Where are your neck lymph nodes located? What causes swollen lymph nodes? Get answers to these questions and more in this comprehensive article.

Understanding the Lymphatic System

The lymphatic system is a complex network of vessels, valves, ducts, nodes, and organs that play a crucial role in the body’s fluid balance and immune response. Its primary functions are to drain excess fluid from the body’s tissues, filter out foreign substances, and help fight infections and diseases.

Lymph Nodes and Their Locations

Lymph nodes are an essential component of the lymphatic system. They are present throughout the body, and their locations can be easily felt, especially when they are enlarged. Common areas where lymph nodes can be felt include:

• Groin
• Armpits (axilla)
• Neck (cervical chain on either side of the front, sides, and back)
• Under the jaw and chin
• Behind the ears
• On the back of the head just above the hairline (occipital)

Swollen Lymph Nodes: Causes and Symptoms

Swollen lymph nodes, also known as lymphadenopathy, are a common condition that can be caused by a variety of factors. The most common cause is a localized or systemic infection, which triggers the lymph nodes to swell as they work to fight off the invading pathogens.

Other potential causes of swollen lymph nodes include:

• Abscess formation
• Malignancy (such as cancer)
• Inflammatory conditions

In addition to swelling, other symptoms that may be present include sore throat, fatigue, and headache.

The Role of Lymph Nodes in Immune Response

Lymph nodes play a crucial role in the body’s immune response. They filter the lymph fluid that flows through them, removing bacteria, abnormal cells, and other foreign materials. Immune cells within the lymph nodes then work to destroy these threats, which can cause the nodes to swell as they engage in this process.

When the body is invaded by foreign organisms, the swelling felt in the neck, armpits, groin, or tonsils is a result of the microorganisms being trapped and filtered within the lymph nodes. Once these organisms are destroyed and eliminated, the swelling and pain will subside.

Diagnosing and Treating Swollen Lymph Nodes

If you notice swollen lymph nodes, it’s important to consult with a healthcare provider to determine the underlying cause. They may perform a physical examination, order diagnostic tests, and develop a treatment plan based on the specific condition causing the swelling.

In many cases, swollen lymph nodes are a result of a minor infection and can be managed with rest, hydration, and over-the-counter pain medication. However, if the swelling persists or is accompanied by other concerning symptoms, further medical evaluation may be necessary.

Maintaining a Healthy Lymphatic System

To support the proper functioning of the lymphatic system, it’s important to maintain a healthy lifestyle. This includes staying hydrated, engaging in regular physical activity, and practicing stress management techniques. Proper nutrition and proper sleep can also contribute to a well-functioning lymphatic system.

If you have any concerns about your lymphatic system or swollen lymph nodes, it’s always best to consult with a healthcare professional for personalized medical advice.

Frequently Asked Questions

What are the main functions of the lymphatic system? The lymphatic system has two primary functions: it helps balance the body’s fluid by draining excess fluid, known as lymph, from the body’s tissues and returning it to the bloodstream, and it plays a crucial role in the body’s immune system by producing immune cells and filtering out harmful substances.

How do lymph nodes work to fight infection? Lymph nodes filter the lymph fluid that flows through them, trapping bacteria, abnormal cells, and other foreign materials. Immune cells within the lymph nodes then work to destroy these threats, which can cause the nodes to swell as they engage in this process.

What are the common areas where lymph nodes can be felt? The common areas where lymph nodes can be easily felt, especially if they are enlarged, include the groin, armpits (axilla), above the clavicle (supraclavicular), in the neck (cervical), and the back of the head just above the hairline (occipital).

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.

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.

Causes of Swollen and Painful Cervical Lymph Nodes and How to Manage Them

Find out why your cervical lymph node can be swollen and painful and what are the possible causes of this condition. Get to know the symptoms, diagnosis, and treatment for various conditions associated with cervical lymph node enlargement and disease.

The cervical lymph nodes are part of the body’s immune system and play an important role in fighting infections. They are located in different parts of the neck and can sometimes grow and cause pain. The causes of enlargement and pain of the cervical lymph node can be varied and require careful attention and diagnosis.

