What Is Axillary Lymphadenapathy?

Woman touching her armpit lymph nodes

Pongsak Tawansaeng / EyeEm / Getty Images

Axillary lymphadenopathy, also known as adenopathy, describes changes in the size and consistency of lymph nodes in the armpit (axilla). It is not a disease itself but rather a symptom associated with a range of diseases and conditions from mild infections to breast cancer. (Lymphadenopathy caused by infection or other inflammatory processes is more accurately referred to as lymphadenitis.) Along with swelling, axillary lymphadenopathy may involve tenderness, pain, redness, and fatigue, all of which can point to possible causes that a doctor can home in on in order to decide how to go about making a diagnosis and from there ,determine what, if any, treatment is required.

Symptoms of Axillary Lymphadenopathy

Axillary lymphadenopathy is characterized by swelling and inflammation of one or several of the 20 to 40 axillary lymph nodes in each armpit. The swelling may be unilateral (involving one armpit) or bilateral (involving both).

Unilateral swelling often (but not always) is symptomatic of an infection or disease on that side of the body, while bilateral swelling tends to point to such an illness that's systemic.

Swollen axillary lymph nodes can range in size from a small pea to a large grape. They can feel spongy or hard like a marble and be accompanied by additional symptoms:

  • Warmth
  • Redness
  • Pain or tenderness
  • Fever and chills
  • Fatigue
  • Malaise
  • Joint or muscle pain
  • Night sweats
  • Lymphedema (swelling of the affected arm)
  • Unexplained weight loss
  • Splenomegaly (swollen spleen)

Causes

Lymph nodes are part of the lymphatic system, which also is comprised of lymph fluid, lymph vessels, the spleen, tonsils, and thymus gland. The lymphatic system plays a central role in immune function, fluid balance, and absorption of fats and fat-soluble nutrients.

As lymph vessels drain fluid from the body's tissues, the fluid is channeled to the lymph nodes for inspection by the immune system. Any foreign agent can trigger the release of inflammatory proteins (called cytokines) and defensive white blood cells (called lymphocytes) to isolate and neutralize the invader within the node itself. The resulting inflammation and build-up of fluid leads to the swelling recognized as lymphadenopathy.

Axillary lymphadenopathy can occur alongside lymphadenopathy of the neck or chest or as part of generalized lymphadenopathy (lymphadenopathy occurring in many parts of the body as a result of a systemic illness). It also can occur in isolation along with symptoms that provide clues about the underlying cause, such as:

  • Local infection of the arm, hand, chest, or shoulder (especially streptococcal and staphylococcal skin infections)
  • Short-term inflammation resulting from a shoulder or arm tattoo
  • Vaccinations (especially for measles, smallpox, tuberculosis, or anthrax)
  • Strep throat, which can affect the axillary lymph nodes as well as the cervical lymph nodes)
  • Cat-scratch fever resulting from a cat scratch on an arm or hand
  • Sporotrichosis, a rare fungal infection also known as rose gardener's disease
  • Hidradenitis suppurativa, a painful skin condition of uncertain origin affecting sweat glands
  • Tularemia, also known as deer fly fever, a rare infectious disease that typically attacks the skin, eyes, lymph nodes, and lungs
  • HIV (particularly early-stage infection in which axillary and cervical lymph nodes are most likely to be affected)
  • Autoimmune lymphoproliferative syndrome (characterized by swollen lymph nodes in the armpit, neck, or groin)
  • Lymphoma in the chest (cancer of lymph nodes and lymphatic tissue)
  • Regional cutaneous tuberculosis, a form of TB characterized by scaly and crusting skin lesions
  • Breast cancer especially with locally advanced breast cancer or inflammatory breast cancer)

Lung, thyroid, stomach, colorectal, pancreatic, ovarian, kidney, and skin cancer can also sometimes metastasize (spread) to the axilla.

Diagnosis

Axillary lymphadenopathy usually can be identified with a physical exam. You may notice swollen nodes while bathing or if there is pain or discomfort under your arms. our doctor may discover them during a routine checkup even if you have no symptoms.

