What are the key lymph node levels in the neck. How are cervical lymph nodes classified anatomically. Which cancers typically spread to specific neck lymph node groups. Why is understanding cervical lymph node anatomy important for diagnosis and treatment.

Cervical Lymph Node Classification: Understanding the Levels

The cervical lymph node classification system divides the neck into distinct levels and sublevels. This standardized approach, proposed by the American Head and Neck Society and the American Academy of Otolaryngology-Head and Neck Surgery, defines 10 primary node groups. Each group has specific anatomical boundaries and is associated with particular tumor sites that may metastasize to those nodes.

The key anatomical landmarks used to delineate these levels include:

• Hyoid bone
• Cricoid cartilage
• Carotid arteries
• Sternocleidomastoid muscle
• Manubrium of sternum

Understanding this classification system is crucial for accurate diagnosis, staging, and treatment planning in head and neck cancers. Let’s explore each level in detail.

Level I: Submental and Submandibular Nodes

Level I is divided into two sublevels:

Level Ia – Submental Nodes

These nodes are located in the median region between the anterior bellies of the digastric muscles. They are at risk for metastases from cancers of the anterior oral cavity and lower lip.

Level Ib – Submandibular Nodes

The submandibular nodes occupy the space between the inner aspect of the mandible laterally and the digastric muscle medially. They extend from the symphysis menti anteriorly to the submandibular gland posteriorly. These nodes are susceptible to metastases from cancers of the oral cavity, anterior nasal cavity, soft tissues of the mid-face, and the submandibular gland.

Why are Level I nodes significant? They often serve as the first echelon of lymphatic drainage for many oral cavity cancers, making their assessment critical in determining the extent of disease spread.

Level II: Upper Jugular Nodes

Level II is a key area in cervical lymph node assessment, further subdivided into levels IIa and IIb.

Level IIa

These nodes are located anterior to the spinal accessory nerve. They receive lymphatics from various structures, including:

• Face
• Parotid gland
• Submandibular and submental nodes
• Retropharyngeal nodes
• Nasal cavity
• Pharynx
• Larynx
• External auditory canal
• Middle ear
• Sublingual and submandibular glands

Level IIb

These nodes are posterior to the spinal accessory nerve. They are more commonly associated with metastases from primary tumors of the oropharynx or nasopharynx, and less frequently with tumors of the oral cavity, larynx, or hypopharynx.

How can one differentiate between Level IIa and IIb? The distinction is made by drawing a line at the posterior edge of the internal jugular vein.

Level III: Mid Jugular Nodes

Level III nodes play a crucial role in the lymphatic drainage of several head and neck structures. They receive efferent lymphatics from:

• Level II nodes
• Level V nodes
• Retropharyngeal nodes
• Pretracheal nodes
• Recurrent laryngeal nodes

Additionally, Level III collects lymphatics directly from:

• Base of the tongue
• Tonsils
• Larynx
• Hypopharynx
• Thyroid gland

What is the anatomical border between Level III and Level IVA? The inferior border of the cricoid cartilage serves as the demarcation between these two levels.

Level III nodes are at risk of harboring metastases from cancers of the oral cavity, nasopharynx, oropharynx, hypopharynx, and larynx. Their central location in the neck makes them a common site for metastatic spread from various head and neck cancers.

Level IV: Lower Jugular and Medial Supraclavicular Nodes

Level IV is further divided into two sublevels: IVa and IVb.

Level IVa

These nodes are at risk for harboring metastases from cancers of:

• Hypopharynx
• Larynx
• Thyroid
• Cervical esophagus

Interestingly, metastases from the anterior oral cavity may occasionally manifest in this location with minimal or no proximal nodal disease, highlighting the importance of thorough evaluation of all neck levels.

Level IVb

Level IVb nodes are susceptible to metastases from cancers of:

• Hypopharynx
• Subglottic larynx
• Trachea
• Thyroid
• Cervical esophagus

Where is the border between Level IVa and IVb? It is arbitrarily set at 2 cm cranial to the sternoclavicular joint.

