Enlarged Lymph Nodes

Nationwide Children’s Hospital

Overview

Signs & Symptoms

Diagnosis

Treatment

What Are Enlarged Lymph Nodes?

There are thousands of collections of immune cells throughout the body called lymph nodes. Hundreds of these lymph nodes are present in your child’s neck and face. Lymph nodes act as surveillance sites for your child’s immune system. As a result, when an infection is present, lymph nodes can become enlarged as an immune response is mounted. This can occur with certain viruses and with bacterial infections.

Often, after an infection has passed, a lymph node or group of nodes that reacted to the infection can remain enlarged for months (reactive adenopathy). While this is a normal process, reactive adenopathy needs to be differentiated from worrisome processes that also can affect lymph nodes.  For example, the lymph node itself can become infected, a condition called lymphadenitis, or can progress to form a fluid filled collection called an abscess. In rare circumstances, childhood cancers can be present in lymph nodes and lead to enlargement of the lymph nodes. There also are several rare syndromes that can present with enlarged neck lymph nodes.

What Are the Symptoms of Enlarged Lymph Nodes?

If your child has a lump or bump on the neck, this may represent an enlarged lymph node. 

How Are Enlarged Lymph Nodes Diagnosed?

After careful examination of the head, neck, ears, nose and throat, additional testing may be needed to more completely evaluate the lump. This could include blood tests and often an ultrasound exam will be ordered. At times, a CT scan or magnetic resonance imaging (MRI) scan may become necessary.

How Are Enlarged Lymph Nodes Treated?

The management of enlarged lymph nodes depends on the reason that they have become enlarged. Treatment can include watchful waiting, antibiotic treatment or other medical treatments. Sometimes, surgical removal of the enlarged lymph node will be necessary to confirm the reason for enlargement.

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Lymphadenopathy in Cats | PetMD

What Is Lymphadenopathy in Cats?

Lymphadenopathy is the enlargement (swelling) of a single lymph node, a group of lymph nodes, or all lymph nodes. Lymphadenopathy is not a primary disease; it is a symptom of an underlying condition, such as lymphoma, a tick-borne illness, or another infectious disease. This enlargement of lymph nodes can happen quickly or gradually.

Lymph node swelling is most often noticed first in peripheral lymph nodes, those  that can be felt under the skin:

• On the neck

• Behind the jaw

• In front of the shoulders

• In the armpits

• In the inguinal (groin) area

• Behind the knee joints

If you notice any new or growing swelling in these or any other areas of your cat’s body, take them to your veterinarian as soon as possible. Treatment is dependent on the underlying cause.

Symptoms of Lymphadenopathy in Cats

Other than lymph node enlargement, other symptoms depend on the underlying cause of the swollen lymph nodes. They include:

Causes of Lymphadenopathy in Cats

Lymphadenopathy can affect cats at any age. It is a reaction in the lymph nodes that can be caused by a virus, inflammatory condition, vaccine reaction, tick-borne illness, cancer, or other infection.

Cats that are not on tick preventatives are at a higher risk of developing this condition, due to their susceptibility to tick-borne illnesses. It is important to uncover the underlying cause of the lymph node swelling to decide on the right diagnostics and treatment needed.

Specific causes include:

• Reactive hyperplasia—enlargement due to reaction to things like vaccines or immune-mediated disease

• Lymphadenitis—enlargement due to reaction to things like bacterial infections, rickettsial infections, fungal infections, parasitic infections, and viral infections

• Neoplasia—primary, such as lymphoma; or secondary, such as carcinoma, melanoma, sarcoma, or mast cell tumors

• Rare causes such as edema

How Veterinarians Diagnose Lymphadenopathy in Cats

After your veterinarian examines your cat, the next step is for them to take a fine needle aspirate of any enlarged lymph nodes. This involves taking a small needle, inserting it into the lymph node, drawing out some cells, spreading these cells onto a microscope slide, and looking at them under the microscope. This is generally not a painful procedure and does not require sedation.

CBC, chemistry panel, and urinalysis, along with diagnostic imaging such as x-rays or CT scan, are often needed to find the underlying cause as well. Imaging can show the severity of disease by finding how large the lymph nodes are, if any internal lymph nodes are abnormal, or if anything else internally looks abnormal and points to an underlying cause. Cats should also be tested for feline leukemia virus and feline immunodeficiency virus (FIV), as these are typically underlying conditions causing lymphadenopathy.  

If no cause is initially found, a lymph node biopsy may be needed. This sample would be sent out to a reference lab and processed to figure out what types of cells make up the enlarged lymph node, which would show a potential cause. Less commonly, more advanced testing may be needed.