One of the most common causes of cervical lymph node enlargement and pain is infectious diseases. Viruses and bacteria can enter the body through the respiratory tract or skin, causing inflammation of the lymph nodes. For example, colds, flu, sore throats, infections of the teeth or gums can lead to an enlarged and painful cervical lymph node. In such cases, the lymph node may be painful to the touch and enlarged in size.

Another reason for the enlargement and pain of the cervical lymph node can be cancer. Cancerous tumors located in the head and neck area can cause swollen lymph nodes. For example, laryngeal cancer, thyroid cancer, oral cancer, or cervical cancer can cause the cervical lymph node to become enlarged and painful. In such cases, swollen lymph nodes may be accompanied by other symptoms, such as weight loss, weakness, or a change in voice.

If you have enlargement and pain in the cervical lymph node, it is important to see a doctor to diagnose and determine the cause. Depending on the diagnosis found, the doctor may prescribe the appropriate treatment. In the case of an infectious disease, antibiotics or antiviral drugs may be required. If cancer is found, chemotherapy, radiation therapy, or surgery may be required.

In any case, it is important not to ignore the enlargement and pain of the cervical lymph node and seek medical help. Seeing a doctor early can help identify and treat the condition early, increasing the chances of a full recovery.

What is a cervical lymph node?

Neck lymph nodes are small oval glands found in the neck that play an important role in the body’s immune system. They are part of the lymphatic system, which helps the body fight infection and disease.

Lymph nodes contain lymph, a clear fluid that carries white blood cells known as lymphocytes. The lymph nodes filter the lymph, trapping and destroying bacteria, viruses, and other infectious agents. They also help control and regulate inflammation in the body.

Cervical lymph nodes are located in different parts of the neck and can be felt on palpation. They can grow in size and cause discomfort or pain, especially if they become inflamed or infected. An enlarged cervical lymph node can be a sign of a variety of conditions, including infections, cancer, and autoimmune diseases.

Description and function of the lymph node in the cervical region

Lymph nodes in the cervical region are small organs of the lymphatic system that are located around the neck. They are bean-shaped and can be felt on palpation.

The main function of the lymph nodes in the cervical region is to filter the lymph, which is a fluid containing proteins, cells and other substances. The lymphatic system plays an important role in the body’s immune response, protecting it from infection and disease.

Lymph nodes in the neck are key to fighting infections because they contain lymphocytes, the cells responsible for destroying pathogens. When an infection occurs in the body, the lymph nodes can increase in size and become painful, which indicates the activation of the immune system.

In addition, the lymph nodes in the cervical region also play a role in the drainage of lymph from the head and neck. They help remove excess fluid, waste and toxins from the body.

Causes of an enlarged cervical lymph node

Cervical lymph nodes are small organs that are located in the neck and are part of the lymphatic system. They play an important role in protecting the body from infections and diseases. However, sometimes cervical lymph nodes can increase in size, which can be a sign of various problems.

One of the causes of an enlarged cervical lymph node may be an infection. In the event of an infection, the lymph nodes become active and produce more white blood cells to fight the infection. This can lead to their enlargement and pain. Some of the most common infections that can cause swollen lymph nodes in the neck include respiratory infections, influenza, sore throats, tonsillitis, and others.

Cancer can be another reason for an enlarged cervical lymph node. Cancer cells can enter the lymphatic system and cause swollen lymph nodes. In this case, swollen lymph nodes may be accompanied by other symptoms such as weight loss, fatigue, and changes in the appearance of the skin.

Also, lymph nodes in the neck may become enlarged due to an allergic reaction. With allergies, the immune system can react to certain substances, causing inflammation and swollen lymph nodes. It can be caused by pollen, dust, food or other allergens.

If a cervical lymph node is enlarged and painful, see a doctor to diagnose and determine the cause of the enlargement. Depending on the cause, your doctor may prescribe treatment, which may include antibiotics, antivirals, antihistamines, or other medications.

Infectious diseases as a cause of swollen lymph nodes

Swollen cervical lymph nodes can be caused by various causes, including infectious diseases. Lymph nodes are part of the body’s immune system and play an important role in protecting against infections.