Level V: Posterior Triangle and Supraclavicular Nodes

Level V encompasses the nodes of the posterior triangle group, located posterior to the sternocleidomastoid muscle. This level is further subdivided into Va and Vb.

Level Va

Level Va includes the spinal accessory nodes and the transverse cervical nodes. These nodes are at risk for metastases from:

• Nasopharyngeal carcinoma
• Oropharyngeal carcinoma
• Cutaneous malignancies of the posterior scalp and neck

Level Vb

Level Vb contains the supraclavicular nodes. These nodes are particularly significant as they can harbor metastases from:

• Nasopharyngeal carcinoma
• Thyroid carcinoma
• Lung cancer
• Esophageal cancer
• Breast cancer

Why is Level V important in cancer staging? The presence of metastases in Level V nodes often indicates advanced disease and may significantly impact treatment planning and prognosis.

Retropharyngeal and Parapharyngeal Nodes: The Hidden Players

While not part of the traditional neck levels, retropharyngeal and parapharyngeal nodes play a crucial role in head and neck cancer metastasis.

Retropharyngeal Nodes

These nodes are located in the retropharyngeal space, posterior to the pharyngeal wall. They are particularly important in the context of:

• Nasopharyngeal carcinoma
• Oropharyngeal carcinoma
• Hypopharyngeal carcinoma

Retropharyngeal node involvement can be challenging to detect clinically, making imaging studies crucial for their evaluation.

Parapharyngeal Nodes

Located in the parapharyngeal space, these nodes can be involved in metastases from:

• Nasopharyngeal carcinoma
• Oropharyngeal carcinoma
• Sinonasal tumors

How do retropharyngeal and parapharyngeal nodes impact treatment planning? Their involvement may necessitate more aggressive treatment approaches, including extended radiation fields or more extensive surgical resections.

Clinical Implications of Cervical Lymph Node Anatomy

Understanding the intricate anatomy of cervical lymph nodes has significant implications for clinical practice:

Diagnosis and Staging

Accurate identification of involved lymph node levels is crucial for proper staging of head and neck cancers. This, in turn, guides treatment decisions and helps predict prognosis.

Surgical Planning

Knowledge of lymph node levels informs the extent of neck dissection required. For instance, a selective neck dissection may target specific levels based on the primary tumor site and its typical lymphatic drainage patterns.

Radiation Therapy

Radiation oncologists use lymph node levels to define target volumes for treatment. This ensures adequate coverage of at-risk areas while minimizing radiation to uninvolved tissues.

Follow-up and Surveillance

Understanding normal lymph node anatomy aids in the detection of recurrent disease during post-treatment surveillance.

How does lymph node anatomy knowledge impact multidisciplinary care? It facilitates effective communication between surgeons, radiologists, radiation oncologists, and medical oncologists, ensuring comprehensive and coordinated patient care.

Advanced Imaging Techniques in Cervical Lymph Node Assessment

Modern imaging modalities have revolutionized the evaluation of cervical lymph nodes:

Computed Tomography (CT)

CT scans provide detailed cross-sectional images of the neck, allowing for precise localization of lymph nodes within the various levels. Key features assessed on CT include:

• Node size
• Shape
• Presence of necrosis
• Extranodal extension

Magnetic Resonance Imaging (MRI)

MRI offers superior soft tissue contrast, making it particularly useful for evaluating retropharyngeal nodes and assessing perineural spread. MRI can also provide functional information through techniques like diffusion-weighted imaging.

Positron Emission Tomography (PET)

PET, especially when combined with CT (PET/CT), adds metabolic information to anatomical imaging. This is particularly useful for:

• Detecting occult metastases
• Evaluating treatment response
• Identifying recurrent disease

How has advanced imaging impacted lymph node assessment? These techniques have improved the accuracy of staging, allowing for more tailored treatment approaches and better patient outcomes.

Emerging Concepts in Cervical Lymph Node Management

The field of head and neck oncology is constantly evolving, with new approaches to lymph node management emerging:

Sentinel Lymph Node Biopsy

This technique, well-established in breast cancer and melanoma, is gaining traction in head and neck cancer. It involves identifying and sampling the first draining lymph node(s) from the primary tumor site, potentially allowing for more targeted and less extensive neck dissections.

