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Swollen Lymph Nodes

Posted Feb 03 2010 12:00am

When swollen lymph nodes in the neck, above the clavicles (collarbone) or in the axilla (armpit) occur there are a few immediate questions we need to answer.

  • Is there infection occurring in the body?
  • Could lymphoma (a cancer that begins in the immune system lymphocytes) be present or developing?
  • Is there cancer spreading from other sites?

A number of factors will help determine the importance of each of these questions.

For example, if a teenager has signs and symptoms of tonsillitis and there lymph nodes are swollen in the neck, we disregard the question of cancer.  We know infection is causing the lymph node swelling.

On the other hand, if a 30 year women has swollen lymph nodes above both clavicles and complaining of weight loss and night sweats, we must rule out lymphoma (e.g. Hodgkin or non Hodgkin).

Lastly, if a patient with a history of cancer …say prostate or cervical cancer…develop swollen glands in both axilla,  then we should wonder if the cancer has reoccurred and is it metastasizing (traveling to other parts of the body).

The lymph system is comprised of lymph vessels, lymph tissue including lymph nodes and lymph fluid.  These components are located throughout the body and are intimate with cardiovascular, pulmonary, digestive, genito-urinary, musculoskeletal and neurological systems.  The lymph system also includes the spleen, thymus and bone marrow where blood cells are produced.

The basic job of the lymph system is threefold:

Lymph nodes become enlarged with the increased influx of lymphocytes (white blood cells).  The immune response to foreign material also increases the production rate of T and B cells (part of the immune system) withing the lymph node.

Since lymph nodes are spread out in the body, some are palpable and some are not.  During infection of the throat for example, lymph node swelling may be felt in the area below the jaw or along the side of the neck.

In other cases, if cancer is suspected… say due to unexplained weight loss or lump in the breast, lymph nodes in that region of the body will be evaluated with palpation or sometimes with a CT scan of  the chest and abdominal cavity.

In sum, if you notice swollen glands, question why they are there.  Often it is nothing more than a short term infection.  But the best route is to notify your physician who will take a history and physical exam and give an appropriate diagnosis and treatment plan.

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