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The lymphatic system is a complex network of thin vessels, valves, ducts, nodes and organs. It helps to protect and maintain the fluid environment of the body by producing, filtering and conveying lymph and by producing various immune blood cells.
The lumps that you feel in your neck or under your jaw when you have a cold or a sore throat are called lymph nodes. Lymph nodes are part of the body's immune system. They help to destroy infectious germs, such as viruses (e.g. the common cold virus) and bacteria (e.g. strep). The lymph nodes make antibodies that will help keep you from being infected with a particular germ in the future.
The lymph system is present throughout the body. Common areas where enlarged lymph nodes can be felt (palpable nodes) include the groin area (inguinal region), armpit (axilla), the neck (there is a chain of lymph nodes on either side of the front of the neck, both sides of the neck, and down each side of the back of the neck), under the jaw and chin, behind the ears, and over the occiput (prominence on the back of the head). Their function is the same regardless of their location.
There are also lymph nodes that you can not feel, in your abdomen, pelvis and chest.
Lymph nodes play an important part in the body's defense against infection. Swelling might occur even if the infection is trivial or not apparent.
Lymphadenitis is an infection and inflammation of one or more of the lymph nodes and usually results from an infection that begins near a lymph node. Often caused by Staphylococcus aureus bacteria, this condition affects the nodes in the neck, groin and armpit. It sometimes strikes individuals who have had coronary artery bypasses using a saphenous vein from the leg: The removal of this vein is accompanied by removal of related structures of the lymphatic system, lowering immunity to infection.
Acute lymphangitis is a bacterial infection in the lymphatic vessels which is characterized by painful, red streaks below the skin surface. This is a potentially serious infection which can rapidly spread to the bloodstream and be fatal.
Lymph nodes are filters that can catch malignant tumor cells or infectious organisms. When they do, lymph nodes increase in size and are easily felt.
While lymph nodes are the most common cause of a lump or a bump in the neck, there are other, much less common causes, e.g., cysts from abnormalities of fetal development or thyroid gland enlargement. Usually, your doctor can tell the difference on a physical examination.
Causes & Development
When lymph nodes are active in fighting infection, they may become swollen and painful. Usually, the pain is mild, and the lymph node does not get much bigger than 2 centimeters (slightly under 1 inch) in size.
Swelling of lymph nodes generally results from localized or systemic infection, abscess formation, or malignancy; other causes of enlarged lymph nodes are extremely rare. By far the most common cause of lymph node enlargement is infection. As a rule, when swelling appears suddenly and is painful, it is usually caused by injury or an infection. Enlargement that comes on gradually and painlessly may result from malignancy or tumor.
Common causes of enlarged lymph nodes: - Infectious mononucleosis (behind the ears or neck)
- Rubella, also known as German measles (behind the ears)
- Tuberculosis (above the collar bone)
- Mumps (salivary glands)
- Ear infections or sore throat (neck glands, sometimes)
- Infection in the scalp (behind the ears or in back of the head)
- Impacted tooth (swollen gums)
HIV disease or AIDS; cat-scratch fever; juvenile rheumatoid arthritis; serum sickness; leukemia; Hodgkin's disease; non-Hodgkin's lymphoma; canker sores; drugs (such as phenytoin); typhoid vaccination; salivary duct stones. Any persistently swollen lymph gland requires careful diagnostic study.
Lumps in the armpit (axilla) may arise from various causes, including:- Bacterial
- localized infection, possibly somewhere in the arm or breast draining into the glands of the armpit, or infection within the armpit itself
- cat scratch disease
- ascending lymphangitis
- lymphadenitis, lymphangitis
- Viral
- Malignant
- Hodgkin's lymphoma
- non-Hodgkin's lymphoma
- leukemia
- Fungal
- Antigenic
- smallpox vaccination
- typhoid vaccine
- measles, mumps, rubella vaccine (rare)
- allergic reaction possibly caused by sulfa drugs, iodine, or penicillin
- Other
- lipomas (harmless fatty growths)
- benign cyst
- normal breast tissue (breast tissue extends into the armpit area)
Cysts and superficial infections in the skin of the armpit may follow shaving or use of antiperspirants (as compared to deodorants). This occurs most frequently in adolescents just beginning to shave. Subcutaneous abscesses may also produce large painful lumps in the axilla. Lumps may be produced by enlargement of the lymph nodes secondary to bacterial infections, viral infections, antigenic stimulation (as from vaccinations), and malignancy.
Treatment & Prevention
Generally, if you have symptoms of a cold or other minor infection, give the glands about 2 weeks to go back to normal. No specific treatment for them is needed. If the glands are small (less than 2cm or 3/4 inch across), are in your groin or under the chin, and you are a young adult, this is considered normal. Children tend to have a more active lymphatic system, so their glands may feel enlarged.
