Lymph Checking
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Symptoms
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Your lymphatic system comprises a network of organs, vessels and glands situated throughout your body. A lymph node is a small, round or bean-shaped cluster of cells covered by a capsule of connective tissue. The cells are a combination of lymphocytes — which produce protein particles that capture invaders, such as viruses — and macrophages, which break down the captured material. Lymphocytes and macrophages filter your lymphatic fluid as it travels through your body and protect you by destroying invaders.
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Lymph nodes occur in groups, and each group drains a specific area of your body. That's why the site of your swollen lymph nodes helps your doctor determine the underlying cause.
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Lymphadenitis means inflammation of the lymph nodes. If a lymph node is overwhelmed by invading material, it may enlarge to 1 centimeter (cm) or more and become inflamed. In general, swollen lymph nodes that you can feel (palpate), such as the ones in your neck, are likely to be tender and painful. In addition, you may have the following signs and symptoms, depending on the cause of your swollen lymph nodes:
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Runny nose, sore throat, fever and other indications of an upper respiratory infection
General swelling of lymph nodes throughout your body, indicative of infections such as HIV or mononucleosis, an infection of the glands, or immune disorders, such as lupus or rheumatoid arthritis
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Red, inflamed skin over the swollen lymph node
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Swollen limb, possibly indicating lymph system blockage caused by swelling in a lymph node too far under your skin to feel
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Hardened, fixed, rapidly growing nodes, possibly indicating a tumor (rare)
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Causes
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The most common cause of swollen lymph nodes is an infection, particularly viral infections such as the common cold. However, there are other types of infection, including parasitic and bacterial, and other possible swollen lymph node causes. They include:
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Common infections
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Strep throat
Mumps
Measles
Ear infections
Infected (abscessed) tooth
Mononucleosis
Wound infections
Other infections
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Tuberculosis |
Certain sexually transmitted diseases, such as syphilis
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Toxoplasmosis — a parasitic infection resulting from contact with the feces of an infected cat or eating undercooked meat
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Cat scratch fever — a bacterial infection from a cat scratch or bite
Immune system disorders
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Lupus — a chronic inflammatory disease that can target your joints, skin, kidneys, blood cells, heart and lungs
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Rheumatoid arthritis — a chronic inflammatory disease that targets the tissue that lines your joints (synovium)
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Human immunodeficiency virus (HIV) — the virus that causes AIDS
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Cancers
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Lymphoma — cancer that originates in your lymphatic system
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Leukemia — cancer of your body's blood-forming tissue, including your bone marrow and lymphatic system
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Other possible but rare causes include certain medications, such as phenytoin (Dilantin), used to prevent seizures, and certain immunizations, such as for malaria.
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When to seek medical advice
Some swollen lymph nodes return to normal when the underlying condition, such as a cold, resolves. However, see your doctor if you're concerned or if your swollen lymph nodes:
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Have appeared for no apparent reason
Continue to enlarge
Feel hard or fixed
Are accompanied by fever, night sweats or unexplained weight loss
Are red, warm and tender
Tests and diagnosis
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Your doctor is likely to take a medical history, ask about when and how your swollen lymph nodes developed, ask about other signs and symptoms, and check your palpable lymph nodes for size, tenderness, warmth and texture. The site of your swollen lymph nodes and your other signs and symptoms will offer clues to the underlying cause.
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In addition, your doctor may request laboratory tests to help pin down the diagnosis, including:
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Blood tests. Depending on what your doctor suspects is causing your swollen lymph nodes, he or she may request certain blood tests to confirm or exclude the suspected underlying condition. The specific tests will depend on the suspected cause, but most likely will include a complete blood count (CBC), which helps evaluate your overall health and detect a range of disorders, including infections, such as mononucleosis, and leukemia.
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Imaging studies. A chest X-ray or computerized tomography (CT) scan of the affected area may help determine potential sources of infection or find tumors.
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Lymph node biopsy. If your doctor can't pin down the diagnosis, it may be helpful to remove a sample from a lymph node or even an entire lymph node for microscopic examination.
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The method of biopsy may be fine-needle aspiration (FNA), which your doctor may perform during an office visit or refer you to a surgeon or radiologist for this procedure. In FNA, the doctor inserts a thin, hollow needle into the lymph node and removes (aspirates) cells, which are then sent to a lab for study. Ultrasound — a noninvasive procedure that uses sound waves to create images of organs and tissues — may be used to ensure accuracy.
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In some cases, you may require an excisional biopsy. This type of biopsy — also called surgical biopsy — removes a portion or all of a lymph node through an incision for analysis. A surgeon performs this procedure using local or general anesthesia.
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