Swollen Lymph Nodes

Swollen lymph nodes, also known as lymphadenopathy, are a symptom that typically occurs when your body is fighting an infection. Lymphadenopathy is not a disease but a symptom of a disease or medical condition. In addition to infections, lymphadenopathy can be caused by autoimmune diseases, certain medications, and cancer.

Lymph nodes play an important role in your immune system. These tiny, bean-shaped organs are clustered throughout the body. They're tasked with filtering foreign invaders—such as bacteria and viruses—from circulating lymph fluid. They destroy them with immune cells called lymphocytes.

When this occurs, the ensuing inflammation causes the organs to swell, often with pain or tenderness. When you notice swollen lymph nodes that don't go away or occur with other symptoms, check with your healthcare provider. Based on the location of the swelling, they'll look at possible causes and order the appropriate tests.

This article explores the symptoms and causes of lymphadenopathy and provides insights into how the condition is diagnosed and treated.

Symptoms of Lymphadenopathy

The symptoms of lymphadenopathy (also known as adenopathy) can differ by their location, severity, and underlying cause. Sometimes the swelling will be limited to a specific part of the body or affect lymph nodes throughout the body.

Some cases of lymphadenopathy may be subclinical (not severe enough to cause readily observable symptoms). Others may be severe and cause extreme pain with disfiguring swelling.

Common symptoms of lymphadenopathy include:

• Swelling, redness, and warmth in the lymph node site
• Tenderness or pain when touched
• Fever
• Headache
• Fatigue
• Malaise (a general feeling of unwellness)

Other symptoms, such as unexplained weight loss or night sweats, may occur based on the underlying cause.

Even the presence or absence of pain can tell a lot about the possible causes of swelling. For example, lymphadenopathy caused by HIV is typically painless. Lymphadenopathy caused by acute upper respiratory infections is often tender or painful.

Lymphadenopathy by Location

The typical person has around 600 lymph nodes clustered in key locations throughout their body. These clusters are classified by their location, including:

• Axillary (in the armpit)
• Cervical (in the neck)
• Inguinal (groin area)
• Mastoid (beneath each ear)
• Mediastinal (central part of the chest)
• Occipital (back of the head)
• Popliteal (behind the knee)
• Submandibular (under the jaw)
  
• Supraclavicular (above the collarbone)

When lymphadenopathy occurs in a specific part of the body, the healthcare provider will refer to it by its location. For example, they may refer to it as inguinal lymphadenopathy or cervical adenopathy.

Causes of Lymphadenopathy

The causes of lymphadenopathy can be broadly classified as being either infectious, autoimmune, malignant (cancerous), or pharmaceutical (medication-related).

Infectious

Infectious causes of lymphadenopathy are mainly bacterial or viral but can also be caused by a fungus or parasite.

Common infectious causes of lymphadenopathy include:

• Chlamydia
• Cytomegalovirus
• Ear infection
• Genital herpes
• Histoplasmosis
• HIV
  
• Mononucleosis
• Strep throat
• Upper respiratory infection
• Secondary syphilis
  
• Streptococcal skin infections
• Tooth abscesses
• Toxoplasmosis
• Tuberculosis

Autoimmune

Autoimmune causes of lymphadenopathy are those that arise from certain autoimmune diseases. These are diseases that cause the immune system to attack healthy cells and tissues.

The ensuing systemic (whole-body) inflammation can lead to the generalized swelling of lymph nodes. However, certain autoimmune diseases like sarcoidosis can directly target the lymph nodes and trigger localized swelling.

Autoimmune causes of lymphadenopathy include:

• Lupus
• Psoriatic arthritis
• Rheumatoid arthritis
• Sarcoidosis
• Sjögren's syndrome

Malignancy

Malignant causes of lymphadenopathy are those caused by cancer. The symptoms can vary based on whether a solid tumor cancer or blood cancer is involved. It can also vary in whether there is metastasis (the spread of cancer beyond its initial site).

In people with solid tumor cancers, the lymph nodes nearest the tumor typically serve as the stopgap against the spread of cancer. Any infiltration of cancer into these lymph nodes can cause lymphadenopathy.

Certain blood cancers like lymphoma may either cause systemic lymphadenopathy or progressive, localized lymphadenopathy as the malignancy advances.

