes play a vital role in your body’s ability to fight off infections. Common areas where you might notice swollen lymph nodes include your neck, under your chin, in your armpits and in your groin.

Swollen lymph nodes

One of the most common places to find swollen lymph nodes is in the neck. The inset shows three swollen lymph nodes below the lower jaw.

In some cases, the passage of time and warm compresses may be all you need to treat swollen lymph nodes. If an infection causes swollen lymph nodes, treatment depends on the cause.

Products & Services

Symptoms

Your lymphatic system is a network of organs, vessels and lymph nodes situated throughout your body. Many lymph nodes are located in your head and neck region. Lymph nodes that frequently swell are in this area, as well as in your armpits and groin area.

Swollen lymph nodes are a sign that something is wrong somewhere in your body. When your lymph nodes first swell, you might notice:

• Tenderness and pain in the lymph nodes
• Swelling that may be the size of a pea or kidney bean, or even larger in the lymph nodes

Depending on the cause of your swollen lymph nodes, other signs and symptoms you might have include:

• Runny nose, sore throat, fever and other indications of an upper respiratory infection
• General swelling of lymph nodes throughout your body. When this occurs, it may indicate an infection, such as human immunodeficiency virus (HIV) or mononucleosis, or an immune system disorder, such as lupus or rheumatoid arthritis
• Hard, fixed, rapidly growing nodes, indicating a possible cancer or lymphoma
• Fever
• Night sweats

When to see a doctor

Some swollen lymph nodes return to normal when the underlying condition, such as a minor infection, gets better. See your doctor if you’re concerned or if your swollen lymph nodes:

• Have appeared for no apparent reason
• Continue to enlarge or have been present for two to four weeks
• Feel hard or rubbery, or don’t move when you push on them
• Are accompanied by persistent fever, night sweats or unexplained weight loss

Seek immediate medical care if you’re having difficulty swallowing or breathing.

Causes

Lymph nodes are small, round or bean-shaped clusters of cells. Inside lymph nodes are a combination of different types of immune system cells. These specialized cells filter your lymphatic fluid as it travels through your body and protect you by destroying invaders.

Lymph nodes are located in groups, and each group drains a specific area of your body. You may be more likely to notice swelling in certain areas, such as in the lymph nodes in your neck, under your chin, in your armpits and in your groin. The site of the swollen lymph nodes may help identify the underlying cause.

The most common cause of swollen lymph nodes is an infection, particularly a viral infection, such as the common cold. Other possible causes of swollen lymph nodes include:

Common infections

• Strep throat
• Measles
• Ear infections
• Infected (abscessed) tooth
• Mononucleosis
• Skin or wound infections, such as cellulitis
• Human immunodeficiency virus (HIV) — the virus that causes AIDS

Uncommon infections

• Tuberculosis
• Certain sexually transmitted infections, such as syphilis
• Toxoplasmosis — a parasitic infection resulting from contact with the feces of an infected cat or eating undercooked meat
• Cat scratch fever — a bacterial infection from a cat scratch or bite

Immune system disorders

• Lupus — a chronic inflammatory disease that targets your joints, skin, kidneys, blood cells, heart and lungs
• Rheumatoid arthritis — a chronic inflammatory disease targeting the tissue that lines your joints (synovium)

Cancers

• Lymphoma — cancer that originates in your lymphatic system
• Leukemia — cancer of your body’s blood-forming tissue, including your bone marrow and lymphatic system
• Other cancers that have spread (metastasized) to lymph nodes

Other possible but rare causes include certain medications, such as the anti-seizure medication phenytoin (Dilantin) and preventive medications for malaria.

Complications

If infection is the cause of your swollen lymph nodes and isn’t treated, an abscess may form. Abscesses are localized collections of pus caused by infections. Pus contains fluid, white blood cells, dead tissue, and bacteria or other invaders. An abscess may require drainage and antibiotic treatment.

Lymphadenopathy (swollen lymph nodes) – symptoms and treatment

What are lymph nodes

The lymphatic system is a part of the vascular system, similar to a second bloodstream. It consists of capillaries, vessels and ducts through which lymph flows – a transparent viscous liquid with a large number of immune cells.

The lymphatic system is connected with the circulatory system. The task of the lymph is to take excess proteins, salts, water, toxins, cellular debris, pathogens and metabolic products from the tissues, and then send them to the blood for further utilization by the organs of the excretory system.

