Swollen lymph node on back: Swollen lymph nodes – Symptoms and causes
When should you worry about swollen lymph nodes?
Lymph nodes are no bigger than a baked bean, but they’re powerful weapons in the body’s defense against disease and infection. These ovoid glands are scattered throughout the body, helping filter impurities in the blood. Perhaps their mightiest role, though, is producing B-cells, lymphocytes that make specialized proteins called antibodies to attack foreign invaders.
Sometimes, you may notice swollen lymph nodes in your neck, armpits or groin. This is usually a sign that your immune system is producing an abundance of B-cells to help your body fight off infection. But swollen lymph nodes may also signal more serious conditions.
In this article, we’ll explain when swollen lymph nodes may indicate more than a common infection. Topics include:
- How do you know if swollen lymph nodes are caused by a serious condition?
- When should you call a doctor?
- Which tests may be used to determine why they’re swollen?
- Which cancers are associated with swollen lymph nodes?
- What is a sentinel lymph node biopsy?
- What is lymphedema?
If you’ve been diagnosed with a blood cancer, such as lymphoma, leukemia or multiple myeloma, and are interested in a second opinion on your diagnosis or treatment options, call us or chat online with a member of our team.
How do you know if swollen lymph nodes are due to a serious condition?
The body has more than 600 lymph nodes in clusters in the neck, armpits, groin and torso, between the lungs, and in the belly, and around the bowels. They’re part of the body’s lymphatic system, which also includes the spleen, tonsils and adenoids. The lymph nodes scattered throughout the body act to filter out harmful, foreign cells like viruses and bacteria as well as cancer cells.
Lymph nodes are connected by vein-like vessels that carry lymph, a clear, watery liquid made up of cells called lymphocytes that help the lymphatic system protect the body from germs and impurities. The fluid flows through the vessels and the lymph nodes, where it’s filtered and then released back into the bloodstream.
When you have a bacterial or viral infection like a cold, the flu, an ear infection or an abscessed tooth, your lymphatic system kicks into action, producing lymphocytes to fight the infection and causing the lymph nodes to swell.
If you’re aware you have an infection like strep throat or an infected cut, for instance, you may recognize that the swollen lymph nodes are related to the infection. The lymph nodes may swell in an area that corresponds to the infection. For instance, an abscessed tooth may cause the lymph nodes in the neck to swell as the lymphatic fluid from the infection site drains through the nodes in that area, just as an infected cut on your leg may make the lymph nodes in your groin swell.
Immunizations, including the COVID-19 vaccine, may cause swollen lymph nodes and usually disappear after a few days. Certain medications, like those to prevent malaria, may also cause lymph nodes to swell.
You may have swollen lymph nodes and not be able to pinpoint the cause or location of the infection without the help of a doctor, such as in the case of mononucleosis, shingles, a sexually transmitted disease or an autoimmune condition, such as lupus or rheumatoid arthritis.
Sometimes, swollen lymph nodes are a sign of a more serious condition—like cancer.
Some characteristics may help distinguish worrisome swollen lymph nodes from those just doing their job defending the body against infection.
“If you can feel a lymph node that’s bigger than a half-inch, or if you can’t move it with your finger, that’s more worrisome,” says Beomjune B. Kim, MD, Head and Neck and Microvascular Reconstructive Surgeon at Cancer Treatment Centers of America® (CTCA), Atlanta.
Also, if it feels firm, that may cause concern, he says. Here’s how to tell the difference between a normal and abnormal lymph node:
- A normal lymph node feels like pressing on the tip of your nose.
- An abnormal lymph node feels harder, like pressing on your chin.
When should you call your doctor?
Generally speaking, call your doctor if:
- You have any symptoms that concern you.
- You feel may need medical attention for any reason.
- You can’t think of or discern a reason why your lymph nodes are swollen.
