Swollen Lymph Nodes

Swollen lymph nodes, also known as lymphadenopathy, are a symptom that typically occurs when your body is fighting an infection.

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

When this occurs, the ensuing inflammation causes the lymph nodes to swell and sometimes turn painful. Based on the location of the swelling, your healthcare provider will often venture a guess as to the possible causes and order the appropriate tests.

Lymphadenopathy, also known as adenopathy, is not a disease but a symptom of a disease or medical condtion. The causes are many including infections, autoimmune diseases, medications, and cancer.

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 can differ by their severity, location in the body, and underlying cause. Sometimes the swelling will be limited to a specific part of the body or it may affect lymph nodes throughout the body.

In addition, some cases may be subclinical (not severe enough to cause readily observable symptoms), while other cases 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.

By way of example, lymphadenopathy caused by HIV is typically painless, while lymphadenopathy caused by acute upper respiratory infections is often tender or painful.

Types 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)
  

Causes of Lymphadenopathy

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

Infectious

Infectious causes of lymphadenopathy are mainly bacterial or viral but can also be caused by a fungal or parasitic infection.

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.

Autoimmune diseases cause the immune system to attack healthy cells and tissues. The ensuing systemic (whole-body) inflammation is largely responsible for the swelling, although certain types of autoimmune disease directly target lymph nodes themselves.

Autoimmune causes of lymphadenopathy include:

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

Malignant

Malignant causes of lymphadenopathy are those caused by cancer. In people with solid tumor cancers, the lymph nodes nearest the tumor serve as the initial stopgap against the spread of cancer. Any infiltration of cancer into these lymph nodes can cause lymphadenopathy.

Certain blood cancers 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

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

Among the drugs that have to potential 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

Lymphadenopathy is treated by treating the underlying cause. By doing so, the lymph nodes will almost invariably resolve 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.

Are There Tests to Diagnose the Cause of Lymphadenopathy?

Lymphadenopathy can be diagnosed by appearance alone. Diagnosing the underlying cause is another matter and may sometimes require time and patience to pinpoint the exact cause and nature of your condition.

Your healthcare provider will start by reviewing your medical history to see if you are at risk of any disease, or infection. This includes reviewing yoru family history and any medications you may be taking.

At the same time, your healthcare provider will perform a physical exam to characterize the exact nature of your condition. By examining the swollen glands and asking you questions, the healthcare provider can determine whether:

• The lymph nodes are painful or non-painful.
• The swelling is localized or systemic.
• The lymph nodes are hard or rubbery, fixed or mobile, or separate or matted.
• There are other symptoms suggestive of an illness or disease.

Based on the initial findings, the healthcare provider may also order blood tests to see if you have any abnormalities suggestive of an infection, autoimmunity, inflammation, or cancer. These may include tests like:

• Complete blood count (CBC)
• C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), both of which detect signs of inflammation
• Antibody tests to check for specific viral or bacterial infections, like HIV
• Antinuclear antibody (ANA) test to check for certain autoimmune diseases
• Tumor marker tests, like a prostate-specific antigen (PSA) test to check for prostate cancer
  

Other tests and procedures may be ordered based on the suspected causes. This may include bacterial, fungal, or viral cultures, imaging tests to check for tumors or swollen lymph nodes inside the body, and a biopsy of a lymph node itself to check for cancer.

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. With that said, there are times when they may a sign of something more serious or in need of immediate medication attention.

You should see your healthcare provider immediately if you experience any of the following:

• Sudden, unexplained swollen lymph glands on any part of the body
• Severe and/or painful swollen lymph nodes
• Swollen lymph nodes that persist and. 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 as sign that yoru body is fighting an infection. As part of your immune system, lymph nodes are tasked with trapping and neutralizing foreign agents, and the swelling is a sign that they are doing so.

Lymphadenopathy may also occur with certain autoimmune diseases and is a common occurrence with cancer. It can also be the result of a hypersensitive reaction to a medication you are taking.

While lymphadenopathy can often be diagnosed with visual inspection, the underlying cause may require multiple tests, including blood tests, imaging studies, and even a biopsy of the lymph node itself. Treating the underlying cause will almost always resolve the swelling.

A Word From Verywell

It can be easy to panic when you notice a swollen lymph node, particularly if it occurs out of the blue. But, it is important to remember that lymphadenopathy can occur for any number of reasons, and the swelling is actually a sign that your immune system is working as it should.

While cancer can cause lymphadenopathy, it is one of the more uncommon causes. With that said, you should never ignore swollen lymph nodes if they are severe, persistent, or worsening. Out of the utmost caution, you should have them checked out if you only for your peace of mind and good health.