Swollen Lymph Nodes (Adenopathy) in Cancer

Adenopathy (also known as lymphadenopathy) describes lymph nodes that have become enlarged or swollen. The most common cause of this is an infection. Swollen lymph nodes can also be caused by other conditions, including autoimmune disorders or cancer.

Adenopathy can be caused by cancer that starts in the lymph nodes. It can also occur when cancer spreads (metastasizes) from other parts of the body to the lymph nodes.

Read on to learn more about lymph nodes, adenopathy in cancer, how it's diagnosed, and how it may impact treatment.

doctor palpating woman's lymph nodes
Universal Images Group/Getty Images

What Are Lymph Nodes?

Lymph nodes are small, bean-shaped organs that produce and store blood cells (called lymphocytes) that help fight infection and disease. There are roughly 600 of these nodes throughout the body. Their primary role is to filter waste from the lymphatic fluid. As they do so, the lymphocytes work to neutralize any foreign substance they encounter.

While some lymph nodes are located superficially—in the groin, armpit, and neck, for example—others are situated deeper in the body, such as in the chest or abdomen.

Adenopathy in Cancer

Cancer adenopathy is the term used to describe the swelling of the lymph nodes due to cancer. Cancers that start in the lymph nodes are called lymphoma. Two of the more common types are Hodgkin lymphoma and non-Hodgkin lymphoma. Each behaves and develops differently, but both originate in the lymphocytes themselves. Adenopathy is just one of the features of these diseases.

More commonly, cancer adenopathy will occur when a malignancy in one part of the body (known as the primary tumor) spreads to other parts of the body to create new (secondary) tumors. The lymph nodes are the organs most commonly affected by this.

Cancer Adenopathy vs. Infection-Related Adenopathy

Not all adenopathies are the same. Cancerous nodes tend to be hard, painless, and firmly affixed to surrounding tissue. Benign or noncancerous lymph nodes, by contrast, are usually painful to the touch and will decrease in size and density as the infection resolves.

That said, you cannot diagnose the cause of adenopathy by physical characteristics alone. In some cases, a cancerous node may press on a nearby nerve and cause pain. In others, a benign node may be hard and relatively painless (such as those that can happen with persistent generalized lymphadenopathy seen in HIV).

How Cancer Spreads Through the Lymph Nodes

When a tumor metastasizes, cancer cells break away from the primary tumor and spread to other parts of the body through either the circulatory (blood) system or the lymphatic system.

When the cells are in the blood, they are swept along in the blood flow until they get stuck somewhere, usually a capillary. From this point, the cell can slip through the capillary wall and create a new tumor wherever it landed.

A similar thing happens with the lymphatic system. In this case, the cancer cells break off and are carried to the lymph nodes, where they get stuck. While the nodes will respond with an aggressive immune attack, some cancer cells will survive to form a new tumor.

But here is where the difference lies: Unlike the circulatory system, which can carry cancer cells to almost any part of the body, the distribution of cancer through the lymphatic system is more constrained. The nodes nearest the tumor will typically be the first affected. From there, additional cells can break off and move to distant nodes in other parts of the body.

Because of how lymph nodes are affected, healthcare providers will routinely check them to see if cancer has started to spread and, if so, by how much.

Diagnosis

The enlargement of superficial lymph nodes can often be detected through a physical examination. Imaging tests such as computed tomography (CT) scans can also be used, particularly for lymph nodes in the chest or abdomen.

Additionally, the healthcare provider may order a lymph node biopsy. The biopsy involves the removal of lymph node tissue for examination under a microscope. It would be used either to see if cancer has spread from a primary tumor or in cases where lymphoma is suspected.

The biopsy can either be performed by surgically removing a node or, less commonly, by removing cells using a less invasive procedure called fine needle aspiration. The biopsy results are important for both the diagnosis and staging of cancer.

How Adenopathy Affects Cancer Treatment

Adenopathy on its own does not alter the course of cancer treatment. However, having cancer cells in your lymph nodes can affect treatment insofar as it will inform the stage of your disease.