Also be aware of other persistent symptoms you may be experiencing along with the swollen lymph nodes, such as:
- Fever
- Chills
- Night sweats
- Loss of appetite
- Unexplained weight loss
- Non-healing sores in the mouth
- Ear pain
- Cough that produces blood
- Blood-tinged mucus
Other symptoms that may warrant a trip to your doctor include:
- Skin that’s red, irritated or warm around the lymph node
- Bleeding, non-healing sores
- Fatigue
- Trouble swallowing
- Coughing or shortness of breath
- Abdominal pain
- Feeling full after eating just a small amount of food
“Whenever an adult older than 40 can feel a lymph node in the neck, that’s a worrisome sign,” says Dr. Kim.
Which tests may be used to determine why the lymph nodes are swollen?
To determine the cause of your swollen lymph nodes, your doctor will begin with a physical exam, feeling the lymph nodes, examining you for other signs of infection and evaluating your general health.
Most likely, the doctor will order a complete blood count (CBC) to help gather information about your infection-fighting white blood cells. Depending on your symptoms, the doctor may also request imaging tests, such as:
- X-ray
- Ultrasound
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI) scan
- Fluorodeoxyglucose with positron emission tomography (FDG-PET) to help spot (or rule out) lymphoma and other cancers
Tests to rule out an infection like HIV, tuberculosis, syphilis or the Epstein-Barr virus may also be performed.
If these tests don’t reveal a reason for your swollen lymph nodes, your doctor may want to perform a biopsy to take a sample of the lymph node tissue for a pathologist to examine under the microscope.
Several types of biopsy may be performed, including:
Fine needle aspiration biopsy: Similar to donating blood, the doctor uses a fine, hollow needle to extract some fluid and cells from the lymph node.:max_bytes(150000):strip_icc()/swollen-glands-and-lymphadenopathy-26343681-5c87d173c9e77c0001422fc6.png)
Core needle biopsy: A larger hollow needle is used to remove a small chunk of tissue. This procedure typically requires local anesthesia.
Both types of biopsies take about 15 to 30 minutes, after which you’ll be able to return to your regular activities.
An open biopsy is more like surgery since the doctor makes an incision in the skin to remove part or all of the lymph node, then sutures the wound closed. This procedure may be performed under local or general anesthesia.
What cancers are associated with swollen lymph nodes?
If the pathology report detects cancer in the lymph nodes, it either started there or spread from another cancerous tumor in the body.
Cancer of the lymph nodes is call lymphoma, which is a type of blood cancer. Lymphoma is categorized by a number of types, but the most common are Hodgkin lymphoma and non-Hodgkin lymphoma, differentiated by the type of lymphocyte cells involved. Non-Hodgkin lymphoma, which is more common, is found in lymph nodes anywhere in the body.
Most cases of non-Hodgkin lymphoma are diagnosed in advanced stages.
Hodgkin lymphoma usually forms the lymph nodes in the chest, armpits or neck and, because it’s likely to be diagnosed early, patients generally have positive outcomes.
Cancer cells found in lymph nodes may also have broken away from another cancer elsewhere in the body and traveled there through the bloodstream or lymphatic system. Most of these stray cancer cells die before they can start growing somewhere else. But if the cells spread to a new organ or lymph node, the cancer is considered metastatic. Metastatic cancers often cause swollen lymph nodes near the tumor, as the body tries to do its job fighting off the disease.
What is a sentinel lymph node biopsy?
If the pathology report analysis suspects metastasis, the doctor may perform a sentinel lymph node biopsy to confirm it. The sentinel lymph node is the first node cancer cells are likely to spread to from the primary tumor. If the sentinel lymph node shows no signs of cancer, it’s likely that the cancer has not metastasized—a conclusion that may help the patient avoid more extensive lymph node surgery.
This procedure is regularly used for melanomas and breast cancers to help determine whether and to where the cancer has spread, Dr. Kim says. To locate the sentinel lymph node, the doctor will inject a dye or radioactive tracer into the tumor, then observe which node, or nodes, the dye travels. to.