To determine the cause of lymphadenopathy requires further evaluation. Your doctor will consider certain factors, including:

  • Size of the lymph nodes
  • Number of lymph nodes
  • Pain or tenderness
  • Location (unilateral vs. bilateral)
  • Consistency (whether the nodes are hard or spongy)
  • Matting (whether the nodes are conjoined or individual)
  • Mobility (whether the nodes are movable or immovable)

When taken in their entirety, these clues may point the doctor in the direction of certain illnesses and help them exclude others:

Diagnostic Clues in Lymphadenopathy Evaluation
Symptoms Suspected Cause(s)
Acute joint pain and stiffness, muscle weakness, rash Autoimmune
Fever, chills, fatigue, malaise Infection
Splenomegaly, unexplained weight loss of more than 10% Lymphoma, metastatic cancer
Multiple small nodes that feel like "buck shot” Viral infection
A hard, painless or firm, rubbery mass that is fixed Cancer
Swollen lymph nodes appearing days or week after a sexual exposure HIV

Doctors tend to worry about lymph nodes if they develop for no apparent reason. In such cases, additional tests may be ordered to help narrow the causes.

Lab Tests and Procedures

In addition to a physical exam, the doctor will review your medical history and symptoms—such as recent vaccinations, unexplained weight loss, recent sexual exposures, or abnormal skin lesions—to determine which tests to include in the workup. Options may include:

  • C-reactive protein and erythrocyte sedimentation rate (ESR) blood tests to check for generalized inflammation
  • White blood cell count (an elevation may suggest an infection)
  • Infection-specific tests (such as an HIV test, TB test, and strep tests)
  • Immunologic blood tests (to help detect autoimmune disease)
  • Skin biopsy (if skin lesions are present)
  • Diagnostic mammogram or breast ultrasound
  • Imaging studies such as X-ray, ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI)
  • Lymph node biopsy (to determine if an infection, autoimmune disorder, or cancer is involved)

Differential Diagnoses

Lumps and masses in the armpit don't always indicate lymphadenopathy. Some may be benign or malignant growths unassociated with the lymphatic system, such as:

  • Lipomas (benign tumors composed of mature fat cells)
  • Epidermal inclusion cysts (benign cysts usually found on the skin)
  • Fibroadenomas (benign, painless breast lumps that can extend to the armpit)
  • Schwannomas (benign tumors of nerve sheaths)
  • Malignant neuroendocrine tumors (a cancer involving cells of the nervous and endocrine systems that occasionally affects the axilla)

These conditions usually can be differentiated with imaging studies and other procedures, such as fine-needle aspiration.

Treatment

Lymphadenopathy is not a disease but rather a symptom of a disease, infection, or abnormal immune response. As such, axillary lymphadenopathy is not "treated" per se but is resolved by treating the underlying condition.

Symptoms of lymphadenopathy can respond to certain home or over-the-counter (OTC) remedies. These include cold compresses and nonsteroidal anti-inflammatory drugs (NSAIDs) like Aleve (naproxen) and Advil (ibuprofen), both of which can relieve pain and inflammation. Rest is also vital if an infection is involved.

In cases of advanced breast cancer, the axillary lymph nodes are removed as part of a radical or modified mastectomy.

A Word From Verywell

A swollen lymph node is not an uncommon condition but should never be ignored if it is persistent, severe, or unexplained. When seeing a doctor, provide as much information about what you have been doing or experiencing prior to the onset of lymphadenopathy. The more the doctor knows, the sooner a diagnosis can be made.

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  1. Gaddey HL, Riegel AM. Unexplained lymphadenopathy: Evaluation and differential diagnosis. Am Fam Physician. 2016 Dec 1;94(11):896-903.

  2. Net JM, Mirpuri TM, Plaza MJ, et al. Resident and fellow education feature: US evaluation of axillary lymph nodes. Radiographics. 2014;34(7):1817-8. doi:10.1148/rg.347140081

  3. Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A. Peripheral lymphadenopathy: approach and diagnostic toolsIran J Med Sci. 2014;39(2 Suppl):158-70.

  4. Mantis J, Ali Y, Junejo SZ. Cat-Scratch Disease in an AIDS patient presenting with generalized lymphadenopathy: An unusual presentation with delayed diagnosisAm J Case Rep. 2018;19:906–911. doi:10.12659/AJCR.909325

  5. Park JE, Sohn YM, Kim EK. Sonographic findings of axillary masses: What can be imaged in this space?. J Ultrasound Med. 2013;32(7):1261-70. doi:10.7863/ultra.32.7.1261

  6. Plesca M, Bordea C, El Houcheimi B, Ichim E, Blidaru A. Evolution of radical mastectomy for breast cancerJ Med Life. 2016;9(2):183-6.