Location In Body, Purpose, Common Problems

Written by WebMD Editorial Contributors

• How Do They Work?
• Swollen Lymph Nodes

Lymph nodes are your immune system’s first line of defense, protecting you from things like bacteria or viruses that could make you sick.

You have hundreds of the small, round, or bean-shaped glands all over your body. Most are spread out, but some are found in groups in a few major places, like your neck, under your arm, and in your chest, belly, and groin. You might be able to feel some of the clusters in those areas as little bumps, but typically, you don’t feel them or even know they are three.

Your lymph nodes are part of your lymphatic system. Along with your spleen, tonsils, and adenoids, they help you fight off illness and infections.

Your lymph nodes are connected to one another by lymph vessels (tubes that run through your body like veins). They carry lymph fluid — a clear, watery liquid that passes through the nodes.

As the fluid flows through, cells called lymphocytes help protect you from harmful germs.

There are two kinds of lymphocytes — B-lymphocytes (or B-cells) and T-lymphocytes (or T-cells).

• B-cells make antibodies that attach to germs and let your immune system know they need to be killed off.
• T-cells have a couple of jobs. Some destroy germs, while others keep track of immune cells. They let your body know when to make more of certain kinds and less of others. Memory T cells are T-cells that remain dormant after an infection and become active again when they are faced with the same infection.

Lymph fluid also carries protein, waste, cellular debris (what’s left after a cell dies), bacteria, viruses, and excess fat that are filtered by the lymphatic system before it’s dumped back into the bloodstream.

When there’s a problem in your body, like an illness or an infection, your lymph nodes can swell. (This usually happens only in one area at a time. ) It’s a sign that more lymphocytes are in action than usual, trying to kill off germs.

You may notice this most often in the glands in your neck. That’s why your doctor feels the area under your jawbone. They’re checking to see if those glands are bigger than usual or tender.

Many things can make your lymph nodes swell. Any infection can trigger it, including a cold or the flu, an ear infection, STDs (usually inguinal), shingles, tuberculosis, or an abscessed tooth. Rarely a vaccine can cause swollen lymph nodes on the side of the vaccination.  Much less often, it can be a sign of something more serious, like cancer.

Sometimes medicines like phenytoin (taken for seizures), or drugs that prevent malaria can cause swollen lymph nodes, too.

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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 – the causes of occurrence, in what diseases it occurs, diagnosis and methods of treatment

Measles

Rubella

Diphtheria

Chicken pox

Syphilis

Thyrotoxicosis

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Enlargement of lymph nodes – the causes of the appearance, in which diseases it occurs, diagnosis and methods of treatment.

Lymph nodes are small biological filters related to the lymphatic system. Their main function is to protect the body. Lymph nodes allow the flow of lymph through themselves and in their structures trap pathogens that are destroyed by protective cells – lymphocytes.

Under the sight of the lymph nodes are bacteria, tumor cells and toxic substances.

What are lymph nodes? These are small accumulations of lymphoid tissue located on the connective tissue frame.

Lymphoid tissue is a pool of cells that are involved in the destruction of damaged and tumor cells and microorganisms.

Swollen lymph nodes can be a symptom of both a mild infectious disease and a serious pathology that can lead to a severe outcome. Therefore, in all cases of enlarged lymph nodes, you should consult a doctor to diagnose and find out the cause.

Classification

Depending on the localization, the following groups of lymph nodes are distinguished:

• occipital;
• cervical;
• submandibular;
• chin;
• supraclavicular and subclavian;
• axillary;
• elbow;
• inguinal;
• popliteal.

During the examination, the doctor palpates (feels) the lymph nodes and determines their size, structure, soreness, skin changes over the lymph node.

Causes of swollen lymph nodes

An increase in lymph nodes indicates a pathological process. An isolated enlargement of the lymph node, or generalized lymphadenopathy, directly depends on the underlying cause of the disease.

Most cases of enlarged lymph nodes are temporary.

The reasons for the enlargement of the lymph nodes are:

• infectious processes;
• autoimmune diseases;
• tumor pathologies;
• storage diseases (a group of diseases accompanied by metabolic disorders).

Lymph nodes are involved in the formation of immunity, and with any infectious process, cell division is activated in them, protecting the body.

