What are swollen glands?
What causes enlarged lymph nodes?
Who gets enlarged lymph nodes?
What are the common findings?
How is an enlarged lymph node diagnosed?
How is an enlarged lymph node treated?
What are the complications?
How can enlarged lymph nodes be prevented?
Edythe A. Albano, M.D.
Associate Professor of Pediatrics
University of Colorado Health Sciences Center
The Children's Hospital
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.
Lymph nodes are located in the areas beside the head and the neck region. They can
be found in the armpits, the groin, above the elbow, and deep inside the chest and
the abdomen (belly). Their function is the same regardless of their location.
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.
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, us can tell the difference on a physical
Frequently, children have enlarged lymph nodes. The immune system of a child is
constantly being exposed to germs that it has never seen before, and the lymph nodes
may swell in reacting to those germs. In contrast, the immune system of an adult
has seen most of the common germs, and has developed immunity to them.
Therefore, the lymph glands do not need to work so hard, and they are much less
likely to become swollen. In fact, a study published in 1975 showed that 100% of
children who are under 12 years of age had lymph nodes that could be felt in the
In children, once a lymph node becomes enlarged, it may stay enlarged for a long
time. Sometimes, several lymph nodes can become enlarged at the same time. Usually,
the lymph node will begin to decrease in size within two to three weeks, but a little
bump (less than 1 centimeter, or 1/4 to 1/2 inches, in size) may be present for
However, lymph nodes should not continue to grow in size (especially grow greater
than 1 inch in diameter). If they do, you should contact us. Your doctor may want
to measure the lymph node and record the findings in your chart for accurate comparison
on your next examination.
Typically, a fever accompanies enlarged nodes when it is part of an infectious process.
You also may have a sore throat, enlarged tonsils, an earache, a dental problem,
or skin irritation or infection. Often, the problem that caused the swollen gland
will bring you to us and not the swollen lymph node.
Generally, enlarged lymph nodes are evaluated by a physical examination. Your doctor
Your doctor will examine the areas that the lymph node drains. For example, a lymph
node under the jaw should prompt a careful examination of the mouth and the throat.
Your doctor also will look for abnormalities that often are seen with enlarged lymph
nodes, such as a skin rash or a swollen liver and/or spleen.
Enlarged lymph nodes that grow progressively or are very large in size (generally
more than 3 centimeters, or 1 1/4 inches) may require more extensive evaluations,
to include a blood count; blood tests for infections, e.g., mono; a skin test for
TB; or an x-ray. This is particularly true if you have been losing weight, have
joint pain or swelling, have persistent fevers and/or night sweats, or have other
abnormalities that are found on a physical examination.
Sometimes, an enlarged lymph node needs no treatment at all, particularly if it
is enlarged because it is fighting a viral infection. Occasionally, antibiotics
will be prescribed if the lymph node is infected with a bacterial germ or is enlarged
due to a bacterial infection (e.g., strep throat). If the lymph node tenderness
is a problem, acetaminophen or ibuprofen can be taken to ease the discomfort.
Although steroids (prednisone) will cause the lymph nodes to decrease in size, regardless
of the cause of the enlargement, it is strongly discouraged because it could mask
a serious underlying cause of the enlarged nodes, delay the correct diagnosis, and,
possibly, complicate the treatment.
Rarely, us may recommend surgery to remove the lymph node so that it can be examined
under the microscope for the presence of cancer or unusual infections. Usually,
a course of antibiotics is administered first, before surgery is recommended. However,
surgery is most likely to happen if:
Most people worry that a persistently enlarged lymph node is something very serious,
like cancer. In children, this is rare. Even if us recommends a lymph node biopsy,
it is not very likely to show cancer. In fact, in one study of 239 children who
underwent lymph node biopsy, only 13% of the removed lymph nodes showed cancer.
The lymph node itself may become infected (called lymphadenitis), which can be very
painful, and is associated with redness and swelling. Usually, it requires antibiotics
for treatment. Infrequently, the lymph node may have a pus pocket inside of it (i.e.,
an abscess) that requires an operation to drain it.
An enlarged lymph node that is felt immediately above the collarbone is unusual
and seldom is associated with infection. If it occurs, you should contact us, as
it may be a sign of a more serious condition. For example, in teenagers, swollen
glands felt right above the collarbone could be the first sign of Hodgkin's disease,
a type of cancer that occurs in the lymph nodes.