Common malignant causes of lymphadenopathy include:

• Breast cancer
• Cervical cancer
• Colorectal cancer
• Head and neck cancer
• Leukemia
• Lung cancer
• Lymphoma
• Ovarian cancer
• Pancreatic cancer
• Prostate cancer
  
• Skin cancer
• Thyroid cancer

Pharmaceutical

Certain drugs can also cause lymphadenopathy. These are typically due to an adverse reaction called hypersensitivity in which the immune system triggers excessive inflammation in response to a drug. Lymphadenopathy is sometimes the result.

Among the drugs known to trigger drug-induced lymphadenopathy are:

• Capoten (captopril)
  
• Cephalosporin antibiotics
  
• Dilantin (phenytoin)
• Mysoline (primidone)
• Penicillin
• Quinidine
• Sulfonamides antibiotics
• Tegretol (carbamazepine)
• Tenormin (atenolol)
• Zyloprim (allopurinol)

How to Treat Lymphadenopathy

The treatment of lymphadenopathy is mainly focused on treating the underlying cause. By doing so, the lymph nodes will almost invariably return to their normal size.

By way of example:

• Bacterial infections may be treated with antibiotics.
• Viral infections may be treated with antivirals.
• Fungal infections may be treated with antifungals.
• Autoimmune diseases may be treated with immunosuppressants or biologics.
• Cancer may be treated with surgery, chemotherapy, radiation therapy, immunotherapy, or targeted therapies.
• Drug hypersensitive reactions are commonly treated by stopping the offending drug.

Supportive therapies may also be used to help ease lymphadenopathy symptoms.

Are There Tests to Diagnose the Cause of Lymphadenopathy?

Lymphadenopathy can often be diagnosed by its appearance. Diagnosing the underlying cause is another matter. It sometimes requires time and patience to pinpoint the exact cause of the swelling.

Your healthcare provider will start by reviewing your medical history to see if you have risk factors for any disease or medical condition. This includes reviewing your family history and any medications you may be taking.

Your healthcare provider will also perform a physical exam to characterize the nature of your symptoms. This can help establish:

• Whether the lymph nodes are painful or non-painful
• Whether the swelling is localized or systemic
• Whether the lymph nodes are hard or rubbery, fixed or movable, or separate or matted
• If there are other symptoms suggestive of an illness or disease

Based on the initial findings, the healthcare provider may order blood tests to see if you have signs of infection, autoimmunity, inflammation, or cancer. These may include:

• Complete blood count (CBC): This blood test can detect a wide range of disorders, including anemia, infection, and leukemia, based on the composition of cells in your blood.
• C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR): Both of these tests can detect generalized inflammation.
• Antibody tests: These blood-based tests can diagnose viral or bacterial infections, such as HIV or COVID, based on disease-specific immune proteins called antibodies.
• Antinuclear antibody (ANA) test: This is one of several tests used to determine if you have an autoimmune disorder.
• Tumor marker test: This is one of several tests used to detect signs of cancer, such as a prostate-specific antigen (PSA) test used when prostate cancer is suspected.
  

Other tests and procedures may be ordered based on the suspected cause. This may include lab cultures to detect bacterial, viral, or fungal infections. Imaging studies like computed tomography (CT) can check for tumors or other swollen lymph nodes inside the body. If cancer is suspected, a biopsy of a lymph node may be recommended.

When to See a Healthcare Provider

In most cases, lymphadenopathy will be the result of a transient infection and will improve once you get better. However, there are times when it may be a sign of something more serious in need of immediate medication attention.

Call your healthcare provider as soon as possible if you experience any of the following:

• Severe and/or painful swollen lymph nodes
• Swollen lymph nodes that persist or worsen after several weeks
• Lymph nodes that are hard, matted, or don't move when you push them
• Lymph nodes that are accompanied by high fever, chills, night sweats, or unexplained weight loss

Summary

Swollen lymph nodes, also known as lymphadenopathy or adenopathy, are usually a sign that your body is fighting an infection. Lymphadenopathy may also occur in response to certain autoimmune diseases, medications, and cancers.

While lymphadenopathy can often be diagnosed by symptoms alone, diagnosing the underlying cause may require blood tests, imaging studies, lab cultures, or even a biopsy of the lymph node itself. Treating the underlying cause will usually resolve the pain and swelling.

A Word From Verywell

It can be easy to panic when you get swollen lymph nodes, particularly if they appear suddenly or severely. But it's important to remember that lymphadenopathy can occur for any number of reasons. A condition like cancer is one of the more unlikely causes.

Even so, you should never ignore swollen lymph nodes if they are persistent or worsening. Out of the utmost caution, have them checked by your healthcare provider if only for your peace of mind.