When infectious agents such as bacteria, viruses or fungi enter the body, the lymph nodes become activated and produce cells that help fight the infection. This can lead to their enlargement and pain.

Various infectious diseases can cause swollen lymph nodes in the neck. Some of these include respiratory infections such as colds, flu, or sore throats. Other causes may be due to an infection in the head and neck area, such as a tooth or ear infection.

If you have swollen and painful lymph nodes in your neck, it is important to see a doctor to diagnose and determine the cause. In some cases, the infection may need to be treated to reduce swollen lymph nodes and relieve symptoms.

Inflammation of the cervical lymph node in dental problems

Inflammation of the cervical lymph node may be one of the symptoms of dental problems. Lymph nodes in the neck are part of the lymphatic system, which plays an important role in protecting the body from infection and disease. When dental problems occur, such as cavities, periodontitis, or abscesses, bacteria can invade the surrounding tissues and cause the lymph nodes to become inflamed.

One of the signs of inflammation of the cervical lymph node with dental problems is pain when touching the node or chewing food. The knot may also increase in size and become more visible to the touch. In addition, swelling and redness around the node may occur.

To cope with inflammation of the cervical lymph node in case of dental problems, it is necessary to consult a dentist. Your doctor will examine your mouth and may order additional tests, such as x-rays or tests. Depending on the diagnosis, dental problems may need to be treated, such as tooth extraction or caries treatment.

In addition, cold compresses can be applied to the area of ​​the cervical lymph node to relieve pain and inflammation. Your doctor may also recommend taking anti-inflammatory drugs or prescribing antibiotics if you have an infection. It is important to follow the doctor’s recommendations and, if necessary, undergo a full treatment of dental problems in order to prevent re-inflammation of the lymph nodes.

Cancers and enlargement of the cervical lymph node

The cervical lymph nodes can increase in size as a result of various diseases, including cancer. An enlarged cervical lymph node can be one of the first signs of cancer, so it’s important to see a doctor if you find one.

Cancers that can lead to cervical lymph node enlargement include cancer of the larynx, thyroid cancer, cancer of the lymphatic system (lymphoma), and metastases of cancer from other organs. Enlarged lymph nodes in the neck may be the result of the spread of cancer cells from the primary tumor.

If a cervical lymph node is enlarged, which is not associated with infection or other understandable reasons, you should consult a doctor for diagnosis and clarification of the cause. Your doctor may order additional tests, including a lymph node biopsy or other imaging modalities, to determine if a lymph node enlargement is related to cancer.

If cancer is found, the doctor will recommend the most appropriate treatment depending on the type and stage of the cancer. Treatment may include surgical removal of the tumor, radiation therapy, chemotherapy, or immunotherapy. Early detection and treatment of cancer increases the chances of recovery and improves the prognosis of the disease.

Causes of pain in the cervical lymph node

Pain in the cervical lymph node can be caused by various reasons. One of the main causes is inflammation of the lymph node, which can be caused by infectious diseases. For example, inflammation of the pharynx, sinusitis, tonsillitis, scarlet fever, colds and other infections of the upper respiratory tract can lead to pain in the cervical lymph node.

Also, sexually transmitted diseases such as chlamydia, gonorrhea, syphilis can cause inflammation of the lymph nodes in the neck. This is because the lymph nodes are part of the immune system and respond to infections by fighting them.

In some cases, pain in the cervical lymph node can be caused by cancer, such as throat cancer or thyroid cancer. Cancer cells can spread through the lymphatic system and cause swollen lymph nodes in the neck.

Other possible causes of cervical lymph node pain include an allergic reaction, a reaction to a vaccine, trauma, and rare diseases such as sarcoidosis or tuberculosis.

Inflammation and diseases as a cause of pain in the cervical lymph node

Pain in the cervical lymph node can be caused by various reasons, but one of the most common is inflammation and various diseases. Lymph nodes are part of the immune system and play an important role in fighting infections and other harmful substances that may enter the body.

When the body becomes inflamed or diseased, the lymph nodes may enlarge and become painful to the touch. This is due to the activation of the immune system and increased work of the lymph nodes to fight infection or disease. Soreness can be felt when pressing on the lymph node or when moving the neck.