Treatment of Lymphadenopathy in Cats

Treatment is dependent on the diagnosis of an underlying cause. Treatment could include antibiotics, antifungals, supportive care, chemotherapy, radiation, or surgery. For example, lymphoma could be treated with chemotherapy, tick-borne illnesses could be treated with antibiotics like, doxycycline, and supportive care/time in the case of vaccine reactions or viral infections.

Recovery and Management of Lymphadenopathy in Cats

Recovery and prognosis are largely dependent on the underlying cause and how progressive the disease is. For example, recovery for a tick bite infection would potentially be much quicker (maybe weeks to months) and less intense than recovery from an aggressive form of cancer (perhaps untreatable), both of which could cause lymphadenopathy.

Prevention of  Lymphadenopathy in Cats

Most causes of lymphadenopathy are either acquired, infectious, or neoplastic, so unfortunately, there is nothing we can do to prevent these issues. However, tick-borne illnesses can also cause lymphadenopathy, so it is important to keep your pet current on monthly tick preventatives in order to prevent tick-borne illnesses such as Lyme, Babesia, anaplasma, or Ehrlichia.

References

1. Cohn L, Cote E. Dogs and Cats. Cote’s Clinical Veterinary Advisor, 4th ed., Mosby; 2020.

Featured Image: iStock.com/Yelizaveta Tomashevska

WRITTEN BY

Sonja Cox, DVM

Veterinarian

Dr. Sonja Cox is a 2019 graduate of Auburn University’s College of Veterinary Medicine. She is originally from Huntsville, AL and now lives…

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Swollen lymph nodes in children – symptoms, treatment, prevention and diagnosis

An increase in the number and size of lymph nodes (lymphadenopathy) occurs in 80% of children and adolescents. The causes of enlarged lymph nodes are infectious diseases, inflammatory processes, benign lymphoproliferative diseases and malignant neoplasms. Also, the lymph nodes in children can be enlarged in cases of systemic autoimmune and autoinflammatory diseases, due to the use of certain groups of drugs, in rare cases – after vaccination.

All children and adolescents with enlarged lymph nodes should be carefully examined to look for the cause of lymphadenopathy – each lymph node is an organ of the human immune system, and its increase is due to pathological causes. Lymphadenopathy with rare exceptions (for example, post-vaccination lymphadenopathy) does not “go away on its own”, the child cannot “outgrow” this condition, the use of homeopathic medicines only increases the time to make a diagnosis.

At what size are lymph nodes considered enlarged? For the occipital, anterior ear, chin, cervical, axillary, popliteal lymph nodes, nodes more than 1.0 cm are considered enlarged, for the inguinal – more than 1.5 cm. It should be remembered that with a simple examination of a child, it is very difficult to distinguish enlarged lymph nodes in the head and neck region from bulk soft tissue formations. The correct plan for examining a child in such a situation is a pediatric oncologist.

Most cases of PAP in children are indeed due to the course of the infectious process or an early period of recovery after it. However, given the high risk of non-Hodgkin’s lymphomas in children under adolescence and Hodgkin’s lymphoma in adolescents, when enlarged lymph nodes appear, the child should be shown to a pediatric oncologist to draw up a diagnostic plan and determine the need for a biopsy.

The decision to send a child for a biopsy of an enlarged lymph node is made by a pediatric oncologist only on the basis of the results of a comprehensive examination.

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Swollen lymph nodes in the groin

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Inguinal lymphadenopathy is a fairly common symptom. With genitourinary infections, inflammatory processes and neoplasms, the lymphoid tissue in the groin area immediately reacts. The result of such transformations is the formation of nodes over 1 cm, which are well palpable on palpation. The fight against this serious manifestation must begin with the elimination of the problem. But it is impossible to establish the source on your own. Only a competent doctor will help to cope with this difficult task.

Clinic “Edcar” in Kaliningrad has everything you need to provide high quality services to the population. Timely consultation with a dermatovenereologist will help to avoid the consequences of diseases.

Causes

Consider the most common pathologies in which this symptom manifests itself.

