Lymph nodes on back of neck diagram: [Figure, Illustration of the lymph nodes of the head and neck. Contributed by Chelsea Rowe] – StatPearls

14.12.202020.07.2023 by alexxlab

Thoracic Lymph Nodes Anatomy, Diagram & Function

Thoracic Lymph Nodes Anatomy, Diagram & Function | Body Maps

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Medically reviewed by the Healthline Medical Network — By The Healthline Editorial Team on July 6, 2020

Thoracic lymph nodes are separated into two types: parietal lymph nodes located in the thoracic wall, and visceral lymph nodes, which are associated with the internal organs. Due to their location, abnormalities of the lymph nodes in the thorax, or chest, are not easily detected. However, any changes in the size or amount of these lymph nodes could be indicative of several types of extrapulmonary or pulmonary diseases. For diagnostic purposes, lymph nodes of the thorax can be further divided into sub-categories. The lung lymph nodes can be found along the bronchi. The paratracheal and tracheobronchial groups of lymph nodes are located in the neck and also in the junction where the trachea meets the bronchi, respectively. These accept drainage from the heart, lungs, bronchi, and thoracic trachea as well as other lymph nodes. The posterior mediastinal group of lymph nodes, located near the thoracic aorta, is closely linked to the tracheobronchial group and primarily drains into the thoracic duct. The chest wall thoracic lymph nodes receive drainage from the breasts, arms, pectoral muscles, and other muscles and skin located in the upper section of the chest.

Last medically reviewed on July 6, 2020

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Medically reviewed by the Healthline Medical Network — By The Healthline Editorial Team on July 6, 2020

Swollen cervical lymph nodes: What does it mean?

Cervical lymph nodes are small nodes or glands in the neck. Swelling in the neck may indicate a nearby infection or other health condition.

The lymphatic system is a network of organs and tissues that helps support immunity. The lymph nodes are tiny, kidney-shaped structures that act as filters in this system. They trap and kill viruses, bacteria, and fungi before these pathogens can return to the bloodstream.

Swollen lymph nodes are usually a sign of infection but can stem from an inflammatory condition, an autoimmune disease, a reaction to a medication, or cancer. Sometimes they happen for no clear reason.

Swelling in the cervical lymph nodes may indicate a problem in the head, neck, throat, or lymphatic system.

This article outlines the potential causes of swollen cervical lymph nodes and information on treatment options and when to see a doctor.

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Lymph nodes are part of the immune system. They can enlarge when the system is defending the body from a nearby infection.

Cervical lymph nodes are in the front, sides, and back of the neck. They are usually smaller than 1 centimeter in diameter. If they are bigger, this could be a sign of an infection or other health problem, such as:

an ear infection
a dental infection
a skin infection
acne
a salivary gland infection
inflammation due to hair dye use or tight hair braids
COVID-19
a cold or flu
tonsillitis
glandular fever (mononucleosis or mono)
some types of cancer

Lymph nodes can also become noticeable under the chin, under the arms, and around the groin, depending on where an infection occurs.

A person may or may not be able to feel if their cervical lymph nodes are swollen. However, a doctor may be able to feel one or more bumps beneath the skin when examining the neck region.

The precise symptoms that may occur with swollen lymph nodes will depend on the cause, but common symptoms of an infection include:

fever or chills
a general feeling of being unwell, known as malaise
fatigue
body aches
pain or tenderness around the swollen nodes

Many conditions can cause swollen cervical lymph nodes, each with its own symptoms.

Here are some possible causes:

infections
autoimmune diseases
inflammatory conditions
tumors or cancer
genetic conditions present since birth
medication use or exposure to toxins

Here we look at some examples.

Infection

Infection is a common cause of swollen lymph nodes anywhere in the body.

When an infection occurs somewhere in the body, the lymph nodes in that area fill with white blood cells. The white blood cells then start to destroy the pathogens responsible for the infection.

The accumulation of white blood cells in the lymph nodes causes them to swell.

Some common infections that may lead to swollen cervical lymph nodes include:

the common cold
strep throat or tonsillitis
ear infections
dental infections

Additional signs of infection depend on the specific illness but may include:

sore throat
coughing
earache
fever
fatigue

Lymph nodes that swell due to infection may be painful when a person touches them. They usually return to their usual size once the infection clears.

HIV

Swollen lymph nodes are common in the early or acute stage of HIV infection. At this stage, the body starts fighting the infection.

Research suggests the virus reaches nearby lymph nodes 3–6 days after infection. Noticeable symptoms occur in around two-thirds of people within 2–4 weeks.

They include swelling in the lymph nodes. Swelling can affect any lymph nodes but commonly occurs in the cervical lymph nodes.

A 2016 study investigated lymph node abnormalities in 100 people with HIV and swollen lymph nodes. Of the participants, 60% had swelling in the cervical lymph nodes.

Other symptoms of the early or acute stage of HIV include:

sore throat
mouth ulcers
night sweats
muscle aches
fever and chills
fatigue
a rash

Cancer

Swollen cervical lymph nodes can sometimes be a sign of cancer.

Cancers that can cause swelling in the lymph nodes are:

Hodgkin lymphoma, which commonly appears first in the neck and usually affects young adults
chronic lymphocytic leukemia (CLL), a type of blood cancer that may cause swollen lymph nodes in the neck, above the collarbone, and under the arms
non-Hodgkin lymphoma, which can develop in lymph nodes anywhere in the body and is most common among people aged 64–74 years
other cancers, especially head and neck cancers, which can spread to the cervical lymph nodes

Other symptoms that may occur with all these conditions include:

fever
night sweats
fatigue
unexplained weight loss

The outlook for most cancers is better if a person seeks early treatment.