Immunotherapy

Immune checkpoint inhibitors have shown promise in the treatment of head and neck cancers, including those with nodal metastases. These therapies may alter the traditional paradigms of lymph node management.

Radiomics and Artificial Intelligence

Advanced image analysis techniques, including radiomics and machine learning algorithms, are being developed to improve the accuracy of lymph node assessment. These tools may help identify subtle features indicative of metastatic involvement.

What impact might these emerging concepts have on cervical lymph node management? They have the potential to further personalize treatment approaches, potentially reducing treatment-related morbidity while maintaining or improving oncologic outcomes.

Conclusion: The Continuing Importance of Cervical Lymph Node Anatomy

As we’ve explored throughout this comprehensive guide, a thorough understanding of cervical lymph node anatomy is fundamental to the effective diagnosis, staging, and treatment of head and neck cancers. From the submental nodes of Level I to the supraclavicular nodes of Level V, each group plays a crucial role in the complex lymphatic drainage of the head and neck region.

The standardized classification system we’ve discussed provides a common language for clinicians across specialties, facilitating clear communication and coordinated care. As imaging technologies advance and new treatment modalities emerge, this anatomical framework remains the foundation upon which modern head and neck oncology is built.

Looking ahead, continued research into lymphatic pathways, coupled with innovations in imaging and treatment, promises to further refine our approach to cervical lymph node management. This ongoing evolution underscores the dynamic nature of the field and the enduring relevance of anatomical knowledge in clinical practice.

For healthcare professionals involved in the care of head and neck cancer patients, maintaining a solid grasp of cervical lymph node anatomy is not just an academic exercise—it’s a critical skill that directly impacts patient care and outcomes. As we continue to unravel the complexities of cancer biology and develop more targeted therapies, this anatomical understanding will remain an indispensable tool in the fight against head and neck malignancies.

The Radiology Assistant : Cervical Lymph Node Map

modified from Robbins

Aurelia Fairise and Robin Smithuis

Institut de Cancérologie de Lorraine in Nancy, France and the Alrijne hospital in Leiderdorp, the Netherlands

Publicationdate 2022-07-11

This article is based on the nomenclature proposed by the American Head and Neck Society and the American Academy of Otolaryngology-Head and Neck Surgery.

10 node groups are defined with a concise description of their main anatomic boundaries, the normal structures juxtaposed to these nodes, and the main tumor sites at risk for harboring metastases in those levels [1]. 

Overview

In this cervical lymph node map the levels were extended to 10.

Some of these are being divided into sub-levels to correspond more completely with the TNM atlas.

Borders

Important landmarks are:

• Hyoid bone
• Cricoid
• Carotids
• Sternocleidomastoid muscle
• Manubrium of sternum

Axial CT

Axial CT slices in correlation to overview illustration.

Axial CT slices in more detail.
Enlarge images by clicking on them.

Levels

I – Submental and submandibular

Nodes in level I are at risk of developing metastases from cancers of the oral cavity, anterior nasal cavity and the soft tissues of the mid-face and the submandibular gland.

Level Ia 
is a median region located between the anterior belly of the digastric muscles, which contains the submental nodes.

Level Ib 
contains the submandibular nodes located in the space between the inner side of the mandible laterally and the digastric muscle medially, from the symphysis menti anteriorly to the submandibular gland posteriorly.

II – Upper jugular

Level II receives lymphatics from the face, the parotid gland, and the submandibular, submental and retropharyngeal nodes.
Level II also directly receives the collecting lymphatics from the nasal cavity, the pharynx, the larynx, the external auditory canal, the middle ear, and the sublingual and submandibular glands [1]. 

Level II can be divided into level IIa and level IIb by drawing a line at the posterior edge of the internal jugular vein.

The nodes in level IIa and IIb are at risk of harboring metastases from cancers of the nasal and oral cavity, nasopharynx, oropharynx, hypopharynx, larynx and major salivary glands.

