How to Tell a Lump From a Lymph Node

Lymph nodes are tiny organs that appear throughout the body and function as part of the lymphatic system. The lymphatic system is an extension of the immune system. Lymph nodes filter a fluid called lymph, trapping bacteria and other harmful substances. Because of their function, they often become swollen during an infection.

common causes of a swollen lymph node — Illustration by Jessica Olah, Verywell

Identifying Lymph Nodes

Lymph nodes are found in the neck, armpits, chest, abdomen, and groin. Medical professionals know where these nodes are located, which helps a lot when it comes to diagnosing lumps. Swollen lymph nodes are often accompanied by other symptoms of infection.

When you have enlarged lymph nodes, people, or even doctors, might refer to them as swollen glands. This can be confusing because a true gland is an organ that secretes something—hormones, saliva, oil, etc.

If you have an active infection, you might be able to feel lumps in your neck, especially under the jaw and chin—these are lymph nodes. They should return to their normal size when the infection clears up.

Some of the more common illnesses that can cause swollen lymph nodes include:

Infection is by far the most common cause of enlarged lymph nodes. However, enlarged lymph nodes can also be caused by cancer, especially Hodgkin's disease and non-Hodgkins lymphoma. Enlarged lymph nodes can also be caused by immune disorders, such as rheumatoid arthritis.

How to Examine Your Lymph Nodes

If your lymph nodes are swollen, you can often feel them by pressing lightly and circling your three middle fingers:

Behind the ears and under the jawline
On both sides of the back of your neck
From the middle of your armpit to the side of your breast
Along the crease where the thigh meets the pelvis

Identifying Lumps and Tumors

Abnormal lumps and tumors are often mistaken for lymph nodes due to their location. They can often be differentiated by the hardness, texture, regularity, and whether they are free-floating or attached to other tissues. While most will be benign (non-cancerous), some may be malignant (cancerous).

Nodules

A nodule is actually a generic term. It can refer to all kinds of lumps both cancerous and not. Usually, physicians will refer to a lump as a nodule until they can discover exactly what the lump is. Cysts can sometimes be called nodules.

Nodules can form on any part of the body including the thyroid and vocal cords. A nodule can be a solid lump of non-cancerous tissue. Whether a nodule should be treated depends on whether or not it is causing symptoms, if or how quickly it is growing, and where it is on the body.

nodule dermatofibroma — DermNet / CC BY-NC-ND

Cysts

Cysts are fluid-filled sacs of tissue that appear as lumps. They are not solid. Cysts can occur in almost every area of the body. Depending on their size and location they may have to be surgically drained. Many cysts go away on their own.

Lipomas

A lipoma is a benign lump filled with fat. They are not cancerous but sometimes have to be surgically removed depending on their size and location. People who have had one lipoma or a family history of lipomas have a tendency to get them again.

Goiters or Colloid Nodular Goiters

Goiters are lumps on the thyroid gland. They appear in the front of the neck but can be deviated to one side. Because your thyroid moves up and down when you swallow, goiters and lumps on the thyroid will do this also.

Goiters often indicate abnormal thyroid function but can occur with normal thyroid function as well. Some goiters are caused by iodine deficiency. This was once common in the United States but the prevalence has decreased dramatically since table salt has become iodine fortified.

Goiters may be treated with medication, such as Synthroid (levothyroxine) if they are caused by thyroid hormone deficiency, or by radioactive iodine if they are related to too much thyroid hormone. In some cases, they may have to be surgically removed.

Boils

Boils are skin infections that can appear as lumps. Most of the time they are close to the surface of the skin and pus may come out of them. However, this is not always the case. Boils can be deep and appear or be palpated as a fairly large hard lump. They can occur at any place on the body.

Boils are treated with drainage. Occasionally, antibiotics are also necessary—either topical or taken by mouth in pill form, or in extreme cases intravenously. Sometimes they may have to be drained by a surgeon, known as an I&D (incision and drainage).

Malignant Tumors

Malignant or cancerous lumps are called tumors. While some sources say that the definition of a tumor is an abnormal growth of any tissue, the term is not usually used to define a benign growth. Cancer cells are mutated cells that grow and enlarge at an abnormal rate and can be very difficult to stop. There are thousands of ways to classify tumor types.

While there are many symptoms of cancer, a visible lump is often the first thing a patient will notice and seek treatment for. This is why, despite the overwhelming odds that a lump will be noncancerous, it is so terrifying to notice any lump on your body and why it is so important to monitor the lump and get medical treatment.

Cancers with palpable lumps are most commonly found in the breast, testicle, or lymph nodes. According to the American Cancer Society, lumps that are fluid-filled and easily rolled in the fingers are less likely to be cancerous than those that are hard, irregular, rooted, and painless.

Diagnostic Tools

In the case of swollen glands, your doctor will often notice other signs of an infection. If the infection is bacterial, such as strep throat, you will need antibiotics. If the infection is viral, such as in mono, it will take time for your immune system to fight the infection and the glands to decrease in size.

For other lumps, several tests may have to be done. An ultrasound, X-ray, CT scan, or magnetic resonance imaging (MRI) can be useful in telling whether or not the lump is solid or fluid-filled. It can also measure the lumps and sometimes tell how the lump is affecting surrounding structures in the body.

However, ultimately a biopsy will be needed (if the lump is not caused by infection or filled with fluid). A biopsy involves taking a small amount of tissue from the lump and having it analyzed in a laboratory. This will determine exactly what the lump is.

Sometimes the tissue can be retrieved using a needle. Other times the sample will have to be taken surgically. Your doctor will determine if and when you need to have a biopsy and the best way to retrieve the tissue.