Causes of Swollen Neck Lymph Nodes

The neck contains a large number of lymph nodes, known as the cervical lymph nodes and many are superficial and easily palpable (can be felt by touch). A swollen neck lymph node is not uncommon and frequently occurs in children, even when there is no disease or obvious cause present. With age, the incidence of enlarged neck lymph nodes declines except when it is due to some pathology.

The most common cause for swollen neck (cervical) lymph nodes is an infection. While most incidents of cervical lymph node enlargement is self-limiting and resolves quickly, some may persist for a longer time and may need more active management. Amongst this group, the supraclavicular lymph nodes are of special significance. Their enlargement may be an ominous sign since it is most often associated with malignancy and careful assessment and investigation is indicated.

Anatomy of Cervical or Neck Lymph Nodes

Swollen lymph nodes of the neck may be localized, where only groups of lymph nodes in the neck are enlarged. In some cases, it may be generalized where lymph nodes in other parts of the body are also involved.

There are mainly six different groups of lymph nodes situated in the neck and according to their location they are classified as :

  • Anterior cervical lymph nodes which lie in the front of the neck and are of two types, superficial and deep. They drain the internal structures of the throat as well as the tonsils and thyroid gland.
  • Posterior cervical lymph nodes which are located in a line at the back of the neck, extending from the mastoid part of the temporal bone (from about the middle of the head) to the clavicle (collar bone). They normally become enlarged in the event of an upper respiratory tract infection.
  • Tonsillar lymph nodes which are situated just beneath the mandible (jaw bone). They drain the tonsils and posterior part (back) of pharynx.
  • Sub-mandibular lymph nodes which lie along the bottom of the mandible (jaw bone) and drain the floor of the mouth tongue, lips, and conjunctiva. They are normally enlarged due to infections of the head, neck, sinuses, ears, eyes and pharynx.
  • Sub-mental lymph nodes which are located just below the chin and help to drain the teeth, lower lip, floor of the mouth, tongue and cheek. They commonly enlarge due to mononucleosis, toxoplasmosis, and dental infections such as periodontitis.
  • Supraclavicular lymph nodes which are situated in the hollow just above the clavicle (collar bone).
  1. The right supraclavicular lymph nodes drain the lungs, mediastinum and esophagus. It is commonly enlarged due to lung cancer, gastrointestinal cancer or Hodgkin’s lymphoma.
  2. The left supraclavicular lymph node drains the thorax (chest) and abdomen. It may be enlarged due to thoracic or retroperitoneal cancer, breast cancer, lymphoma, or an infection. The left supraclavicular lymph node or Virchow’s node enlargement may be the first sign of stomach cancer, even before the presentation of any other symptoms.

Causes of Neck Lymph Node Swelling

The common causes of lymph node swelling of the neck include :


Infections are the most common cause of swollen neck lymph nodes whether it is a viral, bacterial or parasitic infection is an infection. Some of these infections include :

  • Strep throat.
  • Tonsillitis.
  • Peritonsillar abscess.
  • Mumps.
  • Measles.
  • Rubella (German measles).
  • Dental infections.
  • Ear infections.
  • Skin infections and infected wounds of the head and neck particularly.
  • Sinusitis.
  • Epiglottitis.
  • Infectious mononucleosis.
  • Tuberculosis.
  • Sarcoidosis.
  • Cat scratch disease.
  • Toxoplasmosis.
  • Sexually transmitted disease (STD) such as syphilis can also produce lymph node swelling of the neck.


Malignant tumors, particularly in the head or neck, may cause lymphadenopathy of the cervical lymph nodes. This may also indicate metastasis (cancer spread) from other parts of the body or the areas drained by the affected lymph nodes. It is important to take note of the Virchow’s node which may be an early warning sign of stomach cancer.

  • Lymphoma is cancer of the lymph node and there are two forms of lymphomas – Hodgkin’s disease and non-Hodgkin’s disease.
  • Leukemia is cancer of the blood forming tissues, including bone marrow and lymphatic system and may cause lymph node enlargement.
  • Melanoma – a type of skin cancer.
  • Cancer of the mouth, larynx, or oropharynx can cause enlargement of the draining lymph nodes in the neck.


Systemic causes of swollen neck lymph nodes usually involve different types of autoimmune diseases and other diseases that cause an immune deficiency. This includes :

  • Rheumatoid arthritis.
  • Systemic lupus erythematosus (SLE).

Usually the lymph node swelling is not isolated to the cervical lymph nodes and may be generalized.