Enlarged lymph nodes cannot be prevented. The lymph node helps the body to fight
infection, and, in the process, the lymph gland may increase in size. This is normal.
The lymph tissue decreases in size after puberty, and it becomes less noticeable.
However, you should contact us if:
About the Author
Dr. Albano is a board certified pediatric hematologist/oncologist.
She graduated summa cum laude from Loyola University, Stritch School of Medicine
and did both her pediatric residency as well as hematology/oncology fellowship at
The Children's Hospital National Medical Center in Washington, DC.
Besides a full time practice in clinical oncology, Dr. Albano is actively involved
in research in infections that occur in immunocompromised patients and their treatment.
Copyright 2012 Edythe A. Albano, M.D., All Rights Reserved
The information contained in these topics is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition. Nothing contained in these topics is intended to be used for medical diagnosis or treatment.
By using this website, you accept the information provided herein "AS IS." Neither RemedyConnect nor the providers of the information contained herein will have any liability to you arising out of your use of the information contained herein or make any express or implied warranty regarding the accuracy, content, completeness, reliability, or efficacy of the information contained within this website.
RemedyConnect, Inc. has created this privacy statement in order to demonstrate our firm commitment to your privacy. The following discloses our information gathering and dissemination practices for this website: http://www.remedyconnect.com.
We do not acquire any more information about website visitors than is required by law or is otherwise necessary to provide a high level of service efficiently and securely. Our site's registration form requires users to give us contact information (e.g., their name and e-mail address) and demographic information (e.g., children's birth months, but not birth dates). We use customer contact information from the registration form to (1) send the user pertinent medical and parenting information and (2) allow your local health provider lists of who is registering on that provider's site as a parent/guardian, staff member, doctor, or visitor. Users may opt-out of receiving future mailings; see the choice/opt-out section below.
We use your IP address to help diagnose problems with our server and to administer our Website. Your IP address is used to help identify you and to gather broad demographic information.
Demographic and profile data is also collected at our site. We may use this data to tailor the visitor's experience at our site, showing them content that we think they might be interested in, and displaying the content according to their preferences.
Our site may use order forms to allow users to request information, products, and services.
We will respect your doctor's right to privacy. A doctor typically does not give his/her e-mail address to the parents/guardians of patients. We will not provide the e-mail addresses of doctor(s) in the local practice to users of their site without the doctor(s)' permission. Their site is restricted to use by whomever they wish, and they may deny access to their site to one or more prior users. In unusual cases, doctors may change their private site's access code and arrange for us to e-mail the new access code to approved users.
This site contains links to other sites. RemedyConnect.com is not responsible for the privacy practices or the content of such Websites. See Disclaimers.
We will provide individually-identifiable information about website users to third parties only if we are compelled to do so by order of a duly-empowered governmental authority, we have the express permission of the visitor, or it is necessary to process transactions and provide you services from our affiliates: Live Agent Answering Service, Digital Answering Service, Medical Answering Service and Pediatric Answering Service.
This site may make chat rooms, forums, message boards, and/or news groups available to its users. Please remember that any information that is disclosed in these areas becomes public information and you should exercise caution when deciding to disclose your personal information.
This site has security measures in place to protect the loss, misuse and alteration of the information under our control. For further information regarding our security, please contact us at email@example.com. If you have any concerns regarding the security of information, please do not provide any information to RemedyConnect, Inc. until you are comfortable with our security measures.
You may correct or update your User Registration information at any time, by visiting the User Registration section and providing your personal password that you set at registration. If need be, please email us at firstname.lastname@example.org.
Our site provides users the opportunity to opt-out of receiving e-mail communications from our partners or us, except communications approved by your doctor's practice office. To so opt-out, please email us at email@example.com. To be removed as a user, please email us at the same address. If need be, you may mail requests to us at RemedyConnect, Inc., 9200 E. Mineral Avenue, Suite 100, Centennial, CO 80112. Our telephone number is 303-793-0703.
If you have any questions about this privacy statement, the practices of this site, or your dealings with this Website, you can contact us by email at firstname.lastname@example.org or by mail at our address above.