Swollen Lymph Nodes
Swollen lymph nodes, medically known as lymphadenopathy, occur when these small immune system structures enlarge in response to infection, inflammation, or other conditions. While usually a sign that your immune system is working properly, persistently swollen or unusually large lymph nodes can indicate serious conditions requiring medical evaluation.
Quick Facts
- Part of immune system
- Usually from infection
- 600+ nodes in body
- Can indicate cancer
- Often self-limiting
⚠️ Seek Immediate Medical Care For:
- Rapidly enlarging lymph nodes over days
- Very hard, fixed, or matted lymph nodes
- Lymph nodes larger than 2 cm (about 1 inch)
- Swollen nodes with difficulty breathing or swallowing
- Lymph node swelling with high fever and severe illness
- Red, warm, or very painful lymph nodes
- Swollen nodes with unexplained weight loss
- Night sweats with swollen lymph nodes
- Swelling above the collarbone (supraclavicular nodes)
- Generalized lymph node swelling throughout body
- Lymph nodes that don't shrink after 2-4 weeks
These symptoms may indicate lymphoma, metastatic cancer, severe infection, or other serious conditions requiring urgent evaluation.
Understanding Lymph Nodes
Lymph nodes are small, bean-shaped structures that are part of your body's lymphatic system. They act as filters, trapping viruses, bacteria, and other causes of illness before they can spread to other parts of your body. When they detect these invaders, lymph nodes produce more white blood cells to fight the infection, causing them to swell.
You have hundreds of lymph nodes throughout your body, but you can only feel them in certain areas where they're close to the skin surface. The most common locations include the neck, under the jaw, behind the ears, in the armpits, and in the groin. Each group of nodes drains a specific body region, so their location often provides clues about the underlying cause.
Normal lymph nodes are usually less than 1 cm in size (about the size of a pea), moveable, and not painful. When they become swollen, they may feel like firm, round, or oval lumps under the skin. The characteristics of swollen nodes - their size, consistency, mobility, and associated symptoms - help determine whether the swelling is due to a benign condition or something more serious.
Common Lymph Node Locations
Head and Neck
- Behind ears (postauricular)
- Base of skull (occipital)
- Under jaw (submandibular)
- Under chin (submental)
- Side of neck (cervical)
- Above collarbone (supraclavicular)
Upper Body
- Armpits (axillary)
- Above elbow (epitrochlear)
- Chest (mediastinal - internal)
- Around lungs (hilar - internal)
- Behind breastbone
- Under arms
Lower Body
- Groin (inguinal)
- Behind knee (popliteal)
- Deep abdomen (internal)
- Along blood vessels
- Pelvis (internal)
- Along spine (paraaortic)
What Location Tells Us
- Neck: Head/throat infections
- Armpit: Arm/breast issues
- Groin: Leg/genital problems
- Generalized: Systemic disease
- Supraclavicular: Often serious
- One area: Local problem
Common Causes
Infections (Most Common)
- Upper respiratory infections: Colds, flu, strep throat
- Ear infections: Cause swelling behind ears
- Dental infections: Jaw and neck node swelling
- Skin infections: Cellulitis, abscesses
- Mononucleosis: "Mono" causes widespread swelling
- HIV: Persistent generalized lymphadenopathy
- Tuberculosis: Often neck nodes
- Cat scratch disease: From cat scratches/bites
- Sexually transmitted infections: Cause groin swelling
- Toxoplasmosis: From undercooked meat or cats
Cancers
- Lymphoma: Cancer of lymph system (Hodgkin's and non-Hodgkin's)
- Leukemia: Blood cancer affecting nodes
- Metastatic cancer: Spread from other organs
- Head and neck cancers: Cause neck node swelling
- Breast cancer: May spread to armpit nodes
- Lung cancer: Can cause chest/neck node swelling
- Melanoma: May spread to nearby nodes
- Thyroid cancer: Neck node involvement
Immune System Disorders
- Lupus: Autoimmune disease
- Rheumatoid arthritis: Can cause node swelling
- Sjögren's syndrome: Affects salivary glands and nodes
- Sarcoidosis: Inflammatory disease
- Kawasaki disease: In children
Other Causes
- Medications: Phenytoin, allopurinol, some antibiotics
- Vaccinations: Temporary swelling after vaccines
- Stress: Can affect immune system
- Storage diseases: Gaucher's, Niemann-Pick
- Hyperthyroidism: Can cause node enlargement
Node Characteristics and What They Mean
Size
- <1 cm: Usually normal
- 1-2 cm: Reactive, monitor
- >2 cm: Needs evaluation
- >3 cm: Higher cancer risk
- Rapidly growing: Concerning
- Slowly growing: Less urgent
Consistency
- Soft: Often infection
- Firm: Various causes
- Hard: More concerning
- Rock-hard: Cancer risk
