Lymph nodes are small, bean-shaped glands throughout the body that play an important role in the immune system. They contain white blood cells that help fight infection and disease. Lymph nodes can swell or enlarge in response to illness, infection, inflammation, or even cancer.
Most of the time, enlarged lymph nodes are not a major cause for concern. They often get bigger when fighting an infection and then shrink back down afterwards. However, sometimes enlarged lymph nodes can be a sign of something more serious like cancer. That’s why it’s important to know what enlarged lymph nodes feel like and when you should see a doctor.
What is a lymph node?
Lymph nodes are small structures that contain white blood cells which help fight infection and filter unwanted substances from your body. They are located throughout the body along the lymphatic system. Lymph fluid flows through the lymphatic system, passing through lymph nodes which filter the fluid and remove bacteria, viruses, cancer cells and other waste products. The lymph nodes contain lymphocytes (white blood cells) which attack and destroy these harmful substances.
The major groups of lymph nodes in the body include:
- Cervical lymph nodes – Located in the neck
- Axillary lymph nodes – Located under the arms
- Inguinal lymph nodes – Located in the groin area
- Mediastinal lymph nodes – Located in the chest cavity
- Abdominal lymph nodes – Located in the abdominal cavity
What causes lymph nodes to enlarge?
There are several possible causes for swollen or enlarged lymph nodes. These include:
- Infection – Viruses, bacteria, and other germs often cause lymph nodes to swell as they activate the immune response.
- Inflammation – Conditions like arthritis or eczema can cause inflammation that leads to enlarged lymph nodes.
- Cancer – Lymphoma and cancers that spread through the lymph system often cause swollen lymph nodes.
- Immune disorders – Diseases like lupus and HIV/AIDS can cause lymph nodes to enlarge.
- Medications – Some medications like antibiotics can sometimes cause temporary lymph node swelling.
- Injury or trauma – Injuries or surgery to lymph nodes or nearby areas can cause temporary swelling.
In most cases, the swelling is just the body’s normal immune response and the lymph nodes will return to normal size once the infection or inflammation goes away. But persistent, enlarged lymph nodes or those that keep growing larger may need medical evaluation to check for a more serious underlying problem like cancer.
What does a normal lymph node feel like?
When lymph nodes are normal and healthy, they are typically very small – about the size of a bean or pea. You usually can’t see or feel them under the skin unless you deliberately press the area and deliberately feel for them.
Normal lymph nodes are soft, smooth, small and somewhat oval or bean-shaped. They may feel rubbery and roll slightly under the skin when pressed gently. It’s normal to have a number of lymph nodes in areas like the neck, under the jaw, behind the ears, on the back of the head, and in the armpits that you can feel when pressing the skin.
What does an enlarged or swollen lymph node feel like?
Swollen lymph nodes are larger than the typical small, bean-sized nodes. They may be the size of a pea, marble, grape or even larger. Other characteristics of enlarged lymph nodes include:
- Round, oval or irregular shape
- Rubbery, firm or hard
- Fixed or immobile instead of movable under the skin
- Tender, painful or sensitive to the touch
- Clustered or grouped together
Swollen lymph nodes are commonly felt in the neck, under the jaw and chin, behind the ears, on the back of the head, and in the armpits and groin area. Lymph nodes deeper in the body can sometimes be felt as lumps or cause fullness or swelling in the abdomen, chest or pelvis. These warrant medical attention even if they are not tender or painful.
When are swollen lymph nodes a cause for concern?
In most cases, enlarged lymph nodes are not something to worry about. They often swell as part of the body’s natural immune response. However, you should see a doctor if you notice any of the following:
- Nodes are larger than 1 cm or continue to increase in size
- Last longer than 2-4 weeks without getting smaller
- Do not decrease after the illness or infection is gone
- Are hard, immovable, or fixed in place
- Feel clustered together in a group
- Are tender, painful or uncomfortable
- Swollen nodes along with unexplained weight loss or fever
Lymph nodes that persistently remain enlarged or continue to grow larger may indicate an underlying medical condition needing evaluation. This is especially important when swollen nodes are present without any other symptoms like a cold, ear infection, or skin infection.
What diseases or conditions cause concerning lymph node swelling?
Some examples of concerning conditions that can lead to swollen lymph nodes include:
Cancer
Cancers like lymphoma, leukemia, and metastatic cancers often cause lymph nodes to enlarge as cancer cells collect there. Swollen nodes may be the first sign of cancer. Lymphoma specifically involves the lymph nodes.
Infections
Serious infections like HIV, tuberculosis, syphilis, and toxoplasmosis can cause lasting lymph node swelling. Swollen nodes typically persist even after the acute infection goes away.
Immune disorders
Autoimmune diseases like rheumatoid arthritis, lupus and Sjogren’s syndrome can cause enlarged lymph nodes, especially near affected joints. Lymph nodes may remain chronically swollen.
Medications
Some medications used to treat autoimmune disorders, seizures, and heart conditions can rarely cause swollen lymph nodes. Stopping the medication usually resolves swelling.
Sarcoidosis
Sarcoidosis is an inflammatory disease that commonly causes swollen lymph nodes, especially in the chest and neck areas. Nodes typically enlarge slowly over weeks to months.
How are swollen lymph nodes evaluated?
If swollen lymph nodes do not diminish over 2-4 weeks or have features worrisome for cancer, your doctor will likely do some or all of the following tests:
- Physical exam – Feeling all node areas for enlarged nodes and their characteristics
- Blood tests – Complete blood count, blood protein levels, inflammatory markers, and tests to rule out infections
- Imaging tests – CT scan, MRI, or ultrasound to look at lymph node size and distribution
- Biopsy – Removing part or all of an enlarged lymph node to examine under a microscope
These tests help determine the cause of lymph node swelling and whether further treatment or cancer care is needed.
Conclusion
It’s common for lymph nodes to become temporarily swollen or enlarged when fighting infection. This is usually not a major cause for concern. However, lymph nodes that remain very enlarged or continue growing larger may be a sign of cancer or another serious medical condition that needs evaluation.
See your doctor if you notice any of the following:
- Lymph nodes larger than 1 cm (about the size of a grape)
- Persistently enlarged lymph nodes longer than 2-4 weeks
- Additional symptoms like unexplained weight loss or fever
- Lymph nodes that are hard, fixed, or clustered together
With appropriate testing and treatment as needed, concerning lymph nodes can be effectively managed. Being aware of your lymph nodes and any changes is important for identifying potential problems early.