Tiny roundish lumps exist throughout the body. These lumps are known as lymph nodes and most of the time it cannot be felt. The lymph nodes play an important role in immunity and when there is an infection it is these lymph nodes that become active to form part of the body’s defenses. However, problems can arise with the lymph nodes as it can with any part of the body. Sometimes this causes the nodes to become enlarged or swollen.
Lymph Nodes Fight Infections
Lymph nodes are part of the lymphatic system, a ‘backup’ system for the blood vessels and also a part of the immune system. The lymphatic system is a network of channels (lymph vessels) and ‘filters’ (lymph nodes) that exists throughout the body. Any fluid that exists outside of the blood vessels needs to be drained back into the bloodstream and it is the lymphatic system that does this quite effectively.
Invading microbes in the tissue, like bacteria, usually cannot enter the blood vessels. These invaders are then drained away by the lymphatic vessels. Lymph nodes contain a range of of white blood cells but the main cells are those that attack and destroy invading pathogens (lymphocytes) and the cells that consume debris (macrophages). Once the lymphatic fluid is ‘filtered’, it is emptied back into the veins to join the bloodstream.
What is lymphadenopathy?
When a lymph node becomes enlarged (swollen lymph gland), it is referred to as lymphadenopathy. A swollen lymph node or gland is a term commonly used to describe lymphadenopathy. The enlarged lymph nodes may be isolated to a specific area of the body (localized lymphadenopathy) or present throughout the entire body (generalized lymphadenopathy).
Lymphadenopathy is an indicator of a disorder affecting a certain area of the body or a generalized condition throughout the body. Some groups of lymph nodes are more likely to become swollen, like those of the neck, axilla (armpits) and groins. It is important to differentiated between a firm and rubbery lymph node from one that is hard as this can indicate different conditions.
What is lymphedema?
Lymphedema is the swelling of an area due to a blockage within a lymph node or lymphatic vessel. If lymphatic fluid cannot filter and move through a lymph node, the lymph vessels become clogged. This prevents interstitial fluid from entering the lymph vessels and being carried back to the bloodstream. Lymphedema more often occurs in the limbs, upper and lower, and is evident as a swelling of the arm or leg, respectively.
Causes of Lymphadenopathy (Swollen Lymph Gland)
Swelling of the lymph nodes occurs as symptom of many diseases and has to be identified along with other signs and symptoms of the causative factor or disease.
- Inflammation of a neighboring organ or body structure or of the lymph node itself (lymphadenitis) or lymph vessels (lymphangitis).
- Infection. Viral, bacterial, protozoa or fungal infections. May be a localized infection or generalized.
- Cancer. Cancer of node or blood cells within a node (lymphoma, leukemia). Secondary spread (metastasis) from another site.
- Immune Disorders ranging from immune mediate hypersensitivity (allergies) to autoimmune conditions (like rheumatoid arthritis, sarcoidosis, SLE)
- Metabolic Disorders (1)
- Drugs (2)
Swollen lymph nodes can be a normal occurrence in certain cases and may not indicate any underlying disorder or disease. Lymphadenopathy is common in acute infections like influenza and will subside within a few weeks.
Lymphadenopathy may be asymptomatic meaning that the patient is not able to perceive any abnormality of the affected lymph nodes. Often the lymph node may be palpable (detectable to touch) but there are no other symptoms. At other times the enlarged lymph node may be accompanied by these other signs and symptoms:
- Tender or painful lymph node sometimes only detectable upon deep palpation (firm pressure) during a physical examination.
- Visibly swollen lymph node which is rare except in severe swelling of superficial (lying close to the skin) lymph nodes.
- Hard or rubbery lymph node that is either mobile or fixed (immobile).
- Size of the lymph node is equally important as it can help differentiate between infection and cancer.
The enlargement of the lymph node may be accompanied by other signs and symptoms depending on the underlying condition. This includes fever, muscle and joint aches, malaisea, fatigue and specific symptoms related to the problem area.
It is important for the physician to investigate further if a swollen lymph node or group of nodes is detected. With regards to the lymph node itself, the following factors pertaining to the swollen ‘gland’ need to be taken into consideration.
- Large or small
- Tender or painless
- Hard or soft
- Fixed or mobile
The following investigative procedures of the lymph node or group of lymph nodes may be necessary to assist with a diagnosis.
- CT Scans
It is important that lymphadenopathy is assessed by a doctor. While the enlargement occurs often during minor infections like the common cold, sometimes it can be more serious. Any lymph node enlargement that is persisting or becoming larger in size needs to be immediately investigated. Do not wait for other symptoms to arise.
Treatment should be directed at the underlying condition causing the swollen lymph node. Attempting to treat a swollen lymph node itself is pointless unless there is a specific pathology of the node. Sometimes a node may be drained through procedures such as fine needle aspiration (FNA). Contrary to popular belief, massaging a lymph node will not reduce swelling and may actually cause further complications.
It is important to stress that a swollen lymph node can be indicative of a minor or very serious underlying pathology. A swollen lymph node or groups of enlarged nodes should not be an immediate cause for concern unless it is persisting over a long period of time. If it is noticed that lymph node is growing, tender, hard or fixed, medical attention should be sought immediately.
1. Lymphadenopathy & Metabolic Deterioration. Wrongdiagnosis.com
2. Lymphadenopathy Differential Diagnosis & Evaluation. American Academy of Family Physicians