In general, always check with your health care provider to determine the nature of the lump. Do not try to diagnose lumps without professional help.
For a lump in the armpit caused by an infected, painful gland, follow the instructions about the proper treatment for the underlying infection.
Prognosis; Seek medical attention if
Soreness in lymph glands usually disappears in a couple of days without treatment. Glands become painful due to the rapid swelling of the gland in the early stages of fighting the infection. It takes much longer for the gland to return to normal size than it did to enlarge.
A lump in the armpit caused by a generalized viral infection will eventually disappear without therapy. A lump in the armpit caused by an allergic reaction will go away after the provoking substance is removed. No treatment is necessary for a lump in the armpit caused by normal breast tissue, and usually no treatment is necessary for a cyst. A lump in the armpit caused by a lipoma (fatty growth) is harmless, unless it grows so large that it causes discomfort. For a lump in the armpit caused by a malignancy, follow the appropriate cancer treatment recommended by a doctor.
Call your health care provider if:- after several weeks of observation the glands do not get smaller
- swollen glands are red and tender
- glands are hard, fixed to the skin, or are growing rapidly
- swollen glands are located behind the ear and there is also a scalp infection
- symptoms such as weight loss, night sweats, fatigue, or prolonged fever are also present
- one or more glands get larger over a period of 2-3 weeks.
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Signs, symptoms & indicators of Enlarged Lymph Nodes:
Risk factors for Enlarged Lymph Nodes:
Recommendations and treatments for Enlarged Lymph Nodes:
KEY | | Weak or unproven link |  | | Proven definite or direct link |  | | Likely to help |
GLOSSARY
Abdomen (Abdominal)
That part of the body between the chest and the hips that contains the stomach, intestines, liver, bladder, pancreas and other organs.
Acute
An illness or symptom of sudden onset, which generally has a short duration.
AIDS
Acquired Immune Deficiency Syndrome. An immune system deficiency disorder that suddenly alters the body's ability to defend itself. The AIDS virus invades the T4 helper/inducer lymphocytes and multiplies, causing a breakdown in the body's immune system, eventually leading to overwhelming infection and/or cancer, with ultimate death.
Antibody (Antibodies)
A type of serum protein (globulin) synthesized by white blood cells of the lymphoid type in response to an antigenic (foreign substance) stimulus. Antibodies are complex substances formed to neutralize or destroy these antigens in the blood. Antibody activity normally fights infection but can be damaging in allergies and a group of diseases that are called autoimmune diseases.
Antigen (Antigenic, Antigens)
A substance, usually protein or protein-sugar complex in nature, which, being foreign to the bloodstream or tissues of an animal, stimulates the formation of specific blood serum antibodies and white blood cell activity. Re-exposure to similar antigen will reactivate the white blood cells and antibody programmed against this specific antigen.
Arterial (Arteries, Artery)
Blood that leaves the heart. When it leaves the right ventricle, it is venous blood; and when it leaves the left ventricle, through the aorta, it is fresh and oxygenated. After it has passed out to the capillaries and started to return, it is venous blood.
Bacteria (Bacterial, Bacterium)
Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.
Benign
Literally: innocent; not malignant. Often used to refer to cells that are not cancerous; they tend to grow slowly and don't spread (metastasize) like cancer tumors do.
Boil (Abscess, Abscesses, Boils, Carbuncle, Carbuncles, Cystic Acne, Furuncle, Furuncles, Hidradenitis Suppurativa, Pilonidal Cyst, Pilonidal Cysts)
A localized infection deep in the skin. A boil generally starts as a reddened, tender area. Over time, the area becomes firm and hard. Eventually, the center of the abscess softens and becomes filled with white cells that the body sends to fight the infection (pus). Finally, the pus forms a "head" and drains out through the skin. A furuncle or carbuncle is an abscess in the skin caused by the bacteria Staphylococcus aureus. It can have one or more openings onto the skin and may be associated with a fever or chills. Cystic acne is a type of abscess formed when oil ducts become clogged and infected. Cystic acne is most common in the teenage years. Hidradenitis suppurativa is an illness in which there are multiple abscesses that form under the arm pits and in the groin area. These areas are a result of local inflammation of the sweat glands. A pilonidal cyst is a special kind of abscess that occurs in the crease of the buttocks. These frequently form after long trips that involve sitting.
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Canker Sores (Aphthous Ulcers, Apthous Stomatitis)
Small, painful ulcers that occur on the inside of the cheek, lip or underside of the tongue. Caused by an assortment of viruses, doctors call this condition aphthous stomatitis. Canker sores usually clear up by themselves within a week or so, but they often recur, sometimes in the form of multiple sores.