Level IIb is more likely associated with primary tumors of the oropharynx or nasopharynx, and less frequently with tumors of the oral cavity, larynx or hypopharynx [1].

III – Mid jugular

Level III receives efferent lymphatics from levels II and V, and some efferent lymphatics from the retropharyngeal, pretracheal and recurrent laryngeal nodes.
It collects the lymphatics from the base of the tongue, tonsils, larynx, hypopharynx and thyroid gland.

The inferior border of the cricoid is the border between level III and IVA.

Nodes in level III are at risk of harboring metastases from cancers of the oral cavity, nasopharynx, oropharynx, hypopharynx and larynx.

IV – Lower jugular and medial supraclavicular

The border between level IVa and IVb is set arbitrarily 2 cm cranial to the sterno-clavicular joint.

Level IVa
These nodes are at risk for harboring metastases from cancers of the hypopharynx, larynx, thyroid and cervical esophagus.
Rarely metastases from the anterior oral cavity may manifest in this location with minimal or no proximal nodal disease.

Level IVb
These nodes are at risk for harboring metastases from cancers of the hypopharynx, subglottic larynx, trachea, thyroid and cervical esophagus.

V – Posterior triangle and Supraclavicular

Level V contains the nodes of the posterior triangle group located posteriorly to the sternocleidomastoid muscle around the lower part of the spinal accessory nerve and the transverse cervical vessels.

Nodes in level V are most often associated with primary cancers of the nasopharynx, the oropharynx, the cutaneous structures of the posterior scalp, and the thyroid gland.

Level Vc – Supraclavicular

This level contains the lateral supraclavicular nodes located in the continuation of the posterior triangle nodes (level Va and Vb) from the cervical transverse vessels down to a limit set arbitrarily 2 cm cranial to the sternal manubrium.
It corresponds partly to the area known as the supraclavicular fossa.

Level Vc receives efferent lymphatics from the posterior triangle nodes (level Va and Vb) and is more commonly associated with nasopharyngeal tumors [1]. 

Transverse cervical artery
Scroll through the images for the anatomy of the transverse cervical artery.

VI – Anterior cervical

This level contains the superficial anterior jugular nodes (level VIa) and the deeper prelaryngeal, pretracheal, paratracheal and recurrent laryngeal nerve nodes (level VIb).

Level VIa
This level contains the superficially located anterior jugular nodes.

Level VIb
This level is contained between the medial borders of the common carotid arteries.
The nodes in this area are:

• pre-laryngeal nodes in front of the larynx and cricoid
• pre-tracheal nodes in front of the trachea 
• paratracheal nodes also called recurrent laryngeal nerve nodes

Delphian lymph node

The Delphian lymph node derived its name from the oracle of Delphi, whose prophecy would be a death secondary to laryngeal cancer.

It is a pretracheal node in level VIa located anterior to the cricoid and in between the cricothyroid muscles.

The recurrent laryngeal nerves branch off the vagus, the left at the aortic arch, and the right at the right subclavian artery.

The left laryngeal nerve can be compressed by subaortic lymph node metastases in the aorto-pulmonary window as seen in patients with lung cancer.

VII – Retropharyngeal and retrostyloid

Retropharyngeal nodes receive lymphatics from the mucosa of the nasopharynx, the Eustachian tube and the soft palate. 

These nodes are at risk of harboring metastases from cancers of the nasopharynx, the posterior pharyngeal wall and the oropharynx (mainly the tonsillar fossa and the soft palate).

Level VIIa – retropharyngeal

These nodes lie within the retropharyngeal space, extending cranially from the upper edge of the first cervical vertebrae (massa lateralis) to the cranial edge of the body of the hyoid bone caudally (figure).

This space is bounded anteriorly by the pharyngeal constrictor muscles and posteriorly by the longus capitis and longus colli muscles.
Laterally, the retropharyngeal nodes are limited by the medial edge of the internal carotid artery.