So, with brucellosis, tuberculosis, syphilis, diphtheria, bacteria can settle in the lymph nodes, causing inflammation. In this case, the lymph nodes increase in size due to the increased flow of lymph and blood.

Most often, lymph nodes enlarge with acute infections of the upper respiratory tract. Among them, the lymph nodes acquire the largest size with tonsillitis (tonsillitis).

Painful swollen lymph nodes can be a sign cat scratch disease (from the name it is clear that the disease occurs in persons scratched by a cat). The cause of the inflammatory process is the bacterium Bartonella henselae.

One of the clearest examples of a viral disease accompanied by a significant increase in lymph nodes is infectious mononucleosis . The disease is caused by the Epstein-Barr virus and cytomegalovirus.

Infectious mononucleosis is more common in children and young adults. In addition to an increase in lymph nodes, it is characterized by an increase in body temperature, weakness and sore throat.

In children, generalized lymphadenopathy occurs with childhood infectious diseases , such as measles, rubella, parotitis, chickenpox.

Among other viral diseases accompanied by lymphadenopathy, it is worth noting HIV infection .

Lymphadenopathy in HIV infection is accompanied by a number of symptoms: weight loss, unexplained fever, night sweats, fatigue, and later infectious diseases (herpes, cytomegalovirus infection, candidiasis).

Systemic (autoimmune) connective tissue diseases such as rheumatoid arthritis, systemic lupus erythematosus may be accompanied by enlarged lymph nodes. Under these conditions, there is a violation of the recognition of “foreign” and “own” proteins, as a result of which the body begins to attack its own cells. If the process is active, then the lymph nodes increase in size due to the increasing load.

Often, autoimmune diseases are accompanied by an enlarged spleen and additional symptoms.

With systemic lupus erythematosus, the skin, kidneys and serous membranes of internal organs are affected (lupus pleurisy, serositis occur). In rheumatoid arthritis, articular cartilage is predominantly affected.

Swollen lymph nodes may be a symptom of the progression of the tumor process in the body. Atypical (tumor) cells migrate to the lymph nodes, get stuck in them, multiply and stretch the node with their mass.

Separately, it is worth highlighting a group of malignant neoplasms that directly affect the lymphatic system.

• Hodgkin’s lymphoma , or lymphogranulomatosis occurs with the formation of conglomerates of affected immature lymphocytes in the lymph nodes and spleen.
• Non-Hodgkin’s lymphomas – a group of lymphoproliferative diseases.

Swollen lymph nodes can be a symptom accumulation diseases : some substance accumulates in organs and tissues, including lymph nodes, as a result of metabolic disorders. Among these diseases: hemochromatosis (iron accumulation), Wilson-Konovalov disease (copper accumulation) and other hereditary metabolic disorders.

Allergic reactions sometimes lead to enlarged lymph nodes. Hypersensitivity to certain drugs leads to generalized lymphadenopathy.

Among endocrinological diseases , hyperthyroidism may be characterized by lymphadenopathy, enlargement of the spleen and an increase in the content of lymphocytes in the blood. With treatment, all indicators return to normal.

It is worth remembering that all the lymph flowing from the organs passes through the lymph nodes, and if a person is engaged in heavy physical labor, then the elbow and popliteal lymph nodes can be enlarged due to a heavy load .

Also, lymph nodes in rare cases increase after vaccination with on the respective side.

Which doctors should I contact for swollen lymph nodes?

The adult should contact

general practitioner

, and examines the child and adolescent

pediatrician

. Depending on associated symptoms, the following specialists may need to be consulted:

• oncologist;
• surgeon;
• phthisiatrician;
• infectious diseases doctor;
• endocrinologist;
• rheumatologist.

Diagnosis and examination of swollen lymph nodes

• CBC;

Treatment of enlarged lymph nodes

In most cases, lymphadenopathy resolves on its own and does not require specific treatment.

If the lymph nodes increase rapidly, are painful to the touch, the process is accompanied by other symptoms, including fever and weakness, you should consult a specialist.

The doctor will conduct the necessary examination and determine a set of therapeutic measures.

In case of bacterial inflammation, antibiotic therapy and the necessary symptomatic treatment (antipyretic and anti-inflammatory drugs) will be prescribed. With infectious mononucleosis, usually no specific therapy is required, mainly symptomatic treatment is carried out. If HIV infection is suspected, a thorough laboratory and instrumental examination is carried out and antiretroviral therapy is prescribed, as well as treatment of concomitant infections.