Drugs and Vaccines

  • Certain drugs like  phenytoin and carbamazepine may cause swelling of the neck lymph nodes as a side effect. Other drugs may also be responsible.
  • Vaccinations like the MMR vaccine for protection against  measles, mumps, and rubella as well as the typhoid vaccine may occasionally cause lymph node swelling although this is usually temporary.


The characteristics of the swollen lymph node often helps to determine the cause of the swelling. Usually, lymph node swelling due to an infection are soft, painful, and mobile, with signs of inflammation on the overlying skin. Cancerous lymph nodes are hard, fixed (not mobile) and usually not painful. Lymph nodes that seem connected to each other are called “matted” lymph nodes and may be associated with tuberculosis, sarcoidosis or malignancy.

Lymph nodes are sometimes described as “shotty” when they may be small, non-tender and have a rubbery consistency. This type of lymph node may be seen following an infection which has already resolved and does not have the typical characteristics of either an infected or a malignant lymph node.

Constitutional symptoms such as fever, night sweats, weight loss and fatigue may also give an indication as to the cause of lymph node swelling. If necessary, your doctor may consider a biopsy for further investigation in order to make a conclusive diagnosis.

Please note that any information or feedback on this website is not intended to replace a consultation with a health care professional and will not constitute a medical diagnosis. By using this website and the comment service you agree to abide by the comment terms and conditions as outlined on this page

  • Pingback: Lymph Node Cancer | Current Health Articles()

  • jonsyt

    I have had swollen gland in neck for about 2 years none stop they are not painful but they ich alot usually early on the morning for about an hour after i wake up the itching is centred mainly around the adams aplle on the rightand left side although the swelling is a bit further up between jaw bone and ear . I have been todoctors and have had 2 tests done one was a camera in my nose to look at throat (cant remember name) the other a ultrasound both showing nothing. I am not losing wait and dont feel unwell .any have any ideas what this could be ?

  • Dr. Chris

    Hi Jonsy1

    Firstly, it has to be assessed whether this is the thyroid gland or not. If it really is the lymph nodes, then further asssessment (possibly a biopsy) of the node is necessary. Persistent enlargement of the node, which from what you say is affecting multiple nodes and spreading, would only happen in a chronic infection like HIV or with conditions like cancer. Both are serious conditions that need to be diagnosed early. Of course there are other causes but these are the most common. I would advise that you start with the HIV test.

  • m_p_kumar


    For past 1 month I am having swollen lymph nodes in my arm pit. It started with high fever [103+ deg] and could not be controlled with normal antibiotics.

    The temperature is now in control after taking IV antibiotics but the lymph glands are continue to swell. During another Ultra Sound, doctors found swollen lymph nodes in my neck and left collar bone area also.

    Have got couple of FNAC done for the axillary nodes and both time it has come negative for malignancy and as reactive.

    Doctors have suggested wait and watch approach but I am very concerned because of family history and the swelling spreading into other areas.

    Please suggest.


  • Dr. Chris

    HI M_P Kumar

    Lymph node swelling after an infection may occur for a short period. The wait and watch approach is advisable since and FNAC has been done. The procedure may need to be repeated at a later stage. Ensure that all the necessary blood tests have been done, including a CBC (complete blood count) and HIV test.

  • Nataliia Kubyshkina

    hi…on my left side , right behind my ear i fill swollen little ball…it heats like crazy…i just had cold for about 3 days with headache and sinuses …. how to treat it ?

  • Hi Nataliia. This is very likely a swollen lymph node. The lymph nodes in this area does swell with a viral infection like the common cold. It can take days or weeks for it to shrink back to a normal size. You do not have to do anything. It will resolve on its own. However, if the swelling persists or gets larger then you should see a doctor. It is also possible that this is not a swollen lymph node but instead a boil or abscess. It is difficult to say with any certainty on an online platform. Rather see a doctor.

  • Bill S

    I am being treated for cervical dystonia and taking Artane (Trihexyphenidyl) for the spasms, and Gralise (Gabapentin) for the associated nerve pain. I’ve received 2 treatments with botox, 1st was October 2014, 2nd was January 2015 (3 months apart). My symptoms (intense spasms in several neck muscles and traps on the right side only) are permanent, but the Rx and botox are supposed to decrease the symptoms (they do, but as stated there are times where it seems they are doing nothing, other times I am able to deal with it). That’s the background. My concern now is swollen cervical anterior (mostly left side) and just recently Supraclavicular lymph nodes on left side. All are palpable, semi-soft / rubbery and movable. I am going to see my PCP regarding this (recommended by the neurology Dr dealing with the dystonia). Here’s my question however: When I press/massage the lymph nodes in question (softly) I get a tingling pain down my right arm. Note that the dystonia is on the right side. I can’t find a single reference doing research on how this could be, and my neurologist is also uncertain. Has any heard of this before?