Retropharyngeal nodes receive efferent lymphatics from the mucosa of the nasopharynx, the Eustachian tube and the soft palate.
These nodes are at risk of harboring metastases from cancers of the nasopharynx, the posterior pharyngeal wall and the oropharynx (mainly the tonsillar fossa and the soft palate).

Level VIIb – retrostyloid

The retro-styloid nodes are the cranial continuation of the level II nodes.
They are located in the fatty space around the jugulo-carotid vessels up to the base of skull at the jugular foramen. 

Click to enlarge

The retro-styloid space is delineated by the internal carotid artery medially, by the styloid process and the deep parotid lobe laterally, by the vertebral body of C1 and the base of skull posteriorly and by the pre-styloid para-pharyngeal space anteriorly.

VIII – Parotid

This level contains the parotid node group, which includes the subcutaneous pre-auricular nodes, the superficial and deep intraparotid nodes and the subparotid nodes. 

These nodes extend from the zygomatic arch and the external auditory canal down to the mandible.

They extend from the subcutaneous tissue laterally to the styloid process medially, and from the posterior edge of the masseter and the pterygoid muscles anteriorly to the anterior edge of the sternocleidomastoid muscle and the posterior belly of the digastric muscle posteriorly [1].

Click to enlarge

The parotid group receive lymphatic from the frontal and temporal skin, the eyelids, the conjunctiva, the auricle, the external acoustic meatus, the tympanum, the nasal cavities, the root of the nose, the nasopharynx, and the Eustachian tube.  

They are at risk of harboring metastases from cancers of the frontal and temporal skin, orbit, external auditory canal, nasal cavities and parotid gland.

IX – Buccofacial

Level IX contains the malar and bucco-facial node group, which includes inconsistent superficial lymph nodes around the facial vessels on the external surface of the buccinator muscle.
These nodes extend from the caudal edge of the orbit (cranially) down to the caudal edge of the mandible (caudally) where they reached level Ib. 

They lay on the buccinators muscle (medially) in the sub-cutaneous tissue, from the anterior edge of the masseter muscle and the Bichat’s fat pad (posteriorly) to the anterior sub-cutaneous tissue of the face.

The bucco-facial nodes receive efferent vessels from the nose, the eyelids, and the cheek. 

They are at risk of harboring metastases from cancers of the skin of the face, the nose, the maxillary sinus (infiltrating the soft tissue of the cheek) and the buccal mucosa.

X – Retroauricular and occipital

Level Xa contains the retroauricular (also called mastoid) and subauricular nodes, which includes superficial nodes lying on the mastoid process from the cranial edge of the external auditory canal cranially to the tip of the mastoid caudally. 

Level Xb contains the occipital lymph nodes, which are the cranial and superficial continuation of the level Va nodes up to the cranial protuberance. They lie from the posterior edge of the sternocleidomastoid muscle to the anterior (lateral) edge of the trapezius muscle.

Lymph node metastases in level X are from skin cancers of the retro-auricular area (Xa) and skin cancers of the occipital area (Xb).

Click on the image below to get more information about Medical Action Myanmar, a medical organization run by Nini Tun and Frank Smithuis, who happens to be the brother of Robin Smithuis.

1. Delineation of the neck node levels for head and neck tumors: A 2013 update. DAHANCA, EORTC, HKNPCSG, NCIC CTG, NCRI, RTOG, TROG consensus guidelines

   DAHANCA, EORTC, HKNPCSG,NCIC CTG, NCRI, RTOG, TROG consensus guidelines.
   by V Grégoire et al.
   Radiother Oncol 2014 ;110:172–81.

2. Integrating radiological criteria into the classification of cervical lymph node disease.
   by Robbins KT.
   Arch Otolaryngol Head Neck Surg 1999 ;125:385–7.

3. International association for the study of lung cancer (IASLC) lymph node map: radiologic review with CT illustration.

   by El-Sherief AH, Lau CT, Wu CC, Drake RL, Abbott GF, Rice TW.
   Radiographics. 2014 Oct;34(6):1680-91.

Primary Neck Cancers ‣ Anatomy

In order to fully understand primary neck cancers, it helps to understand the anatomy and function of the structures in the neck. The neck is a complex anatomic region between the head and the body.

