The lymph nodes are small, oval-shaped organs that can be found all over your body.
They serve an important role in defense against infection and disease because they filter out unwanted particles from your bloodstreams
Lymph glands become enlarged or swollen in response to an infection from your body, and usually go down when you recover.
Lymph nodes that are swollen but not tender can be a sign of a serious problem, such as cancer.
Depending on the cause of swelling in your lymph nodes, bacterial infection may be treated with antibiotics. However, viral infections often go away by themselves without treatment.
Surgical excision of an enlarged lymph node in the form of a biopsy enables your doctor to determine what is causing it and tailor treatment accordingly.
What Are Lymph Glands?
Lymph glands, also known as lymph nodes, are small, oval-shaped organs located throughout your body. They carry lymph fluid, nutrients and waste materials between your body’s tissues and the bloodstream. Lymph nodes are regional, and each group corresponds to a particular region in your body and reflects abnormalities in that region. Lymph glands are not usually visible or palpable.
Lymph glands form part of your body’s immune system, and they enable your body to recognise and fight infections. Lymph nodes filter lymph fluid as it flows through and traps bacteria, viruses and foreign substances. By containing white blood cells, these pathogens are destroyed by the white blood cells, thus helping the body to defend against diseases.
What Happens When A Lymph Gland Swells Or Becomes Enlarged?
“Lymph glands only get enlarged or swollen in response to an infection in your body, and usually go down when you recover. However, sometimes they may be caused by more serious problems and need to be checked by your doctor.”
These glands may swell up to more than a few centimetres as a response to infection or disease. They are commonly felt under the chin or in the neck, underarms or groin area, where they are found in larger groups.
What Are The Characteristics Of An Enlarged Lymph Gland?
An enlarged lymph gland can be as small as the size of a pea and as large as the size of a cherry. As they swell, they can be painful to the touch or hurt when you make certain movements.
In cases when the enlarged lymph gland is found under the jaw or on either side of the neck, you might experience discomfort or pain when you turn your head in a certain way or when chewing.
They can often be felt by running your hand over your neck just below your jawline. The enlarged lymph gland can also be tender to the touch.
Other symptoms that may be present along with the enlarged lymph glands are:
Coughing
Sweating
Fatigue
Fever
Chills
Runny nose
Should you experience one or a combination of these symptoms or have pain in the lymph glands and no other symptoms, consult your doctor. Lymph nodes that are swollen but not tender can be signs of a serious problem, such as cancer.
In some cases, the swollen lymph node will get smaller as other symptoms go away. If a lymph node is swollen and painful or the swelling lasts more than a few days, see your doctor.
At the age of 26, Juliana was not expecting the news of her stage 4 lymphoma when she received news of her condition. As a nurse practitioner, she and a classmate were checking each other in the neck area when her classmate mentioned that she could feel one of Juliana’s lymph nodes was enlarged. At that time, she felt healthy. It wasn’t until later that she noticed that she could also feel some enlarged lymph nodes in her groin area.
After several scans, her results indicated “suspicious for metastatic disease.” She started treatment after confirming the diagnosis and, thankfully, was able to treat her condition.
“When assessing a swollen lymph gland, it is important to understand a patient’s medical history and identify the potential cause before determining if they can be an indicator of something more serious. I would usually advise our patients to do a biopsy if the lymph glands remain swollen after some time even after medication.”
Lymph nodes become swollen when there are signs of infection, illness or stress. The swelling is one sign that your lymphatic system is working to rid your body of the responsible agents.
Swollen lymph glands in the head and neck are typically caused by illnesses such as:
Ear infection
Cold or flu
Sinus infection
HIV infection
Infected tooth
Mononucleosis (mono)
Skin infection
Strep throat
Some medications (including antiseizure and antimalarial drugs) and allergic reactions to medications can result in swollen lymph nodes as well.
When presented in specific areas such as the groin area, the swelling of lymph nodes can indicate the presence of sexually transmitted infections, such as syphilis or gonorrhoea.
For more severe conditions, such as immune system disorders or cancers, the lymph nodes throughout the body would swell.
When cancer from one area spreads to the lymph nodes, a patient’s survival rate is significantly reduced. Lymphoma, which is a cancer of the lymphatic system, also causes the lymph nodes to swell.
How Are Enlarged Lymph Glands Diagnosed?