Centimeter (Centimeters, cm)
A metric unit of length equaling one hundredth of a meter, or ten millimeters. There are 2.54 millimeters in one inch.
Cysts (Cyst)
A closed pocket or pouch of tissue; a cyst may form within any tissue in the body and can be filled with air, fluid, pus, or other material. Cysts within the lung generally are air-filled, while cysts involving the lymph system or kidneys are fluid filled. Cysts under the skin are benign, extremely common, movable lumps. These may develop as a result of infection, clogging of sebaceous glands, developmental abnormalities or around foreign bodies.
Gland (Glands)
The glandular system is one of the most important and complicated systems of the body. Gland tissue can be either an organ or general tissue that secretes chemicals and there are two types of gland: exocrine and endocrine. Those glands which secrete chemicals through tubules or ducts are called exocrine and include sweat, tear and salivary glands. Ductless glands - part of the endocrine system - secrete special chemicals (hormones) directly into the blood.
Hodgkin's Disease (Hodgkin's)
Cancer of the lymphatic system and lymph nodes.
Human Immunodeficiency Virus (HIV)
A retrovirus associated with onset of advanced immunodeficiency syndrome (AIDS).
Immune System (Immune Response, Immunity)
A complex that protects the body from disease organisms and other foreign bodies. The system includes the humoral immune response and the cell-mediated response. The immune system also protects the body from invasion by making local barriers and inflammation. The process may involve acquired immunity (the ability to learn and remember a specific infectious agent), or innate immunity (the genetically programmed system of responses that attack, digest, remove, and initiate inflammation and tissue healing).
Inguinal
Pertaining to the region of the groin. Generally, the lowest lateral regions of the abdomen just above either side of the genitals.
Iodine
A essential mineral that is an integral part of the thyroid hormones, thyroxin and triiodothyronine which have important metabolic roles and govern basal metabolism. The best known iodine deficiency symptom is goiter. Other iodine deficiency problems are reduced vitality, hypothyroidism, inability to think clearly, low resistance to infection, loss of control of the muscles of the mouth resulting in mouth contortion and drooling, defective teeth, tendency to obesity and cretinism which is a congenital abnormal condition marked by physical stunting and mental deficiency.
Leukemia
Cancer of the lymph glands and bone marrow resulting in overproduction of white blood cells (related to Hodgkin's disease).
Lipomas (Hibernoma, Hibernomas, Lipoblastoma, Lipoblastomas, Lipoma)
Very common benign tumors that are made of normal fat cells. They feel like soft, moveable lumps underneath the skin and do not have any malignant potential. Can be easily surgically removed. Most are found under the skin, but they can develop anywhere in the body. Lipoblastomas and hibernomas, like lipomas, are also benign fat tissue tumors.
Lymph
A clear fluid that flows through lymph vessels and is collected from the tissues throughout the body. Its function is to nourish tissue cells and return waste matter to the bloodstream. The lymph system eventually connects with and adds to venous circulation.
Lymph Nodes (Axillary Nodes, Inguinal Nodes, Lymph Gland, Lymph Glands, Lymph Node, Lymphatic)
Small, bean-shaped nodes at various points throughout the body that function to filter the lymph fluid and attempt to destroy the microorganisms and abnormal cells which collect there. The most common locations are the neck (both sides and front), armpit (axillary) and groin (inguinal), but also under the jaw and behind the ears. Swollen or painful lymph nodes generally result from localized or systemic infection, abscess formation, or malignancy. Other causes of enlarged lymph nodes are extremely rare. Physical examination for lymph nodes includes pressing on them to check for size, texture, warmth, tenderness and mobility. Most lymph nodes can not be felt until they become swollen, and then will only be tender when pressed or massaged. A lymph node that is painful even without touching indicates greater swelling. Lymph nodes can usually be distinguished from other growths because they generally feel small, smooth, round or oval-shaped and somewhat mobile when attempts are made to push them sideways. Because less fat covers the lymph nodes in children, they are easier to feel, even when they are not busy filtering germs or making antibodies. Childrens' nodes enlarge faster, get bigger in response to an infection and stay swollen longer than an adult's. Also known (incorrectly) as lymph glands.
Lymphadenitis (Lymphangitis)
Inflammation or swelling of one or more lymph nodes. It may be an acute response or chronic, but signals the drainage into those nodes of microbes, their waste products, or the immuno-complexes produced upstream, whether from infection or allergy. A few infections can target or inhabit lymph nodes such as typhoid and EBV. Some people, with a past history of infection in a specific tissue will have developed a larger-sized node, hard and permanently palpable. These are hypertrophic or "shotty" nodes, and no more significant than pumped-up muscles or old scar tissue. Lymphangitis: Inflammation of one or more lymph nodes and/or lymph vessels, usually part of an acute infectious condition.