- Rubbery: Lymphoma possible
- Fluctuant: Abscess
Mobility
- Mobile: Usually benign
- Fixed: More concerning
- Matted together: Serious
- Attached to skin: Evaluate
- Freely moveable: Reassuring
- Tethered: Needs imaging
Other Features
- Tender: Often infection
- Painless: Various causes
- Warm: Active infection
- Red skin: Infected node
- Draining: Abscess
- Multiple areas: Systemic
Associated Symptoms
Swollen lymph nodes often occur with other symptoms that help identify the cause:
- Fever: Suggests infection or lymphoma
- Fatigue: Common with many causes
- Sore throat: Upper respiratory infection
- Night sweats: Concerning for lymphoma or TB
- Weight loss: Unexplained loss is worrisome
- Rash: Viral infections, lupus
- Joint pain: Autoimmune conditions
- Cough: Lung infection or cancer
- Itching: Sometimes with lymphoma
- Difficulty swallowing: Large neck nodes
- Runny nose: Upper respiratory infection
- Ear pain: Ear infection
- Toothache: Dental abscess
Red Flag Symptoms
Features Suggesting Serious Disease
- Nodes larger than 2 cm
- Supraclavicular node swelling (above collarbone)
- Hard, fixed, non-tender nodes
- Nodes that continue growing
- Swelling lasting more than 2-4 weeks
- Generalized lymphadenopathy (multiple regions)
- Associated B symptoms (fever, night sweats, weight loss)
- Skin over node is red or ulcerated
- Node swelling without obvious infection
- History of cancer
- Age over 40 with new lymphadenopathy
Concerning Patterns
- Virchow's node: Left supraclavicular, suggests abdominal cancer
- Sister Mary Joseph node: Umbilical, indicates abdominal cancer
- Epitrochlear nodes: Above elbow, unusual location
- Generalized swelling: Multiple areas affected
Diagnosis and Evaluation
Medical History
- Duration of swelling
- Rate of growth
- Associated symptoms
- Recent infections
- Travel history
- Animal exposure
- Sexual history
- Medications
- Previous cancers
- Family history
Physical Examination
- Size measurement
- Consistency assessment
- Mobility testing
- Skin examination
- Check all node regions
- Spleen and liver exam
- ENT examination
Diagnostic Tests
- Blood tests: CBC, inflammatory markers, specific infections
- Imaging: Ultrasound, CT, or PET scan
- Fine needle aspiration: Sample cells for analysis
- Core needle biopsy: Larger tissue sample
- Excisional biopsy: Remove entire node
- Flow cytometry: For lymphoma diagnosis
- Cultures: For infections
- TB testing: If suspected
Treatment Approaches
Observation
- Small, mobile nodes
- Recent infection
- No concerning features
- Re-check in 2-4 weeks
- Monitor size changes
- Watch for new symptoms
Medical Treatment
- Antibiotics for bacterial infections
- Antivirals if indicated
- Anti-inflammatory drugs
- Steroids for some conditions
- Treatment of underlying disease
- Pain management
Cancer Treatment
- Chemotherapy
- Radiation therapy
- Immunotherapy
- Surgery
- Stem cell transplant
- Targeted therapy
Supportive Care
- Warm compresses
- Rest
- Good hydration
- Pain relief
- Avoid irritation
- Monitor changes
Self-Care and Management
Home Care for Benign Swelling
- Apply warm compresses several times daily
- Take over-the-counter pain relievers as directed
- Get adequate rest to support immune function
- Stay well hydrated
- Avoid touching or squeezing nodes
- Complete prescribed antibiotics
- Practice good hygiene
Monitoring Guidelines
- Measure node size (use ruler)
- Note any changes in consistency
- Track associated symptoms
- Document duration of swelling
- Photo documentation can help
- Keep symptom diary
Prevention Strategies
- Infection prevention: Hand hygiene, avoid sick contacts
- Vaccinations: Stay up to date on immunizations
- Safe practices: Safe sex, avoid sharing personal items
- Dental hygiene: Prevent tooth and gum infections
- Wound care: Clean cuts properly to prevent infection
- Pet safety: Avoid cat scratches, handle carefully
- Food safety: Cook meat thoroughly, wash produce
- Tick prevention: Use repellent in wooded areas
- Regular check-ups: Early cancer detection
- Know your body: Regular self-examination
- Manage chronic conditions: Keep immune system healthy
- Avoid tobacco: Reduces cancer risk
When to See a Doctor
See Your Doctor For:
- Nodes larger than 1 cm without obvious cause
- Swelling lasting more than 2 weeks
- Nodes that continue to enlarge
- Hard or fixed lymph nodes
- Swelling in unusual locations
- Associated unexplained symptoms
- History of cancer
- Multiple swollen node regions
Seek Immediate Care For:
- Rapidly enlarging nodes
- Difficulty breathing or swallowing
- High fever with node swelling
- Severe pain or redness
- Signs of abscess formation
- Supraclavicular swelling
- B symptoms (fever, night sweats, weight loss)