Various immunosuppressive and anti-inflammatory drugs are used to treat autoimmune diseases. Depending on the indications, pulse therapy and intravenous immunoglobulin therapy can be used.

In case of tumor processes, the issue of chemotherapy, radiation therapy, surgical treatment, as well as bone marrow transplantation is being decided.

What to do if the lymph nodes are enlarged?

First of all, the treatment of enlarged lymph nodes is aimed at treating the underlying disease that led to the development of this symptom. It is important to follow the rules of personal hygiene, organize the daily routine and balance the diet. Any treatment is prescribed by a doctor.

It is unacceptable to rub and warm the enlarged lymph node, lubricate it with ointments, try to crush it and treat it with any folk methods without consulting a specialist.

Sources:

1. Clinical guidelines “Acute tonsillitis and pharyngitis (Acute tonsillopharyngitis)”. Developed by: National Medical Association of Otorhinolaryngologists, Alliance of Clinical Chemotherapists and Microbiologists, Union of Pediatricians of Russia, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy, Euro-Asian Society for Infectious Diseases. – 2021.
2. Clinical guidelines “HIV infection in adults”. Developed by: National Association of HIV Prevention, Diagnosis and Treatment Specialists, National Virological Association. – 2020.
3. Clinical guidelines “Hodgkin’s lymphoma”. Developed by: National Society of Pediatric Hematologists, Oncologists, Association of Oncologists of Russia, Russian Professional Society of Oncohematologists, National Hematological Society. – 2020.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

What are lymph nodes and what to do if they are enlarged?

Lymph nodes allow lymph to pass through, retaining and destroying bacteria, viruses and malignant cells. Sometimes they increase, which raises many questions.

Let’s figure out what lymph nodes are, how they are arranged and why it is impossible to follow the advice from the Internet when they increase.

What are lymph nodes and why are they needed?

Lymph node is a peripheral organ of the immune system, located on the path of lymphatic vessels from organs and tissues.

Lymph is the liquid part of the blood that is filtered into the intercellular space through the walls of the capillaries. It is rich in proteins, electrolytes and water. It is impossible to lose these valuable substances, and it is impossible to return them back to the blood vessels through the wall. The “filtrate” of the blood enters the lymphatic system, from where it enters the superior vena cava through a network of vessels, that is, it returns to the bloodstream.

Along the course of the lymphatic vessels there are lymph nodes – rounded formations the size of a pea. At its core, a lymph node is an accumulation of protective cells – lymphocytes and macrophages – on a “frame” of connective tissue. Lymph nodes allow the flow of lymph through them, and the protective cells that make up them delay and destroy foreign agents (bacteria, parasites, viruses, tumor cells) that have entered the human body.

That is why the lymph nodes are called biological filters, and they themselves resemble knight’s castles, located in the most important directions of medieval states and protecting them from enemy attacks.

Classification of lymph nodes

There are approximately 500 lymph nodes in the human body. They are located mainly in groups. Each group receives lymph from a specific area of ​​the body or part of an organ. There are many classifications of lymph nodes, the simplest of them is a classification based on localization. There are no lymph nodes in the brain and spinal cord, bones, and the area of ​​the hands and feet.

Swollen lymph nodes: symptom or disease?

Swollen lymph nodes, or lymphadenopathy, is a symptom of a large number of diseases. This is not an independent disease, but only one of its signs, such as headache or fever.

Doctors have many classifications of lymphadenopathy. In this article, we will give only a couple of the main ones that will help in understanding the stated problem.

Depending on the extent of the process, the enlargement of lymph nodes can be local and generalized ¹ . In the first case, the lymph nodes of 1-2 adjacent anatomical regions increase. For example, submandibular and cervical. In the second case, there is an increase in lymph nodes in two or more non-adjacent, located far from each other, zones. For example, in the inguinal and axillary regions.

The duration of lymph node enlargement can be short (less than 2 months) and protracted (more than 2 months) ¹ .

Why do lymph nodes enlarge?

Swollen lymph nodes can be a symptom of both a relatively harmless disease and a very serious disease. Therefore, you need not to self-medicate, but to look for the cause. And this is the prerogative of the doctor.