You can check whether their lymph nodes are swollen by gently pressing around the area, such as the side of the neck. Enlarged lymph glands will feel like soft, round bumps, and they may be the size of a pea or a grape. Additionally, they might be tender to the touch, which indicates inflammation.
When consulting a doctor, a physical examination will be performed to check the size of the swelling, tenderness, warmth and texture of the lymph nodes close to the surface of your skin.
He or she will need to assess the symptoms that you are experiencing. The location of the enlarged lymph node and your symptoms will help your doctor find out the underlying cause of the enlarged lymph nodes.
You may be scheduled for further tests such as:
Blood tests, in particular, a complete blood count (CBC). This is to test for infections and leukaemia and help your doctor determine and rule out the underlying cause of your swollen lymph glands.
Diagnostic imaging tests such as an X-ray or CT scan. These find tumours and determine the source of infection.
Lymph node biopsy, where a tissue sample of your lymph node is taken and sent to the laboratory for testing.
When Katie Dimmock, 26, learned she had cancer, she was relieved. While the news of cancer was frightening, she finally understood her symptoms. Nine months later, in April 2018, she found out she was in remission.
Do Enlarged Lymph Glands Go Away On Their Own?
Dr Ganesh says, “Depending on the cause of swelling of lymph nodes, a bacterial infection may be treated with antibiotics, while a viral infection often goes away on its own.”
Should cancer be suspected, a biopsy may be ordered to confirm the diagnosis. Your doctor should check any enlarged lymph glands that do not go away or return to their standard size within a month.
Are Lymph Glands Swelling A Sign Of An Emergency?
Usually, enlarged lymph glands are not an immediate cause for concern. They are simply a sign that your immune system is fighting an infection or illness. But if they are enlarged with no apparent cause, see your doctor to rule out something more serious.
Enlarged lymph glands can occur in your armpits as well as in your neck and groin.
How Long Do Lymph Glands Stay Swollen?
Depending on the cause, viral infections and minor skin infections or irritations can cause lymph nodes to double in size quickly over 2 or 3 days. However, they return slowly to normal size over the next 2 to 4 weeks.
Sometimes, the lymph nodes may remain swollen long after an infection has disappeared, sometimes even up to years. As long as the lymph node does not change or become hard, there is typically no need to worry.
However, should you notice that a lymph node changes, hardens, or grows very large, they should see a doctor.
Do Enlarged Lymph Nodes Always Mean Cancer?
When lymph nodes are enlarged or become sensitive to the touch, they are indicators that your body is fighting an infection. However, it most definitely does not always mean that you have cancer, although they can be an early warning system for cancers, such as lymphoma, leukaemia, and breast cancer.
How Are Enlarged Lymph Glands Treated?
Swollen lymph nodes may become reduced in size on their own without treatment. In some cases, our doctor may wish to monitor them.
If there is an infection, you may be prescribed antibiotics or antiviral medications to eliminate the condition responsible for the swollen lymph nodes. Our doctor might also give you medications such as aspirin and ibuprofen (Advil) to fight pain and inflammation.
However, swollen lymph nodes that are caused by cancer may not shrink back to their standard size until the cancer is treated. Cancer treatment may involve removing the tumour and any affected lymph nodes and chemotherapy to shrink the tumour.
Our doctor will discuss which treatment option is best for you. Surgery for an enlarged lymph node in the form of a lymph node biopsy enables your doctor to determine the underlying cause and tailor the appropriate treatment for your condition.
Should an abscess (infection) be present, the collection of pus may be drained by cutting open your skin, draining the infected fluids and packing the wound. This clears your infection.
For enlarged lymph glands caused by cancer or malignancy, surgical treatment to remove the entire lymph node may be part of a more extensive surgery for cancer removal. This will be accompanied by chemotherapy or radiotherapy to shrink the cancer cells and stop the growth of cancer.
As with the case of Diana Sejas, MD, MPH, who was in her first year of medical school when she first noticed a lump in her neck.
Doctors told her that it wasn’t anything to worry about and was probably just a swollen lymph node and prescribed her antibiotics.
Five years later, she finally decided to do a CT scan, where cancer was detected, and she began treatment.
Diana survived but faced days in the intensive care unit (ICU) followed by months of therapy. She has recovered most of her leg’s function, but her arm is still weak and only has half of the sensory function. She is cancer-free.
Dr. Ganesh Ramalingam
Specialist in General Surgery
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