Medication side effects

Rarely, swollen lymph nodes can occur as a side effect of a medication. When medication is the cause, swelling may develop in any of the nodes, including the cervical lymph nodes.

Medications and toxins that can cause swollen lymph nodes include:

allopurinol (Zyloprim), used for gout
atenolol (Tenormin), used for blood pressure and heart disease
captopril (Capoten), an angiotensin-converting enzyme (ACE) inhibitor used for blood pressure
carbamazepine (Tegretol), an anti-seizure and epilepsy medication
cephalosporins, such as cephalexin (Keflex), an antibiotic
hydralazine (Apresoline), a blood pressure medication
penicillin
phenytoin (Dilantin) and primidone (Mysoline), used to manage seizures
quinidine (Quinidex), used for some irregular heartbeats
sulfonamides, such as sulfasalazine (Azulfidine), a disease-modifying anti-rheumatic drug (DMARD) used to treat psoriatic arthritis and other chronic inflammatory conditions

In rare cases, a chemotherapy drug known as granulocyte colony stimulating factor may also cause swelling of the lymph nodes.

What autoimmune conditions are there?

A doctor can usually detect a swollen cervical lymph node by feeling a person’s neck. They may do additional tests to find out why the swelling has occurred.

A doctor will likely ask about:

other symptoms
personal and family medical history
medications used and possible exposure to toxins
lifestyle habits
recent travel
recent exposure to other people who may have an infectious disease

They may also order the following diagnostic tests to find out the reason for swelling:

blood tests
throat culture
CT or MRI scan
X-rays

If necessary, the doctor may also perform a biopsy of the cervical lymph nodes to check for the presence of cancer cells.

The treatment options for swollen lymph nodes depend on the underlying cause.

Infectious causes

A swollen lymph node usually occurs as a result of infection. In such cases, the lymph node should return to its usual size once the infection has cleared.

Swollen lymph nodes typically do not require treatment unless they are painful. However, the following home remedies may help relieve discomfort:

applying a warm compress several times per day
taking over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs)
getting plenty of rest

A person should see their doctor if symptoms persist or worsen despite home treatment. The doctor may prescribe antibiotics if there are signs of a bacterial infection.

HIV

A person with HIV may receive antiretroviral medications to manage the virus. These drugs reduce the amount of the virus in a person’s blood and bodily fluids.

The drugs can reduce the viral load to where it is undetectable. Then, a person will no longer be able to pass on the disease. Many people can now live long and active lives with HIV, if they receive suitable treatment.

What does it mean when HIV is undetectable?

Cancer

Cancer treatments will depend on several factors, including:

the type of cancer a person has
the stage of the cancer
the person’s overall health

Possible treatment options include:

chemotherapy
radiation therapy
immunotherapy

In most cases, swollen cervical lymph nodes indicate the body is fighting an infection. Infections often go away without treatment, and the node should return to its usual size once the infection clears.

A person should seek medical advice if they experience:

severe symptoms, such as pain, a high fever, or difficulty breathing
swelling that lasts longer than 2 weeks
additional symptoms, such as night sweats and a persistent fever
swelling with no other symptoms, which may be a sign of cancer or an autoimmune disease
a hard and painless swelling in the lymph node
a rapid change in the size of the lymph node
swelling in more than one area of lymph nodes, such as in the neck and the groin

Swollen cervical lymph nodes are common. In most cases, swelling is a temporary response to an infection, but it can also be a sign of a more severe underlying health condition.

A person should see their doctor if the swelling persists, worsens, or if it is causing concern. A doctor will investigate the cause and recommend a suitable course of treatment.

Lymph nodes : normal anatomy

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Schematic drawings
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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Lymphadenopathy (swollen lymph nodes) – symptoms and treatment

What are lymph nodes

The lymphatic system is 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.

Lymphatic system includes 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 located 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. Doctors 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 increases, but also becomes inflamed – and lymphadenitis develops.

In non-infectious lymphadenopathy, enlarged lymph nodes can be caused by 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.

The 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, chicken pox, 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.

Due to occurrence:

infectious;
non-infectious.

Involvement of the tumor process:

tumor;
non-tumor.

By prevalence:

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

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 therapist will pay attention to this during examination and palpation (palpation).

If a patient comes to a therapist with complaints 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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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 general practitioner 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.

Histological examination of lymph nodes (1-5 lymph nodes)

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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 a signal from the body 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.

Lymph nodes on back of neck diagram: [Figure, Illustration of the lymph nodes of the head and neck. Contributed by Chelsea Rowe] – StatPearls

Thoracic Lymph Nodes Anatomy, Diagram & Function

Read this next

Swollen cervical lymph nodes: What does it mean?

Infection

HIV

Cancer

Medication side effects

Infectious causes

HIV

Cancer

Lymph nodes : normal anatomy

Lymphadenopathy (swollen lymph nodes) – symptoms and treatment

What are lymph nodes

Causes of lymphadenopathy

Lymphadenopathy in viral and bacterial infections

Lymphadenopathy in autoimmune diseases

Lymphadenopathy in malignant neoplasms

Types of lymphadenopathy

Symptoms of lymphadenopathy

Diagnosis of lymphadenopathy

Treatment of lymphadenopathy

Sequelae of lymphadenopathy

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