“We surgically remove that lymph node and evaluate it to see whether there’s any cancer there,” Dr. Kim says. “If it’s positive, we know the cancer has spread to the lymph node. At that point, we can proceed to remove the entire lymph node basin in a lymph node dissection. Or we can decide to give radiation therapy or systemic chemotherapy to treat the metastasis, depending on which cancer it is.”
What is lymphedema?
When many lymph nodes are removed, as in a sentinel lymph node biopsy or lymph node dissection, that area of the body no longer has a way to drain lymphatic fluid. The resulting buildup of fluid is called lymphedema. The more lymph nodes removed, the more likely the patient will experience lymphedema.
“Usually, people can regenerate lymphatic vessels within one or three years,” Dr. Kim says. “Lymphedema improves over time.”
But the condition is bothersome for lots of patients, he says, causing discomfort and, in some cases, difficulty swallowing and even numbness if nerves were damaged during the lymph node removal. Some patients who have lymph nodes removed in the neck or armpit area experience shoulder weakness that may require intensive physical therapy, Dr. Kim says.
“Most of these complications or side effects are temporary,” he says.
If you’ve been diagnosed with a blood cancer, such as lymphoma, leukemia or multiple myeloma, and are interested in a second opinion on your diagnosis or treatment options, call us or chat online with a member of our team.
Swollen lymph nodes Information | Mount Sinai
Swollen glands; Glands – swollen; Lymph nodes – swollen; Lymphadenopathy
Lymph nodes are present throughout your body.
They are an important part of your immune system. Lymph nodes help your body recognize and fight germs, infections, and other foreign substances.
The term “swollen glands” refers to enlargement of one or more lymph nodes. The medical name for swollen lymph nodes is lymphadenopathy.
In a child, a node is considered enlarged if it is more than 1 centimeter (0.4 inch) wide.
The lymphatic system has two main functions. Its network of vessels, valves, ducts, nodes, and organs helps balance the body’s fluid by draining excess fluid, known as lymph, from the body’s tissue and returning it to the blood after filtering it.
Some types of blood cells are also made in the lymph nodes.
The lymphatic system also plays an important role in the body’s immune system.
Infection, even a trivial infection is, the most common cause of swollen lymph nodes.
Let’s look at a cut section of a lymph node to see what happens.
Afferent means towards. Afferent lymph vessels bring unfiltered fluids from the body into the lymph node where they are filtered.
Efferent vessels, meaning away from, carry the clean fluid away and back to the bloodstream where it helps form plasma.
When the body is invaded by foreign organisms, the swelling sometimes felt in the neck, armpits, groin, or tonsils comes from the microorganisms trapped inside the lymph nodes.
Eventually, these organisms are destroyed and eliminated by cells that line the node walls. Then the swelling and pain subside.
The lymphatic system filters fluid from around cells. It is an important part of the immune system.
When people refer to swollen glands in the neck, they are usually referring to swollen lymph nodes. Common areas where lymph nodes can be easily felt, especially if they are enlarged, are the groin, armpits (axilla), above the clavicle (supraclavicular), in the neck (cervical), and the back of the head just above hairline (occipital).
Swollen lymph nodes, sore throat, fatigue and headache are some of the symptoms of mononucleosis, which is caused by the Epstein-Barr virus. It is generally self-limiting and most patients can recover in 4 to 6 weeks without medicines.
The lymphatic system is a complex system of fluid drainage and transport, and immune response and disease resistance. Fluid that is forced out of the bloodstream during normal circulation is filtered through lymph nodes to remove bacteria, abnormal cells and other matter. This fluid is then transported back into the bloodstream via the lymph vessels.
Lymph only moves in one direction, toward the heart.