Some of the diseases that can cause neck pain include viral or bacterial infections such as influenza, SARS, tonsillitis, and mononucleosis. Also, pain in the cervical lymph node can be associated with various tumors and cancers that can spread through the lymphatic system.

If you are experiencing cervical lymph node pain, it is important to see a doctor to diagnose and determine the cause of the pain. The doctor may do a physical exam, ask questions about symptoms, and order additional tests, such as blood tests or an ultrasound, to determine the cause of the pain and prescribe appropriate treatment.

Injuries and damage to the cervical lymph node

The cervical lymph node may enlarge and become painful as a result of injury or damage. Injuries to the cervical lymph node can be caused by a variety of factors, including:

• Bruises or blows to the neck;
• Injuries or strains of the neck muscles;
• Tears or sprains in the neck;
• Neck surgeries or procedures.

Trauma and damage to the cervical lymph node can cause it to become inflamed and enlarged. This may be accompanied by soreness, swelling and redness in the area of ​​the lymph node.

If you have an injury or damage to your cervical lymph node, it is recommended that you see a doctor to assess the condition and prescribe appropriate treatment. Depending on the severity of the injury, a neck brace, topical pain medication, or physical therapy may be required to speed up recovery.

Pain in oncological diseases

Pain is one of the main symptoms of oncological diseases. They can occur in different parts of the body, including the cervical lymph node. The pain can be of different intensity and character, from viscous and dull to sharp and stabbing.

In oncological diseases, pain in the cervical lymph node can be caused by several factors. First, cancer cells can enter the lymphatic system and cause inflammation and swollen lymph nodes. This can lead to neck pain.

In addition, cancerous tumors can put pressure on nerve endings, which can also cause pain. This is especially true for tumors located near the cervical lymph node.

Seeing a doctor is important to manage the pain of cancer. He will conduct a detailed examination and determine the cause of the pain. Depending on the diagnosis, the doctor may prescribe treatment aimed at eliminating the underlying disease or relieving pain.

Various methods can be used to relieve pain in the cervical lymph node, including the use of pain medications, physical therapy, massage, and combination therapy. It is important to remember that self-medication can be dangerous, so you should follow the doctor’s recommendations and consult with him before starting treatment.

Question-answer:

Why can a cervical lymph node enlarge and hurt?

The cervical lymph node can become enlarged and painful for various reasons. One of the most common causes is inflammation in the mouth, throat, or head. It may also be associated with infectious diseases such as SARS, influenza or chicken pox. Enlargement and soreness of the lymph node can also be signs of cancer. If you have an increase and soreness of the cervical lymph node, it is recommended to consult a doctor for diagnosis and appropriate treatment.

What symptoms may accompany the enlargement and pain of the cervical lymph node?

Swelling and tenderness of the cervical lymph node may be accompanied by various symptoms, depending on the cause. In case of inflammation in the mouth or throat, pain when swallowing, fever, swelling and redness around the lymph node may occur. With infectious diseases, such as SARS or influenza, weakness, headache, runny nose and cough may appear. Cancer patients may experience prolonged pain, weight loss, fatigue, and changes in appetite. If you have similar symptoms, it is recommended to see a doctor for diagnosis and treatment.

How is the enlargement and tenderness of the cervical lymph node diagnosed?

Diagnosis of enlargement and tenderness of the cervical lymph node includes several stages. The doctor examines and palpates the lymph node to determine its size, texture, and tenderness. To clarify the diagnosis, additional studies may be prescribed, such as blood tests, ultrasound, or a biopsy of the lymph node. Depending on the results of the diagnosis, appropriate treatment will be prescribed.

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Everything you need to know about swollen neck lymph nodes

Introduction:

Lymph nodes are small bean-sized glands that filter the lymph that circulates through the lymphatic system. They contain white blood cells that are responsible for the immune system of the body. Therefore, the lymph nodes are an important part of the immune system. In fact, these glands trap invading microorganisms to prevent them from infecting other parts of the body. These nodes may swell as a result of infections caused by bacteria or viruses, and rarely as a result of tumors. Lymph nodes are located throughout the body, mainly on the neck, in the armpits and in the inguinal fold. They may enlarge in response to infections in the areas where they are located.