  • Hi Bill S. Please provide us with any feedback that you may have received from your PCP. The logical assumption would be that the pressure on the lymph node is pressure on a nerve going down the arm. But as you say the enlarged lymph node is on the left side and the tingling is on the right side. Would be very interesting to hear what is eventually diagnosed.

  • Bill S

    I had a CT scan that showed all lymph glands are fine, and not large. I just notice them more because I rubbing/massaging the neck due to the dystonia. My PCP feels I am inflaming the nerves coming out the neck and that is causing the issue, but he has no solid answer why rubbing the left causes tingling on the right, other than the way I am using my arm/hand to massage somehow is engaging muscles/nerves on the other side. But it doesnt matter which hand I use to rub, it always results in the right arm going numb/tingling. I am seeing my neurologist this week to see if he has any additional tests or ideas. I’ll post the results!

  • Hi Bill. Thank you for coming back to us. It would be interesting to hear if this is probably emanating from your cervical spine and possibly related to the dystonia which may have put pressure on this area of the spine. Waiting to hear the results. Thanks again. Your reports will surely help many of our readers.

  • Stef

    Hey, I’m 22 and I recently slept in the incorrect posture and got neck spasm for 4 days till I got a massage which it all went away but then I noticed this small soft ball on my right side under my ear in the back. For 4 days I thought it was my neck spasm but now that it’s gone I’m left with this uncomfortable little pain. Please help I’m really scared

  • Hi Stef. Hopefully it has resolved by now. This could be an enlarged lymph node which is not uncommon with an ear infection. In fact any infection in the neighboring areas could also cause this lymph node to swell. It usually isn’t a problem if it arose suddenly. It may go away gradually. However, if it persists and is growing in size then you must have it checked up.

  • shanell

    Hello! Im a 28 yr healthy female.I have had a swollen lymphnode on the left side of the back of my neck mear my hair line. It has been this way for a few weels possibly longer (just notifed it) it doesnt hurt, I haven’t been sick, I dont have any dental infections (although i did have one on the right side of my lower mouth for about a month month ago, now has been treated with root canal) , I don’thave a fever, weight loss etc.. It is small maybe the size a a pea maybe a little bigger. It hasn’t grown in size. My question is should i be concerned about cancer or any other serious illness? I had the same thing a few years ago on the right (i think could of been this side) and doctor said i was fine. I have no family hx of lymphoma etc..only breast cancer. I am pn wellbutrin and birth control and thats it. What are your thoughts / questions? Should i get an ultrasound (although, I am terrified)

  • Satriana

    Hi. My son is 14 and was playing american football for a while. Now he’s telling me he was hit a month ago under the mandible. He has now 2 lumps where the sub-mental lymphs are.. He thinks they were growing but, of course, he didn’t tell me! They are not painful and they are very hard.
    He also has a bad case of acne on his face. Not sure if there is a connection. I have been waiting for 3 weeks for a family doctor appointment for his acne but now, with the new issue, I hope the doctor will accept to talk about both… Please help, I am desperate.

  • Bryan Reed

    I have the exact same thing. Went to the doctor today and got blood tested. Depending on the results they’re gonna refer me to an ear nose and throat specialist.

  • Natosha

    Hi, my story started back in July of 20015 I noticed a small lump on the left side of my neck I didn’t pay no mind to it till another one popped up on my right side a few weeks later. I still didn’t think anything of it till I noticed that my left side of neck felt matted. In Sept I went to dr. and they did blood work all came back normal. A few month went by and I still had them but now more have popped up above my collar bone and both sides of my neck felt all matted up. I went back to dr and they did X-rays of my chest those came back normal my Dr sent me to a surgeon and he just felt around and said he don’t fell anything but he sent me to do an ultrasound. By this time we are already in April 2016 my results came back which he won’t tell me much except that my left and right side neck is all matted up and one of my lymph nodes that stands alone is almost 2cm. (Cervical) He wants to do a biopsy on it on the 18th for my cervical one and for the one by my collar bone. Throughout all this I have lost weight, very tired, night sweats, I’m always hot and cold and bad headaches. My lymph nodes have been swollen for 9 months. My question is should I be worried now, I’ve read that matted means “bad”. Is this true? Please help my Dr. won’t tell me anything, I just need honesty from someone. I have lost 2 cousins to lymphoma, my grandma is a survivor of lymphoma and my grandfather is trying to beat it as we speak. What are my odds of it being passed to me? My swollen nodes are fixed, some what hard and doesn’t hurt at all.