Swollen lymph nodes

Definition

Lymph nodes are found 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.

In a child, a node is considered enlarged if it is more than 1 centimeter (0.4 inch) wide.

See also: Lymphadenitis and lymphangitis

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
• Gingivitis
• Mononucleosis
• Mouth sores
• Sexually transmitted illness
• Tonsillitis
• Tuberculosis
• Skin infections

Immune or autoimmune disorders that can cause swollen lymph nodes are:

• HIV
• Rheumatoid arthritis

Cancers that can cause swollen lymph nodes include:

• Leukemia
• Hodgkin's disease
• Non-Hodgkin's lymphoma

However, many other cancers may also cause this problem.

Certain medications 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 pain 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 days, without treatment. The lymph node may not return to its normal size for several weeks.

When to Contact a Medical Professional

Call your doctor or nurse if:

• Your lymph nodes do not get smaller after several weeks or 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 1/2 inch) in diameter.

What to Expect at Your Office Visit

Your doctor or nurse will perform a physical examination and ask questions about your medical history and symptoms, such as:

• Which nodes are affected?
• Is the swelling the same on both sides?
• When did the swelling begin?
• How long has it lasted (how many months or weeks)?
• Did it begin suddenly or did it develop gradually?
• Is the swelling increasing in size?
• Are the number of nodes that are swollen increasing?
• Are any of the swollen nodes painful or tender when you gently press on them?
• Is the skin over or around the nodes red?
• Have you had any other symptoms?

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