The lymphatic system includes the lymphatic vessels, the spleen, and the lymph nodes, which are small collections of lymphoid tissue. They filter the lymph and fight pathogens.

The lymphatic system includes the lymphatic vessels, spleen and lymph nodes

Lymph nodes are peripheral and deep.

Peripheral lymph nodes:

• occipital,
• behind the ear,
• front ear,
• chin pads,
• back neck,
• front neck,
• submandibular,
• supraclavicular,
• jugular,
• axillary,
• cubital (elbow),
• inguinal,
• popliteal.

Peripheral lymph nodes are close to the surface of the skin and can be felt

Deep lymph nodes are located in the chest and abdominal cavities, as well as in the muscle tissue of the thigh.

There are about 500 lymph nodes in the human body.

Lymph nodes are needed to protect the body from the spread of pathogens. Each lymph node plays the role of a “customs” – it passes lymph through itself, but recognizes and retains bacteria, viruses, fungi, toxins, as well as damaged and mutated cells that migrate through the lymphatic vessels from various organs and tissues.

To neutralize pathogens, each lymph node contains clusters of lymphocytes and macrophages – immune cells that quickly destroy harmful atypical cells and microorganisms.

Also in the lymph nodes, the maturation and preparation of lymphocytes for the destruction of foreign proteins and cells occurs.

In the lymph node there are clusters of lymphocytes and macrophages that destroy atypical cells and microorganisms

If there are too many pathogens, the lymph nodes may not be able to cope with the load and increase in size. Physicians call this condition lymphadenopathy .

ICD-10 code for lymphadenopathy – R59 (“Swollen lymph nodes”).

Causes of lymphadenopathy

As a rule, lymphadenopathy is secondary. It does not arise by itself, but as a symptom and consequence of various pathologies.

Causes of lymphadenopathy can be infectious and non-infectious .

When infected, the lymphatic system reacts to the invasion and stimulates the production of protective immune cells – lymphocytes and macrophages, which are needed to destroy foreign microorganisms. Due to the growth in the number of immune cells, the lymph nodes increase in size.

Infection of the lymph node can also lead to lymphadenopathy. In this case, the lymph node not only enlarges, but also becomes inflamed – and lymphadenitis develops.

In non-infectious lymphadenopathy, the cause of enlarged lymph nodes may be the growth of tumor cells, as well as autoimmune diseases.

Lymphadenopathy in viral and bacterial infections

Most often, swollen lymph nodes are associated with infectious diseases.

The most common cause of enlargement of peripheral lymph nodes is acute respiratory diseases (ARI) viral and bacterial nature.

For example, lymph nodes often “swell” in acute tonsillitis, also called tonsillitis. Streptococci, staphylococci, pneumococci, adenoviruses, influenza virus and other infectious agents can provoke tonsillitis. Lymphadenopathy caused by acute respiratory infections, as a rule, affects only the posterior cervical or submandibular lymph nodes.

Most often, swollen lymph nodes are associated with infectious diseases.

Posterior cervical lymph nodes are most often enlarged in acute respiratory infections

Deep lymph nodes increase if the infection has penetrated into the internal organs. With intestinal infections, the mesenteric lymph nodes located in the abdominal cavity, next to the intestines, may increase, and with pneumonia, the lymph nodes of the chest cavity and mediastinum.

In some cases, for example, when infected with the Epstein-Barr virus, which leads to the development of infectious mononucleosis, both peripheral and deep lymph nodes, as well as the spleen (it is also part of the lymphatic system), are significantly enlarged.

With HIV infection, generalized lymphadenopathy is observed – almost all lymph nodes are enlarged at once.

Lymph nodes can also increase in size with diphtheria, chickenpox, tuberculosis, hepatitis, toxoplasmosis, venereal diseases and many other infections.

It is impossible to determine which pathogen has entered the body by the enlargement of the lymph nodes. However, the general complaints of the patient, as well as an examination of enlarged lymph nodes, will help the doctor narrow the area of ​​diagnosis, identify the source of infection and make a diagnosis.

Lymphadenopathy in autoimmune diseases

Lymphadenopathy often occurs in association with systemic autoimmune diseases, such as systemic lupus erythematosus, Still’s disease, or rheumatoid arthritis.

In autoimmune disorders, the immune system mistakenly perceives its own cells as pathogenic and begins to destroy them. Lymph nodes and the spleen are actively involved in this process and increase in size due to the heavy load.