In this article, we will focus on the description of cervical lymph node enlargement or cervical lymphadenopathy, which is considered one of the most common lymphadenitis.

Anatomical overview

Lymph nodes collect and filter fluids, waste products, and potentially harmful pathogens. There are hundreds of lymph nodes in the human body. The following are the lymph nodes that people can see or feel:

• Submandibular
• Neck
• Axillary
• Groin

Lymph fluid circulates throughout the body, entering and leaving the lymph nodes before returning to the chest. At the same time, the lymph nodes trap and neutralize dangerous pathogens (microbes, viruses, and waste products of the body). The lymph nodes filter the fluid and return it to the bloodstream along with essential salts and proteins.

Lymph nodes also contain immune cells that help fight disease by destroying bacteria that have accumulated in the body’s lymphatic fluid. When a person becomes ill with an acute infection, the lymph nodes may swell. The swelling is caused by the activation of immune cells in the lymph nodes.

The location of the swelling is often associated with the affected area. An ear infection, for example, can lead to swollen lymph nodes in the ear, and an upper respiratory infection can lead to swollen lymph nodes in the neck.

Cervical lymph node (N) classification

Level IA: Submental region

These lymph nodes are located within the triangle formed by the anterior belly of the digastric muscles (on both sides) and the hyoid bone on the underside.

Level IB: Submandibular region

These nodes are located within the triangle formed by the anterior and posterior bellies of the digastric muscle on the lower side and the mandibular body on the upper side. It should be emphasized that when the LN is excised at this level, the submandibular gland must be included in the resected material.

Level IIA and IIB: Superior jugular group

These are the lymph nodes that surround the superior part of the internal jugular vein (IJV). They expand from the base of the skull upward to the level of the lower edge of the hyoid bone downward. In front, it borders on the lateral edges of the sternohyoid and stylohyoid muscles. Behind, they are limited by the posterior edge of the sternocleidomastoid muscle.

Level IIA LNs are located anterior to the vertical plane of the spinal accessory nerve, while level IIB LNs are located posterior to this plane. The vertical plane in the posterior submandibular gland radiographically separates the level IB and level IIA LNs.

Level III: Middle jugular group

These lymph nodes are located in the middle third of the VJV and extend from the lower edge of the hyoid bone above to the lower edge of the cricoid cartilage below. The anterior border is also represented by the lateral border of the sternohyoid muscle, and the posterior border is represented by the posterior border of the sternocleidomastoid muscle. This category includes the jugular-hyoid LN.

Level IV: Inferior jugular group

These LNs run from the lower edge of the cricoid cartilage to the clavicle and are located around the lower third of the VJV. This group borders anteriorly on the lateral border of the sternohyoid muscle and posteriorly on the posterior edge of the sternocleidomastoid muscle. It should be noted that the Virchow lymph node falls into this category.

Levels VA and VB: Posterior triangle group

The upper limit of this group is defined by the convergence of the trapezius and sternocleidomastoid muscles, and the lower limit is formed by the clavicle. The anterior border is defined by the posterior border of the sternocleidomastoid muscle, and the posterior border is formed by the anterior border of the trapezius muscle.

The VA and VB lymph nodes are separated by an imaginary horizontal plane that marks the inferior border of the cricoid cartilage. VA nodes contain spinal accessory nodes, while VB nodes include nodes around the transverse cervical vessels and supraclavicular nodes.

Level VI: Central Sector Group

This level contains the pretracheal, paratracheal, precricoid (Delphic), and perithyroid nodes (including the nodes located along the recurrent laryngeal nerves). This region extends from the hyoid bone above to the suprasternal notch below. Laterally, it is bounded by the common carotid arteries (CCA).

Pathophysiology

Lymph nodes are part of the reticuloendothelial system, which also includes blood monocytes, connective tissue macrophages, thymus, spleen, bone marrow, bones, lymphoid tissue associated with the mucous membrane of the internal organs, lymphatic veins and lymphatic fluid located in the inter static fluid.