In the front, the neck extends from the bottom part of the mandible (lower jaw bone) to the bones of the upper chest and shoulders (including the sternum and collar bones). The back of the neck is mostly comprised of muscles, as well as the spine. 

The neck is essentially a passageway for air, food, liquids, blood, and more to travel between the head and the rest of the body, through structures such as blood vessels, nerves, and lymph nodes, as well as the larynx, trachea, and esophagus.  

Important Structures in the Neck

Sternocleidomastoid Muscle
This is the large muscle on either side of the neck. This muscle covers and protects many important deeper structures such as the carotid artery and the jugular vein. This muscle starts at the skull just behind the ear (mastoid bone) and travels down to the sternum (breastbone) and clavicles (collarbones).

Thyroid Gland
The thyroid is located at the midline of the neck, under the skin and a few layers of thin muscles. It sits just in front of and to the side of the upper trachea. It secretes thyroid hormone which is important in regulating many functions of the body. The thyroid gland has a right and left lobe which are connected by an isthmus. Learn more about the thyroid.

Parathyroid Glands
These four glands are located just behind the thyroid gland, two on each side. They are critical in helping to regulate levels of calcium in the blood.

Carotid Sheath
This is an envelope of fascia that envelopes three major structures: the carotid artery, internal jugular vein, and vagus nerve.

Additional Major Arteries & Nerves
Just behind the carotid sheath sits the sympathetic nerve plexus, which helps with blood pressure control and other important functions. There are also other major nerves such as the hypoglossal nerve (which controls tongue movement), the spinal accessory nerve (which controls neck and shoulder movement), and the phrenic nerve that innervates the diaphragm (which facilitates breathing).

Larynx
The larynx is often called the voice box because it houses the vocal cords and is responsible for producing sound during speech. It is part of the throat and is located in the middle of the neck.  The framework of the larynx is formed by the cricoid and thyroid cartilage, as well as, other smaller cartilages. Learn more about the larynx.

Esophagus
The esophagus is the passageway for eating. It is located behind the trachea in the lower neck. Food and liquids travel through this muscular tube which travels from the neck through the chest until it connects to the stomach in the abdomen. 

Trachea
The trachea is the passageway for breathing. It begins just below the cricoid cartilage of the larynx and extends into the chest to eventually split into left and right bronchi which continue to divide in the lungs. The trachea is made up of multiple c-shaped cartilage rings and a posterior muscular wall.

Salivary Glands
The submandibular salivary glands and the tail of the parotid salivary gland are located in the upper part of the neck. Learn more about salivary glands.

Lymph Nodes
There are lymph nodes located throughout the body, and several in the neck. Lymph nodes filter fluid in the body and help to fight infections and cancers. Cancers from a site in the head and neck can drain into lymph nodes and lead to the growth of cancer within the lymph node (called a metastatic lymph node). Learn more about lymph nodes.

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Lymph nodes : normal anatomy

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Literature

• Terminologia Anatomica: International Anatomical Terminology – FCAT Federative Committee On Anatomical Terminology, Federative Committee on Anatomical Terminology – Thieme, 1998 – ISBN 3131152516, 9783131152510
• Selection and delineation of lymph node target volumes in head and neck conformal radiotherapy. Proposal for standardizing terminology and procedure based on the surgical experience. Grégoire V, Coche E, Cosnard G, Hamoir M, Reychler H. Radiother Oncol. 2000 Aug;56(2):135-50. Review.PMID: 10927132
• CT-based definition of thoracic lymph node stations: an atlas from the University of Michigan.Chapet O, Kong FM, Quint LE, Chang AC, Ten Haken RK, Eisbruch A, Hayman JA.Int J Radiat Oncol Biol Phys. 2005 Sep 1;63(1):170-8.
• Definition of the supraclavicular and infraclavicular nodes: implications for three-dimensional CT-based conformal radiation therapy. Madu CN, Quint DJ, Normolle DP, Marsh RB, Wang EY, Pierce LJ. Radiology. 2001 Nov;221(2):333-9.
• Standardizing Neck Dissection Terminology: Official Report of the Academy’s Committee for Head and Neck Surgery and Oncology
  K. Thomas Robbins; Jesus E. Medina; Gregory T. Wolfe; Paul A. Levine; Roy B. Sessions; Charles W. Pruet
  Arch Otolaryngol Head Neck Surg. 1991;117(6):601-605.