Here are just some of the possible causes of swollen lymph nodes:

• infectious diseases . The entry of an infectious agent (virus, bacteria) into the lymph node leads to increased blood flow, active division of lymphocytes and enlargement of the lymph node. That is, this process is of a reciprocal protective nature. An increase in lymph nodes is observed with infections of the upper respiratory tract (adenoviral, tonsillitis), infectious mononucleosis, childhood infections (measles, rubella, mumps, chicken pox), cytomegalovirus infection, etc. In acute infectious diseases, an increase in lymph nodes is temporary and is accompanied by other symptoms (fever, general weakness, malaise, cough, runny nose). Also, swollen lymph nodes can be one of the symptoms of HIV infection;
• autoimmune connective tissue diseases . With these diseases, the human immune system does not work quite adequately, which is why the body begins to attack its own cells. An increase in lymph nodes can be observed with rheumatoid arthritis, systemic lupus erythematosus;
• pyoinflammatory processes skin, underlying structures and internal organs. Even panaritium or a bad tooth can cause an increase in lymph nodes;
• vaccination . The introduction of a killed pathogen or its parts into the body leads to the development of an immune response. An increase in lymph nodes is not at all uncommon;
• allergic reactions . Taking many medications (antibiotics, anti-inflammatory and lowering blood pressure) may be accompanied by an increase in lymph nodes;
• neoplastic diseases . Enlarged lymph nodes are a common and sometimes the only sign of cancer. In oncological diseases, it can be primary and secondary.

Primary enlargement of lymph nodes

It is observed in tumors that directly affect the lymphatic system – lymphomas. Usually in these cases, the lymph nodes are more than 2 cm in diameter, painless, and their increase occurs against the background of apparent health, which is why the person does not immediately turn to the doctor.

Secondary enlargement of lymph nodes

It is observed in a malignant neoplasm of any localization. For example, with breast cancer, the only sign may be an increase in the lymph nodes in the armpit.

The fact is that as soon as malignant cells find themselves in the intercellular space, they quickly enter the lymphatic capillaries, and from there to the nearest lymph node. There, some of them are destroyed, and some settle and begin to divide, forming a secondary tumor focus.

The division of tumor cells and the increase in the number of protective cells over time leads to an increase in the size of the lymph node. This is a kind of “price” for curbing the growth of a tumor and the spread of tumor cells throughout the body, because if there were no lymph nodes, tumor cells would very quickly enter the bloodstream and give distant metastases.

With local lymphadenopathy, the tumor is detected in about half of the cases, and with generalized lymphadenopathy – in almost 90% of cases ¹ ! Therefore, it is so important to exclude the tumor origin of lymphadenopathy and understand its causes. You should not waste precious time on self-treatment, and if enlarged lymph nodes appear, you should consult a doctor as soon as possible.

What should I do if my lymph nodes are enlarged and which doctor should I visit?

The adult needs to see a general practitioner and the child/teenager needs to be taken to see a pediatrician. Usually, a clinical examination and simple studies (general and biochemical blood tests, if necessary, X-ray examination or ultrasound of a certain area of ​​the body) are enough for a specialist to make a preliminary diagnosis and prescribe treatment or refer the patient to a narrower specialist (oncologist, surgeon, rheumatologist, infectious disease specialist) for additional examination.

What not to do when the lymph nodes are “swollen”: breaking the stereotypes

Having found swollen lymph nodes, many people, instead of going to the doctor and understanding the causes of what is happening, begin to self-medicate: heat the area of ​​the enlarged lymph node, drink antibiotics, use compresses, etc. Similar advice can be found on the Internet some set.

Should I do it? No way.

Warming up the lymph node area

Many people use salt or a freshly boiled egg to warm up the swollen lymph node area. This is usually done to reduce pain. But for most patients, this is absolutely impossible. In the presence of an inflammatory process, thermal exposure will lead to vasodilation and increased inflammation, and in the case of a tumor process, it can accelerate cell division. Both will make the situation worse.

Taking antibiotics

There are many people who uncontrollably “treat” any “suspicious” symptoms with antibiotics. Of course, this is wrong. Antibacterial drugs are prescribed only by a doctor and strictly according to indications. In most cases, with an increase in lymph nodes, taking antibiotics is simply not advisable and will not give a positive effect.

Use of compresses, ointments/gels

The result here is the same as when warming up – the situation only gets worse.