Lymphatic System
A network of vessels which collect fluid from the tissues of the body and return it to the blood. Lymphatic fluid (also called lymph) is rich in white blood cells that fight infection and an important part of the body's immune system.
Lymphoma (Lymphomas)
Any tumor of the lymphatic tissues.
Malignant (Cancerous)
Dangerous. Mainly used to describe a cancerous growth -- when used this way, it means the growth is cancerous and predisposed to spreading.
Mononucleosis
Infectious Mononucleosis: An acute, infectious disease caused by the herpes virus or Epstein-Barr virus, with fever and inflamed swelling of the lymph nodes around the neck, under the arms, and in the groin. The general symptoms are fever,
sore throat, exhaustion, and abnormal white blood cells.
Mumps
An acute infectious disease, caused by a paramyxovirus, and most common in children. Although it usually infects the parotid glands, and is often only a mild condition, it can spread to the testes or ovaries and cause serious problems, particularly when contracted by unresistant adults. A mild child's infection that is not properly monitored holds the potential for pancreatic or meningeal complications.
Occiput
Hind-most region on the top of the head.
Pelvis
The lower part of the abdomen between the hip bones. Organs in a woman's pelvis include the uterus, vagina, ovaries, fallopian tubes, bladder and rectum.
Rheumatoid Arthritis
A long-term, destructive connective tissue disease that results from the body rejecting its own tissue cells (autoimmune reaction).
Saliva (Salivary)
The watery mixture of secretions from the salivary and oral mucous glands that lubricates chewed food and moistens the oral walls.
Serum
The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.
Shingles (Herpes Zoster)
A severe infection caused by the Varicella-Zoster virus (VZV), affecting mainly adults. It causes painful skin blisters that follow the underlying route of brain or spinal nerves infected by the virus. Also know as herpes zoster.
Staphylococcus (Staph, Staphylococcal)
A genus of micrococci bacteria with many members that can cause disease. They are gram-positive, nonmotile bacteria
that are aerobic-(unless they need to be anaerobic). Staph of various types are responsible for boils and carbuncles; they may be involved in impetigo, toxic shock syndrome, endocarditis, osteomyelitis, and urinary tract infections, as well as some food poisoning. They stay around hospitals and veterinary clinics waiting to get you. They are also a normal part of the mouth, throat, and skin flora in a third to a half of all of us, causing no problems, but just waiting. Staph has always been with us. Some even eat our antibiotics for breakfast.
Streptococcus (Strep)
A genus of gram-staining chain-forming cocci bacteria. Some are responsible for common and potentially serious human infections, ranging from scarlet fever and strep throat to bacterial endocarditis and pus pockets. Most of the disease-potential streps are also a normal part of the skin, mouth and upper respiratory flora.
Subcutaneous (Subdermal)
Below the surface of the skin. Subdermal: Below the surface of the skin, and below subcutaneous, but definitely higher up than the muscles.
Thyroid (Thyroid Gland)
The thyroid gland is an organ with many veins, anchored around the front of the throat near the voice box. It is essential to normal body growth in infancy and childhood. It absorbs iodine from the diet and releases thyroid hormones - iodine-containing compounds that help govern the rate of the body's metabolism (its total life processes), affecting body temperature, and regulating protein, fat and carbohydrate catabolism in all cells. They keep up growth hormone release, skeletal maturation, and heart rate, force, and output. They promote central nervous system growth, stimulate the making of many enzymes, and are necessary for muscle tone and vigor. To a high degree, metabolism is regulated by the hormone thyroxine, which can be made by the thyroid if enough organic iodine is available. An enlarged thyroid gland that is not cancer is sometimes called goitre.
Tuberculosis
Also known as TB, Consumption or "The White Plague", tuberculosis is an infectious disease caused by a bacterium called Mycobacterium tuberculosis, usually affecting the lungs but possibly also the brain, kidneys and bones. Patients may at first be symptom-free or experience a flu-like illness. In the secondary stage, there might be a slight fever, night sweats, weight loss, fatigue and various other symptoms, depending on the part of the body affected. Tuberculosis of the lung is usually associated with a dry cough that eventually leads to a productive cough with blood-stained sputum. There might also be chest pain and shortness of breath.
Virus (Viri, Viruses)
Any of a vast group of minute structures composed of a protein coat and a core of DNA and/or RNA that reproduces in the cells of the infected host. Capable of infecting all animals and plants, causing devastating disease in immunocompromised individuals. Viruses are not affected by antibiotics, and are completely dependent upon the cells of the infected host for the ability to reproduce.
Last updated: Apr 13, 2008
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