Lymph fluid circulates throughout the lymphatic system, passing from the organs through the lymph capillaries, lymph arteries, and eventually the lymph nodes to filter foreign agents. Foreign substances are absorbed by lymphoid cells, causing them to proliferate and expand. Cellular growth in lymphoid follicles can be seen under the microscope as multiple mitotic figures. Patients may develop local tenderness as the lymph nodes expand as a result of the increased load.

B cell development begins with bone marrow pluripotent stem cells. B cells that efficiently construct their immunoglobulin heavy chains move to germinal centers, providing antibody diversity through somatic hypermutation. B-cell lymphomas are thought to be caused by somatic hypermutation changes and chromosomal translocations.

T cell development also begins with pluripotent stem cells that mature in the thymus cortex. T cells initiate certain rearrangements in the T cell receptor while in the thymus cortex. It is believed that T cell lymphogenesis is caused by chromosomal translocations at the level of T cell receptors.

Lymph node follicle necrosis can develop as a result of various diseases, including inflammatory, infectious, and malignant diseases. A predominance of neutrophilic infiltrates indicates a bacterial disease, while a predominance of lymphocytic infiltrates may indicate a viral infection. However, physicians should keep in mind that the etiology of lymph node enlargement varies; lymphomas, leukemias, tuberculosis, or even systemic lupus may be an appropriate diagnosis in certain clinical settings.

What causes swollen lymph nodes in the neck?

Swollen lymph nodes in the neck are usually a sign that your immune system is fighting to protect your body from illness caused by a foreign agent such as a virus, parasite, or bacterium. Swollen cervical lymph nodes are usually caused by conditions that affect organs near the neck, such as an infected tooth, colds, flu, tonsillitis, ear or throat infections, angina, and cellulitis.

Various conditions can cause swollen lymph nodes in the neck:

Viral infections:

The most common cause is:

• Viral infection of the upper respiratory tract, such as a cold or flu
• Human immunodeficiency virus: HIV
• Herpes simplex virus
• Adenovirus
• Epstein Barr virus mononucleosis
• Cytomegalovirus

Bacterial infections:

• Streptococcal infection of the oropharynx due to streptococcus
• Tuberculosis
• Staphylococcus
• Syphilis (sexually transmitted infection)
• Cat scratch disease

Parasitic infections:

• Toxoplasmosis
• Leishmaniasis

More serious conditions can also lead to swollen lymph nodes throughout the body.

Autoimmune diseases:

• Systemic lupus erythematosus
• Rheumatoid arthritis

Cancers:

Swollen lymph nodes in the neck can sometimes be a sign of cancer that has spread to the lymph glands:

• Non-Hodgkin’s lymphoma
• Leukemia
• Lung cancer
• Metastatic cancer

Cancer is suspected if an enlarged cervical lymph node does not decrease permanently or enlarges over time, is painless, and has difficulty moving. A competent doctor will help to make the correct diagnosis.

Sometimes some medications can cause swollen lymph nodes in the neck, including immunization against typhoid fever.

What are the symptoms of enlarged neck lymph nodes?

Symptoms are widely varied and often associated with the underlying disease causing enlargement of the cervical lymph nodes:

• Localized pain
• High temperature
• Increased swelling
• Temperature increase in affected area
• Weakness
• Difficulty swallowing, breathing or moving
• Night sweats
• Fatigue

All aspects of a complete history and a thorough physical examination must be kept in mind at all times. It is necessary to pay attention to the following history events:

1. Case history: location, pain – if yes, intensity, quality, onset, provoking factors, mitigating factors
2. Medical history: It is critical to understand the patient’s past medical history as this may provide insight into the cause of the lymphadenopathy (eg, HIV/AIDS, distant history of non-Hodgkin’s lymphoma).
3. Drugs: Some drugs may cause reversible lymphadenopathy (eg, cephalosporins, phenytoin)
4. Social history : Important to understand living conditions, toxic exposure, alcohol, cigarette and recreational drug use, pet ownership, contact with animals, and recent travel.
5. Sexual history: Need to know the number of sexual partners, whether they are sexually active with men, women, or both; use of protective equipment, history of sexually transmitted infections, and partners who knew about sexually transmitted diseases.
6. Surgical history: Find out what procedures were performed and when they occurred, and how quickly the lymphadenopathy (i.e., postoperative lymphadenopathy) developed
7. Family history: It is very important to determine if there is a family history of cancer.