One of the most common systems for staging cancer is the TNM system, which is based on the extent of the tumor (T), the extent of spread to the lymph nodes (N), and the presence of metastasis (M). If no cancer is found in the lymph nodes near the tumor, the N will be assigned a value of 0. If nearby or distant nodes show cancer, the N will be assigned a value of either 1, 2, or 3 depending on:

  • How many nodes are involved
  • Where the nodes are located
  • How big the nodes are
  • How much cancer is in them

The recommended course of treatment will largely be based on the staging. The staging will also provide the diagnosis ICD-10 code, which your health insurer will use to approve treatment.

Summary

Adenopathy, or swollen lymph nodes, can be caused by a variety of things, including cancer. When secondary tumors form or when metastasis occurs, the lymph nodes can be affected, and swell. A lymph node biopsy may be done to see if there is cancer in the lymph nodes. This also impacts the stage of the cancer diagnosed.

A Word From Verywell

If cancer is in the lymph nodes, this is part of the cancer staging process, and treatment will be based on the stage and type of cancer. Treatment can vary depending on the amount of cancer, how large the nodes are, and the extent of lymph node involvement. Talk with your treatment team about your specific diagnosis and how much lymph node involvement exists, and the treatment plans.

Frequently Asked Questions

  • Do you have cancer if you have swollen lymph nodes?

    Adenopathy is a non-specific symptom that can be caused by many things. On its own, adenopathy has no diagnostic value. More often than not, it's caused by an infection rather than cancer.

    With that being said, if your lymph nodes are persistently swollen or become larger, you should contact a healthcare provider.

  • What percentage of swollen lymph nodes are cancerous?

    It is estimated that only about 1.1% of swollen lymph nodes are cancerous.

  • How fast do cancerous lymph nodes swell?

    This can vary, depending on the type of cancer it is. Slow-growing lymphomas can take years to cause lymph node enlargement, but fast-growing cancers can cause swelling in days to weeks.

  • What does a cancerous lymph node feel like?

    They may feel hard to the touch - but they might not. Some non-cancerous swollen lymph nodes may also be hard. However, lymph nodes deeper in the body may not be able to be felt, and if there are only a few cancerous cells in the lymph node, it might not be palpable. You cannot tell if a lymph node is cancerous or not just by touch.

  • Does adenopathy go away without treatment?

    If the swollen lymph nodes are due to a virus, once your body clears the virus, the lymph nodes should slowly return to normal without treatment. This can take several weeks. If it's due to cancer, treatment is necessary.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. West H, Jin J. Lymph nodes and lymphadenopathy in cancer. JAMA Oncol. 2016;2(7):971. doi:10.1001/jamaoncol.2015.3509

  2. van Krieken JH. New developments in the pathology of malignant lymphoma. A review of the literature published from September-August 2017. J Hematop. 2017;10(3-4):117-127. doi:10.1007/s12308-017-0310-2

  3. Freeman AM, Matto P. Adenopathy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.

  4. Kawada K, Taketo MM. Significance and mechanism of lymph node metastasis in cancer progressionCancer Research. 2011;71(4):1214-1218. doi:10.1158/0008-5472.can-10-3277

  5. Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A. Peripheral lymphadenopathy: approach and diagnostic tools. Iran J Med Sci. 2014;39(2 Suppl):158-170.

  6. Chheang S, Brown K. Lung cancer staging: clinical and radiologic perspectivesSemin Intervent Radiol. 2013;30(2):99–113. doi:10.1055/s-0033-1342950

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

Additional Reading
  • Nieweg, O.; Uren, O.; and Thompson, J. "The History of Sentinel Lymph Node Biopsy." Canc J. 2015; 12(1);3-6; DOI 10.1097/PPO.0000000000000091.
  • West, H. and Jin, J. "Lymph Nodes and Lymphadenopathy in Cancer." JAMA Oncol. 2016; 2(7):971; DOI 10.1001/jamaoncol.2015.3509.
Originally written by Lisa Fayed