Lymphadenopathy in malignant neoplasms

Lymphadenopathy occurs when cancer cells separated from the main tumor enter the lymphatic system and settle in the lymph node.

Accumulating, such cells begin to form metastases – distant secondary foci of a malignant tumor. With the development of a malignant process, the lymph nodes increase in size and become hard. Gradually, they cease to cope with cancer cells and begin to pass them further along the lymphatic system to the next lymph nodes.

All malignant tumors metastasize to lymph nodes.

In addition, there is a separate type of tumor that initially affects the lymphatic system – they are called lymphomas.

Types of lymphadenopathy

Lymphadenopathy is distinguished by the cause of occurrence, prevalence, duration and nature of the course.

By cause:

• infectious;
• non-infectious.

By involvement of the tumor process:

• tumor;
• non-tumor.

By prevalence:

• localized form – lymph nodes are enlarged only in one part of the body;
• common form – lymph nodes are enlarged in two or more parts of the body.

By duration:

• short – less than 2 months;
• long, or protracted – lasts more than 2 months.

Downstream:

• acute – short-lived, occurred together with any acute pathology;
• chronic – prolonged, persists due to chronic pathology or for no apparent reason;
• recurrent – exacerbates with a certain frequency against the background of a chronic disease or for no apparent reason.

Symptoms of lymphadenopathy

Lymphadenopathy is accompanied by an increase in lymph nodes. In classical lymphadenopathy, the nodes are soft in texture, sometimes slightly painful. In size, the affected lymph node may resemble a bean – it is about 2 cm.

In most cases, patients do not pay attention to enlarged lymph nodes, they are only concerned about the manifestations of the underlying disease. For example, with acute respiratory infections, it can be a sore throat, sore throat, cough, runny nose, fever, chills, a general feeling of malaise.

However, in some cases, an increase in lymph nodes is a symptom of a serious pathology.

An enlarged axillary lymph node in a woman may be a sign of breast cancer.

With the development of lymphoma or the spread of tumor cells (metastasis), the lymph nodes enlarge for no apparent reason and become dense, even hard.

In breast cancer, nearby lymph nodes are enlarged

The patient may not notice enlargement of internal lymph nodes at all. In this case, complaints will primarily indicate the symptoms of the underlying disease, and lymphadenopathy will be detected only after ultrasound, CT or MRI of the corresponding part of the body.

Diagnosis of lymphadenopathy

Most often, patients do not notice lymphadenopathy and do not complain about it. It serves as a secondary symptom of various diseases.

For example, with acute respiratory infections, patients first of all mention sore throat, nasal congestion, cough, chills and other symptoms, but not an increase in the submandibular lymph nodes – the general practitioner will pay attention to this during examination and palpation (palpation).

If a patient comes to a therapist complaining of a “cold”, the doctor will first feel the neck and the area under the lower jaw – he will check the lymph nodes.

In intestinal infections, such as salmonellosis, the main symptoms are abdominal pain, vomiting, diarrhea, high fever. An increase in the abdominal lymph nodes, if any, will reveal only a hardware study.

However, in some cases, the appearance of an unusual “bump” under the armpit or in the groin may be the main complaint. In this case, the doctor will ask in detail about the symptoms and, focusing on the location of the enlarged lymph node, will begin to look for the cause of lymphadenopathy.

To assess the general condition of the patient, detect inflammatory processes and narrow the search area for pathology, a specialist can prescribe a general blood test and biochemistry, a urinalysis, and, if necessary, a set of tests for HIV, syphilis and hepatitis.

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Urinalysis

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If the consistency of the lymph node is not soft, but elastic and hard, the doctor may suggest the development of a lymphoma or metastasis of any tumor. For example, a hard lymph node under the arm of a woman can be a sign of breast cancer.

If a malignant process is suspected, the therapist will refer the patient to an oncologist for an extended examination, including for the appointment of a biopsy – an analysis of the tissues of the lymph node for the presence of pathological changes and cancer cells.

To confirm the diagnosis, the doctor may prescribe a histological examination of the lymph nodes, which will reveal a malignant process, as well as recommend studies for a specific type of cancer.

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Treatment of lymphadenopathy

Lymphadenopathy is not considered an independent disease and does not require separate treatment. It occurs as a result of other diseases, and the main goal of therapy is to cure them, and in the case of autoimmune and some oncological diseases, to achieve a stable remission.

For a viral infection, the patient is prescribed antiviral drugs. If the causative agent of the infection is a bacterium, the doctor will give you a prescription for antibiotics.