Lymph nodes produce immune cells to help fight infection. They also filter the lymph fluid and remove foreign material, such as bacteria and cancer cells. They can become swollen from inflammatory conditions, an abscess, cancer, and most commonly from infection. Common areas where lymph nodes can be felt include the groin, armpit, behind the ears, back of the head, sides of the neck and under the jaw and chin.
Lymph nodes play an important part in the body’s defense against infection. Swelling might occur even if the infection is trivial or not apparent. Swelling of lymph nodes generally results from localized or systemic infection, abscess formation, or malignancy.
Considerations
Common areas where the lymph nodes can be felt (with the fingers) include:
- Groin
- Armpit
- Neck (there is a chain of lymph nodes on either side of the front of the neck, both sides of the neck, and down each side of the back of the neck)
- Under the jaw and chin
- Behind the ears
- On the back of the head
Causes
Infections are the most common cause of swollen lymph nodes.
Infections that can cause them include:
- Abscessed or impacted tooth
- Ear infection
- Colds, flu, and other infections
- Swelling (inflammation) of gums (gingivitis)
- Mononucleosis
- Mouth sores
- Sexually transmitted illness (STI)
- Tonsillitis
- Tuberculosis
- Skin infections
Immune or autoimmune disorders that can cause swollen lymph nodes are:
- HIV
- Rheumatoid arthritis (RA)
Cancers that can cause swollen lymph nodes include:
- Leukemia
- Hodgkin disease
- Non-Hodgkin lymphoma
Many other cancers may also cause this problem.
Certain medicines can cause swollen lymph nodes, including:
- Seizure medicines, such as phenytoin
- Typhoid immunization
Which lymph nodes are swollen depends on the cause and the body parts involved. Swollen lymph nodes that appear suddenly and are painful are usually due to injury or infection.
Slow, painless swelling may be due to cancer or a tumor.
Home Care
Painful lymph nodes are generally a sign that your body is fighting an infection. The soreness usually goes away in a couple of days without treatment. The lymph node may not return to its normal size for several weeks.
When to Contact a Medical Professional
Contact your health care provider if:
- Your lymph nodes do not get smaller after several weeks or they continue to get larger.
- They are red and tender.
- They feel hard, irregular, or fixed in place.
- You have fever, night sweats, or unexplained weight loss.
- Any node in a child is larger than 1 centimeter (a little less than half inch) in diameter.
What to Expect at Your Office Visit
Your provider will perform a physical examination and ask about your medical history and symptoms. Examples of questions that may be asked include:
- When the swelling began
- If the swelling came on suddenly
- Whether any nodes are painful when pressed
The following tests may be done:
- Blood tests, including liver function tests, kidney function tests, and CBC with differential
- Lymph node biopsy
- Chest x-ray
- Liver-spleen scan
Treatment depends on the cause of the swollen nodes.
Tower RL, Camitta BM. Lymphadenopathy. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 517.
Winter JN. Approach to the patient with lymphadenopathy and splenomegaly. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 159.
Last reviewed on: 1/29/2022
Reviewed by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Enlargement of lymph nodes – causes, in what diseases it occurs, diagnosis and methods of treatment
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;
- neck;
- 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, chicken pox.
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.
Enlargement of lymph nodes can be a symptom of storage disease : 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 heavy load .
Also lymph nodes in rare cases increase after vaccination with on the respective side.
Which doctors should I contact with enlarged 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:
- oncologists;
- surgeon;
- TB doctors;
- infectious diseases doctors;
- endocrinologist;
- rheumatologists.
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:
- 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.
- Clinical guidelines “HIV infection in adults”. Developed by: National Association of HIV Prevention, Diagnosis and Treatment Specialists, National Virological Association. – 2020.
- Hodgkin’s Lymphoma Clinical Guidelines. Developed by: National Society of Pediatric Hematologists, Oncologists, Association of Oncologists of Russia, Russian Professional Society of Oncohematologists, National Hematological Society. – 2020.
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.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.
Cancer of the lymph nodes – the first signs and symptoms of cancer of the lymphatic system in Moscow
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