Doctor's Notes on Swollen Lymph Nodes
Swollen lymph nodes are enlargements of the small organs known as lymph nodes that are important for filtering lymph fluid and forming white blood cells to fight infection. Swollen lymph nodes can occur in one area or region of the body, or they may be found throughout the body, depending upon the cause. Lymph nodes are the organs that can trap cancer cells that have spread into the lymphatic vessels. Lymph nodes are sometimes referred to by lay persons as lymph glands, and swollen lymph nodes may be called “swollen glands.” Infection is the main cause of swollen lymph nodes. Spread of cancer to lymph nodes is a less common cause of lymph node swelling.
The neck, groin, and armpits are areas where swollen lymph nodes may be apparent. Associated symptoms are dependent upon the cause of the swollen lymph nodes. Common associated symptoms include fever and chills in the case of infection, and symptoms specific to the tumor type in the case of cancer. If the lymph nodes are enlarged and inflamed (known as lymphadenitis), the nodes may be painful or tender to the touch.
Swollen Lymph Nodes Symptoms
- The symptoms of swollen lymph nodes depend upon both the location and cause of the enlargement.
- Patients may experience symptoms of an upper respiratory infection (runny nose, sore throat, fever) and feel slightly tender or painful nodes under the skin around the ears, under the chin, or on the upper part of the neck under the jaw.
- Sometimes there may be a skin infection or redness and streaking of the skin, and one may feel an enlarged node in the vicinity in the direction toward the heart.
- Swelling of a lymph node located deep inside the body may have different consequences from swelling of those just under the skin. The blockage in the flow of lymph from swelling in a deeper node may cause a swelling of a limb or, for example, swelling of lymph nodes in the lung could cause a chronic cough, even though you would not be able to feel a swollen node in that location.
- Generalized swelling of lymph nodes throughout the body may occur due to infection, systemic inflammation, or cancer.
Swollen Lymph Nodes Causes
Several mechanisms can cause the lymph nodes to enlarge (swell).
- Infection (lymphadenitis): This can increase the number of white blood cells, which multiply in response to stimulation with a foreign substance (antigen). Swollen lymph nodes under the arm (in the armpit) can occur due to infection or injury to the arm or hand. Some infections (mononucleosis or "mono," HIV, and fungal or parasitic infections) may cause generalized swelling of lymph nodes throughout the body.
- Virus: Immune reaction to a generalized infection in the body such as viral infections that can occur with the common cold as well as more serious infections such as HIV.
- Inflammation: Infiltration with inflammatory cells during infection or inflammation in a region of a given lymph node. Some immune disorders, such as lupus or rheumatoid arthritis, may also cause generalized lymph node swelling.
- Cancer: Infiltration with malignant cells (metastases) brought to the node with the lymph flowing from an area of certain types of cancer. In rare cases, breast cancer or lymphoma may cause swollen lymph nodes in the armpit. Rarely, a person may have a node or group of nodes that grows rapidly and becomes hard and can not be easily moved around under the skin. These may indicate a tumor.
- Cancer of the blood: Uncontrolled, malignant multiplication of lymphocytes as in lymphoma or leukemia.
In the most basic terms, cancer refers to cells that grow out-of-control and invade other tissues. Cells may become cancerous due to the accumulation of defects, or mutations, in their DNA. Certain inherited genetic defects (for example, BRCA1 and BRCA2 mutations) and infections can increase the risk of cancer. Environmental factors (for example, air pollution) and poor lifestyle choices—such as smoking and heavy alcohol use—can also damage DNA and lead to cancer.
Most of the time, cells are able to detect and repair DNA damage. If a cell is severely damaged and cannot repair itself, it usually undergoes so-called programmed cell death or apoptosis. Cancer occurs when damaged cells grow, divide, and spread abnormally instead of self-destructing as they should.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.