Physical examination includes the following:

1. Vital signs: Temperature, blood pressure, heart rate, respiratory rate, and oxygen saturation are important in determining whether a patient is hemodynamically stable. This can help distinguish sepsis from other illnesses.
2. A complete physical examination is required , including examination of the head, ears, nose, throat, and thyroid gland. Auscultation of the lungs and heart, as well as palpation for splenomegaly and hepatomegaly. A thorough examination of the skin, including palpation where necessary, should be performed to look for rashes, lesions, and nodules.
3. When palpating lymphadenopathy, be aware of location, size, stiffness, and discomfort.

Location:

• The sternocleidomastoid muscle is located above and below the anterior cervical lymph nodes. Lymph nodes in the posterior cervical region are located behind the sternocleidomastoid muscle.
• In addition, check bilaterally for supraclavicular, axillary, and inguinal lymphadenopathy.
• Local lymphadenopathy means more limited disease than extensive lymphadenopathy.

1. Size:

• Cervical and axillary lymph nodes are normally rarely larger than 1 cm; supraclavicular nodes are rarely larger than 0.5 cm, and inguinal nodes are rarely larger than 1.5 cm.

2. Hardness:

• In general, a mobile lymph node is less likely to be malignant.

3. Pain:

• Pain may be a sign of inflammation or an acute reaction to an infection, but is rare in malignant processes.

However, sometimes an enlarged lymph node in the neck can also be asymptomatic with no symptoms other than swelling.

How is an enlarged cervical lymph node diagnosed?

In addition to the medical history and an accurate physical examination, the doctor will evaluate the characteristics of the node:

• Its size is
• Its consistency is
• Soreness
• Cohesion with surrounding tissues
• Form
• Softness
• Temperature
• Texture

You must disclose all the details to your doctor in order to get the best results: Have you recently been scratched by a cat or dog? Do you eat undercooked meat? Have you traveled recently? Have you had risky sexual behavior? An honest answer to all these questions is an important step in quickly determining the correct diagnosis. Also, some additional tests may be needed to help determine the cause:

• Blood tests: help assess your general health and detect some hidden diseases
• Imaging studies: e. g. x-ray and ultrasound scans to help detect tumors or sources of infection
• Biopsy: a biopsy may be required to confirm or exclude the diagnosis. It involves making a small incision and taking a small sample from a swollen lymph node in the neck for microscopic examination in a laboratory.

How to detect an enlarged cervical lymph node?

You can find a swollen lymph node in your neck yourself.

Here are some simple and easy steps you can follow:

1. Feel the lymph node by rubbing in a circular motion with your fingertips
2. Gently press on the neck
3. Compare lymph nodes on both sides of the neck

If you have an enlarged lymph node, you can easily find it because the swollen lymph nodes in your neck feel larger than usual, soft to the touch, sometimes sore and warm, which are signs of inflammation. You may also feel pain when making sudden movements. Some common symptoms can bring out these swollen nodes.

How often should we check the lymph nodes in the neck?

It is recommended to check the lymph nodes once a month to detect asymptomatic enlarged lymph nodes in the neck at an early stage.

Treatment of enlarged lymph nodes

There is no special kit for the treatment of enlarged lymph nodes in the neck. It all depends on the underlying cause. If a swollen cervical lymph node is not a serious disease, then it will disappear on its own in a few days even without any treatment. You can take certain medications to relieve certain symptoms, such as fever and pain relievers, if necessary. Don’t forget to rest well, it can help.

If a swollen cervical lymph node is caused by a bacterial or viral infection, your doctor will prescribe antibiotics or antivirals to treat it. When the infectious agent is eliminated, the enlarged lymph node returns to its normal size.

When the cause of a swollen cervical lymph node is a tumor, your doctor will decide the best treatment for you by removing the entire node using radiation therapy, chemotherapy, or a combination of treatments.

Complications of swollen cervical lymph nodes

As already explained, a swollen cervical lymph node may be a normal response of the body to disease.