Treatment of autoimmune diseases may be associated with the use of hormonal drugs and immunosuppressants – drugs that reduce the body’s immune response.

Oncological diseases are treated with the help of operations, chemical and radiation therapy.

If the cause of the enlarged lymph nodes is not established (idiopathic lymphadenopathy) and no diseases were found after the examination, the doctor may recommend a preventive visit every 3 months to observe and evaluate changes. Perhaps the disease proceeds in a latent form and it takes time to manifest itself.

Sequelae of lymphadenopathy

Lymphadenopathy is a clinical sign of many diseases and the body’s signal that something is wrong with health.

In advanced infectious diseases, the pathogen can enter the lymph node and lead to its inflammation – lymphadenitis . Pathology is manifested by severe pain in the lymph node, swelling, redness of the skin, and sometimes suppuration or tissue death (necrosis).

Tuberculous lymphadenitis.
Photo: Dr. J. S. Bhandari

Lymphadenitis can lead to blood poisoning – sepsis, as well as to the spread of infection throughout the body.

Moreover, an increase in lymph nodes can be oncogenic in nature – it can be a sign of the spread of secondary foci of a cancerous tumor. For example, lymph nodes increase with the development of a malignant neoplasm – lymphoma, as well as with the spread of cancer cells of other tumors (metastases) through the lymphatic system.

Suspicion of lymphadenopathy is a reason to consult a doctor.

Oncological diseases in the early stages in most cases respond well to treatment. But if their beginning is missed, the malignant process may spread to other organs, and in this case, the treatment may be less effective. For this reason, if you suspect an increase in lymph nodes and the appearance of uncharacteristic seals under the skin, you should immediately seek medical help.

Sources

1. National Clinical Guidelines for the Diagnosis of Lymphadenopathy / National Hematological Society. 2018.
2. Vorobyov A. I. Guide to hematology. Volume 2. M., 2005. S. 274.
3. Dvoretsky L.I. Differential diagnosis in lymphadenopathy. Reference book of the polyclinic doctor. Volume 3. M., 2005. S. 238.
4. Kazantsev A.P. Lymphadenopathy / Differential diagnosis of infectious diseases / ed. Zubik T. M. M., 1991. S. 115–129.

Enlargement of lymph nodes, lymphadenopathy – causes, examination and treatment in Astrakhan | Symptoms

Upper respiratory infection
Signs: Only the lymph nodes of the neck are affected, pain is negligible or absent. Sore throat, runny nose or cough.

Infection of dental tissue
Signs: Only the lymph nodes of the neck on one side are affected, a bad tooth.

Mononucleosis
Signs: Enlargement on both sides, usually in the neck, but sometimes under the armpits or in the groin. Fever, sore throat and excessive fatigue. Usually in teenagers or young adults.

Tuberculosis with lymph node involvement
Signs: Usually swelling of the lymph nodes in the neck or above the collarbone. Sometimes lymph nodes with inflammation or discharge. Often in a patient with HIV infection.

HIV (immediately after infection – primary infection)
Signs: Generalized lymphadenopathy. Usually fever, malaise, rash and joint pain. Often in a person with known HIV infection or risk factors for HIV (sticking with a needle used by another person or high-risk sexual activity).

Sexually transmitted diseases (herpes simplex virus, chlamydia and syphilis)
Signs: With the exception of secondary syphilis, only enlarged lymph nodes in the groin area. Often urinary tract symptoms (pain during urination) and discharge from the urethra or vagina. Sometimes ulcers on the genitals. For secondary syphilis, widespread mucosal ulcers and widespread lymphadenopathy are common.

Skin and soft tissue infections (phlegmon, abscess, cat-scratch disease)
Signs: Usually visible sore or skin infection near the enlarged lymph node.

Toxoplasmosis
Signs: Enlarged nodes on the neck and in the armpit on both sides. Sometimes flu-like symptoms and enlargement of the liver and spleen. Often a history of contact with cat feces.

Leukemias (chronic, acute lymphocytic leukemia)
Signs: Fatigue, fever and weight loss. In acute leukemia, there is often increased bleeding and/or bleeding.

Lymphomas
Signs: Painless lymphadenopathy (local or widespread). The knots are often elastic and sometimes fuse together. Often fever, night sweats, and weight loss.

Metastasizing malignancies (head and neck, thyroid, breast, or lung)
Signs: One or more painless lymph nodes in the neck.