Infections of the genitourinary system

Lymphoid formations in diseases of this group are often detected by patients themselves. The nodes resemble elastic “bumps”, they are not soldered to each other and to the skin surface. The skin over the nodes is hyperemic, and there is a local increase in temperature. These are common symptoms, but there are distinctive signs of different pathologies:

• Genital herpes. An increase in inguinal lymph nodes is accompanied by general malaise. In the perineal region, a finely blistering rash with liquid contents is noted. When the blister bursts, erosion forms in its place.
• Primary syphilis. With this pathology, nodes form on one side, but they can reach the size of a walnut. These formations are very painful. A few weeks before the onset of lymphadenopathy, a chancre appears in the genital area – a fleshy erosion of a rich red color.
• Chlamydia is accompanied by enlarged lymph nodes on both sides. This form is more typical for men, since their infections are usually acute. In women, the clinic is poorly expressed, and the nodes increase slightly.
• Gonorrhea occurs with bilateral nodule formation. In men, often lymphalenopathy is combined with urination disorders, and in the morning purulent discharge is noted from the urethra.
• Ureaplasmosis in both sexes is acute. Patients experience severe pain in the groin, and pain when urinating.

Diseases of the female genital area

Features of the anatomy of the female reproductive system contribute to the rapid penetration of pathogens. And the trigger for starting the inflammatory process can be even a slight hypothermia, stress, errors in personal hygiene. Inguinal lymphadenopathy in this case is a response to inflammation in the following diseases:

• Vulvitis is usually acute with moderate pain during urination. Lymphodenopathy acts as a harbinger of the disease, but the formations are painless. For this reason, women simply do not notice this symptom.
• Bartholinitis with abscess is always severe. Lymphatic tissue grows on the side of the lesion. Education can reach a huge size, which gives a woman incredible suffering due to severe pain in the perineum.
• Colpitis gives a woman significant discomfort. Lymph nodes become inflamed on both sides, but the formations do not reach large sizes. There may be moderate pain radiating to the groin. At the next stage of the pathology, vaginal discharge joins.

Pathologies of the male urogenital area

Men get sick just as often as women. Moreover, they are prone to inflammatory diseases at any age. But there is one feature during the height of the disease, the representatives of the stronger sex experience serious problems in intimate life. And inguinal lymphadenopathy is a symptom typical of such pathologies. Hyperplasia of the lymph nodes in the groin is typical for such “male” diseases:

• Balanitis – inflammation of the glans penis is always accompanied by an increase in nodes. Pain occurs a couple of days after this symptom. Patients also complain of a burning sensation and difficulty urinating. If inflammation covers the foreskin, then we will talk about balanoposthitis.
• Orchitis is an inflammation of the testicles. The process is accompanied by hyperplasia of the lymph nodes on the affected side. Due to swelling of the scrotum, a man experiences pain while walking.
• Gangrene of the penis. This is an irreversible process that can take weeks or months. Therefore, hypertrophied lymph nodes can reach gigantic sizes. Destructive changes in the tissues of the penis also progress slowly.

Diseases caused by parasites

Since the lymph nodes are part of the immune system, they respond to any unauthorized intrusion. Local damage to the nodes of the inguinal region is observed in parasitic infections, and a generalized lesion is characteristic of protozoal diseases.

• Worm infestations affect directly the lymph nodes. Moreover, formations can reach incredible sizes – 10 or more cm in diameter.
• Toxoplasmosis occurs against the background of bilateral lymphadenopathy. In addition to the inguinal nodes, the axillary group is affected. This main symptom is supplemented by rashes in the form of spots and nodules, an increase in the spleen and liver.
• Pediculosis pubis causes bilateral hypertrophy of the lymph nodes in the groin. Formations reach 2 cm, and have an elastic consistency.

Diagnosis

Modern methods of examination allow you to accurately determine the cause of inguinal lymphadenopathy. A dermatovenereologist in Kaliningrad first examines the patient, determines visually and during palpation the state of the lymph nodes. Then the patient is sent for the following types of examination:

• Ultrasound;
• urine and blood tests;
• swabs for microflora;
• serological tests.

In some cases, a biopsy is ordered to determine the nature of the mass. When a malignant neoplasm metastasizes, atypical cells will be detected in the biomaterial.

Treatment

As a rule, inguinal lymphadenopathy does not require specific therapy. All treatment is directed at the underlying disease. After the acute symptoms subside, secondary signs disappear. Lymph nodes also acquire normal parameters. The complex of treatment for such conditions includes anti-inflammatory and painkillers. When an oncology is detected, appropriate treatment is carried out.

Clinic “Edkar” in Kaliningrad has everything necessary for the successful treatment of dermatovenereological diseases. We guarantee each patient:

• professional support at all stages of examination and treatment;
• individual approach;
• high quality of services provided;
• attentive attitude;
• comfortable conditions of stay in the clinic.

On the way to health, you need to take just one step – make an appointment with a specialist by phone or through an online application.