In many cases, it usually decreases on its own within a few weeks. However, the neck node can remain enlarged even after the disease has been treated, and this chronically swollen lymph node in the neck leads to a number of complications. These complications depend on the cause of the swollen cervical lymph node.

For example, if the cause is infectious and the cervical lymphadenopathy is left untreated, an abscess, which is a collection of pus under the skin, can develop, which can become a serious problem requiring surgical treatment. Otherwise, a neglected inflamed lymph node in the neck can spread the infection into the bloodstream, causing septicemia, which is a life-threatening condition.

Differential Diagnosis

Due to the variety of causes of lymphadenopathy, doctors often face diagnostic difficulties. To eliminate confusion and improve diagnostic accuracy, collect a complete history and physical findings, develop a set of differential diagnoses, and categorize them based on their presentation.

Causes of lymphadenopathy:

• Malignant: Lymphadenopathy may be alarming in diagnoses such as metastatic breast cancer, Kaposi’s sarcoma, leukemia, lymphoma, metastatic disease (eg, gastric cancer), and skin malignancies if history and physicist physical examination are the same.
• Autoimmune: Certain immune-mediated diseases such as dermatomyositis, Kawasaki disease, rheumatoid arthritis, sarcoidosis, Sjögren’s syndrome, Still’s disease, and systemic lupus erythematosus can cause lymph node abnormalities.
• Infectious: Various infections can cause benign changes in the lymph nodes. Many types of infections, such as bacterial, viral, and others, may be considered by healthcare professionals:

1. Bacterial diseases include brucellosis, cat-scratch disease, bacterial pharyngitis, syphilis, tuberculosis, tularemia, and typhoid fever.
2. Cytomegalovirus, hepatitis, herpes simplex, HIV, mononucleosis, rubella, viral pharyngitis are all viral infections.

• Drugs: Drug treatment can often cause benign lymph node enlargement. Allopurinol, atenolol, captopril, carbamazepine, cephalosporins, gold preparations, hydralazine, penicillin, phenytoin, primidone, pyrimethamine, quinidine, sulfonamides and sulindac are examples of these drugs

When should you see a doctor if you have an enlarged lymph node in your neck?

It’s time to seek medical help if:

• Nodules suddenly swollen for no apparent reason
• Nodules remain enlarged for more than two weeks
• You have difficulty breathing or swallowing
• You have a persistent high fever and night sweats
• You have unexplained weight loss or loss of appetite
• Swollen neck lymph node gets larger over time
• Swollen lymph node painful or difficult to move

If you notice one or more of these symptoms, contact your doctor as soon as possible. You can start by visiting your primary care physician, who will be able to diagnose your problems by discussing your symptoms, performing a physical examination and possibly some biological tests to evaluate your case and either prescribe treatment or refer you to a specialist (hematologist, infectious disease specialist, oncologist, or surgeon), depending on the cause of the enlarged cervical lymph node.

Prognosis

• Swollen lymph nodes in young people (eg children) are often benign and associated with infection. There are a few exceptions to the norm, especially if the patient’s history and physical findings suggest persistent infection, cancer, or autoimmune disorders.
• Other risk factors that may be poor prognostic indicators include older age, duration of lymphadenopathy (> 4 weeks), widespread lymphadenopathy, male gender, no reduction in node size, and systemic signs such as fever, night sweats, weight loss, and hepatosplenomegaly.

Swollen lymph node prevention

The only way to avoid swollen lymph nodes is to avoid situations that can lead to them. Here are some things you can do:

• Maintain good oral hygiene to keep your teeth and gums healthy.
• Wash your hands often.
• Get immunized against diseases such as shingles, tuberculosis, and influenza.
• Avoid sharing food, drink, or personal items such as towels with someone who has an infectious virus-like illness or a cold.
• Use condoms or other barrier methods during intercourse.
• If you have an adverse or allergic reaction to medicines, talk to your doctor.
• Do not let your indoor cats play outside and do not let them come into contact with feral cats.

To summarize:

Swollen cervical lymph nodes is one of the most common lymphadenitis. They usually appear as a reaction of the body to various conditions, such as an infection. It is a symptom, not a disease. Enlarged lymph nodes in the neck tend to disappear spontaneously within a short period of time and without any treatment.