Almost everyone will experience a swollen lymph node at some point. That’s because these structures are designed to filter germs and other impurities from the body.
Lymph nodes become swollen as they trap viruses, harmful bacteria and damaged cells, then attempt to destroy them with lymphocytes, the white blood cells that fight off infection.
But swollen lymph nodes can also be a sign of cancer, including a type of blood cancer called lymphoma. So, when are swollen lymph nodes just a sign of infection, as opposed to a symptom of lymphoma? We checked in with lymphoma and myeloma specialist Felipe Samaniego, M.D.
How often do swollen lymph nodes appear as the first sign of lymphoma in undiagnosed patients?
That’s kind of hard to say. By the time we see most patients here at MD Anderson, they’ve already been diagnosed elsewhere or been told there’s a strong possibility that whatever it is that they have is cancer.
That being said, in the greater community, swollen lymph nodes among undiagnosed patients tend to fall into one of two categories:
- Lymph nodes that patients notice or that a doctor sees or feels during a physical exam
- Lymph nodes that are found during an MRI or a CT scan because the patient is complaining of something else, such as chest pain or a lump in their breast
What are the most common places in the body where swollen lymph nodes occur as a sign of lymphoma?
Most will be in the neck, because the mouth and throat — or oropharyngeal tract — are the main gateway for things to get inside our bodies. So, we need to have a good defense system there.
But patients can find swollen lymph nodes in other places, too — especially where they lie close to the skin’s surface, like the groin area (where the leg meets the trunk) and the axilla, or armpit.
Lymphoma is actually detected pretty frequently during mammograms, because the field of view also covers the armpit, so it reveals swollen lymph nodes in that area.
Occasionally, patients may develop swollen lymph nodes all over their bodies, but this is relatively rare.
Is there a way to tell the difference between cancerous swollen lymph nodes and non-cancerous ones?
Anyone who’s really concerned about a swollen lymph node should go see their doctor. But here are some general guidelines:
- Size: Lymph nodes are made to change in size because they’re doing a job. They grow larger as the number of cells caught inside of them increases and shrink back down to normal as that number drops. But the normal size of an average lymph node is under 1.5 centimeters, or about ¾ of an inch or smaller. So, if something is larger than that or growing continuously, it needs to be checked out.
- Age: Infections are a frequent cause of swollen lymph nodes among young people. So, if you’re a teen or a college student, my first thought would be something like strep throat or mononucleosis. Cancer is more likely in older people, though I’d still want to rule out an infection first. Even among older groups, probably less than half the people who have swollen lymph nodes will have them because of cancer.
- Consistency: Press the tip of your nose with your finger and you’ll have a pretty good idea of what a typical lymph node should feel like. Tumors tend to be harder and more solid, like what you’ll feel if you push on your chin with your finger.
- Sensitivity: Some people think cancer always hurts, but that’s not true. Tenderness tends to be a sign of an infectious process, because the immune system has been challenged. But lymph nodes that are swollen due to lymphoma are usually not painful.
What are other common symptoms of lymphoma?
In lymphoma’s earliest stages, patients often report itchy, inflamed skin or unexplained rashes. In more advanced cases, where patients have large tumors, we start seeing weight loss, fevers, night sweats, and fatigue. Some experience painful muscle aches after drinking alcohol, too, though that is fairly unusual.
When should someone see their doctor about a swollen lymph node?
Swollen lymph nodes usually just mean your body is working the way it’s supposed to. But if a swollen lymph node keeps getting bigger or doesn’t resolve on its own within two weeks, get it checked out.
Request an appointment at MD Anderson online or by calling 1-877-632-6789.
Overview
Swollen lymph nodes usually occur as a result of infection from bacteria or viruses. Rarely, swollen lymph nodes are caused by cancer.
Your lymph nodes, also called lymph glands, play a vital role in your body's ability to fight off infections. They function as filters, trapping viruses, bacteria and other causes of illnesses before they can infect other parts of your body. Common areas where you might notice swollen lymph nodes include your neck, under your chin, in your armpits and in your groin.
In some cases, the passage of time and warm compresses may be all you need to treat swollen lymph nodes. If an infection causes swollen lymph nodes, treatment depends on the cause.
Symptoms
Your lymphatic system is a network of organs, vessels and lymph nodes situated throughout your body. Many lymph nodes are located in your head and neck region. Lymph nodes that frequently swell are in this area, as well as in your armpits and groin area.
Swollen lymph nodes are a sign that something is wrong somewhere in your body. When your lymph nodes first swell, you might notice:
- Tenderness and pain in the lymph nodes
- Swelling that may be the size of a pea or kidney bean, or even larger in the lymph nodes
Depending on the cause of your swollen lymph nodes, other signs and symptoms you might have include:
- Runny nose, sore throat, fever and other indications of an upper respiratory infection
- General swelling of lymph nodes throughout your body. When this occurs, it may indicate an infection, such as HIV or mononucleosis, or an immune system disorder, such as lupus or rheumatoid arthritis
- Hard, fixed, rapidly growing nodes, indicating a possible cancer or lymphoma
- Fever
- Night sweats
When to see a doctor
Some swollen lymph nodes return to normal when the underlying condition, such as a minor infection, gets better. See your doctor if you're concerned or if your swollen lymph nodes:
- Have appeared for no apparent reason
- Continue to enlarge or have been present for two to four weeks
- Feel hard or rubbery, or don't move when you push on them
- Are accompanied by persistent fever, night sweats or unexplained weight loss
Seek immediate medical care if you're having difficulty swallowing or breathing.
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Causes
Lymph nodes are small, round or bean-shaped clusters of cells. Inside lymph nodes are a combination of different types of immune system cells. These specialized cells filter your lymphatic fluid as it travels through your body and protect you by destroying invaders.
Lymph nodes are located in groups, and each group drains a specific area of your body. You may be more likely to notice swelling in certain areas, such as in the lymph nodes in your neck, under your chin, in your armpits and in your groin. The site of the swollen lymph nodes may help identify the underlying cause.
The most common cause of swollen lymph nodes is an infection, particularly a viral infection, such as the common cold. Other possible causes of swollen lymph nodes include:
Common infections
- Strep throat
- Measles
- Ear infections
- Infected (abscessed) tooth
- Mononucleosis
- Skin or wound infections, such as cellulitis
- Human immunodeficiency virus (HIV) — the virus that causes AIDS
Uncommon infections
- Tuberculosis
- Certain sexually transmitted infections, such as syphilis
- Toxoplasmosis — a parasitic infection resulting from contact with the feces of an infected cat or eating undercooked meat
- Cat scratch fever — a bacterial infection from a cat scratch or bite
Immune system disorders
- Lupus — a chronic inflammatory disease that targets your joints, skin, kidneys, blood cells, heart and lungs
- Rheumatoid arthritis — a chronic inflammatory disease targeting the tissue that lines your joints (synovium)
Cancers
- Lymphoma — cancer that originates in your lymphatic system
- Leukemia — cancer of your body's blood-forming tissue, including your bone marrow and lymphatic system
- Other cancers that have spread (metastasized) to lymph nodes
Other possible but rare causes include certain medications, such as the anti-seizure medication phenytoin (Dilantin) and preventive medications for malaria.
Complications
If infection is the cause of your swollen lymph nodes and isn't treated, an abscess may form. Abscesses are localized collections of pus caused by infections. Pus contains fluid, white blood cells, dead tissue, and bacteria or other invaders. An abscess may require drainage and antibiotic treatment.
Oct. 14, 2021