anatomical structures

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What to do if the lymph nodes in the neck are inflamed

The enlargement of the lymph nodes in the neck, as a rule, occurs as a result of contact with bacteria and viruses. If the enlargement is caused by an infection, it is called lymphadenitis. Rarely, cancer can be the cause.

The lymphatic system plays a vital role in keeping our body alive and is a major component of our immunity. Lymph nodes can be felt in the neck, chin, armpits and groin. In some cases, no action is required for treatment and a warm compress is enough. Treatment depends on the cause.

Symptoms

The lymphatic system includes a network of organs and lymph nodes located throughout the body. Most of them are in the head and neck area. Swollen lymph nodes indicate that something is wrong in the body. The first signs are sensitivity, soreness and an increase in lymph nodes to the size of a bean and even more.

Depending on the cause of the appearance, the symptoms of the disease may be as follows:

Runny nose, sore throat, fever and other signs of an upper respiratory tract infection.
Swollen lymph nodes throughout the body may indicate HIV, mononucleosis, or immune disorders such as lupus or rheumatoid arthritis.
Swollen limbs may indicate a blockage in the lymphatic system caused by tumors in the lymph nodes that are deep under the skin and cannot be felt.

When treatment of lymph nodes in the neck requires a visit to a doctor

Lymph nodes return to normal over time if the cause of the increase was an infection that could be treated. But there are a number of factors in which you should consult a doctor:

• Swelling without apparent cause
• Duration 2-4 weeks
• Knots are difficult to feel and do not move when pressed
• Associated with persistent fevers, night sweats and weight loss
• Accompanied by sore throat and difficulty swallowing.

Why lymph nodes in the neck become inflamed – causes

A lymph node is a small, round or bean-shaped cluster of cells covered with a capsule of connective tissue. The cells are a combination of lymphocytes that produce protein particles that fight viruses and macrophages that break down harmful substances. Lymphocytes and macrophages filter the lymphatic fluid that flows throughout the body and protects us.

Lymph nodes are located in groups, each of which serves a specific area of ​​the body. An increase in a specific area may suggest a cause. The most common is an infection, especially a viral one, such as a cold. But there are other types0019 lymphadenitis of the cervical lymph nodes , such as parasitic or bacterial, which can cause enlargement of the lymph nodes.

Common infections:

• Measles
• Ear infections
• Infection of the tooth – abscess
• Mononucleosis
• Skin infections
• HIV

Atypical infections:

• Tuberculosis
• Sexually transmitted (syphilis and others)
• Toxoplasmosis
• Cat scratch bacterial infection

Autoimmune diseases:

• Lupus
• Rheumatoid arthritis

Cancer:

• Lymphoma
• Leukemia
• Other cancers that have spread to lymph nodes

Complications

If the cause is an infection and not properly treated, complications may occur.

Abscess formation. Localization of the accumulation of pus caused by infection. Pus contains fluid, white blood cells, dead tissue, bacteria, and other harmful elements. If an abscess occurs, drainage or antibiotic treatment may be required. Significant damage can be done if vital organs are affected.

Bloodstream infection. Bacterial, can start anywhere in your body and progress to sepsis caused by significant blood poisoning. Sepsis can lead to multiple organ failure and death. Treatment includes hospitalization and intravenous antibiotics.

Diagnosis

To diagnose an illness, your doctor may need to:

• Medical history
• Medical examination
• Blood test
• Chest x-ray and computed tomography
• Lymph node biopsy (as a last resort).

Treatment of lymph nodes in the neck

If the cause is a virus, the lymph nodes in the neck will recover on their own after the infection itself is treated. But if this does not happen or there is another reason, the following treatment may be required:

• Infection.