Lifespan's A - Z Health Information Library

The term "swollen glands" refers to enlargement of one or more lymph nodes.

In a child, a node is enlarged if it is larger than one centimeter (0.4 inch) in diameter.

See also lymphadenitis and lymphangitis.

Lymph nodes are glands that play an important part in your body's defense against infection. They produce lymph, which travels throughout your body in the lymph system, and filters impurities from the body.

Common areas where the lymph nodes can be felt (with the fingers) include:

• Groin
• Armpit
• 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
• On the back of the head

Lymph nodes can become swollen from infection, inflammatory conditions, an abscess, or cancer. Other causes of enlarged lymph nodes are rare. By far, the most common cause of swollen lymph nodes is infection.

When swelling appears suddenly and is painful, it is usually caused by injury or an infection. Enlargement that comes on gradually and painlessly may, in some cases, result from cancer or a tumor.

Infections that commonly cause swollen lymph nodes include mononucleosis, German measles (rubella), tuberculosis, mumps, ear infection, tonsillitis, an abscessed or impacted tooth, gingivitis (swelling of the gums), mouth sores, and sexually transmitted diseases.

Immune or autoimmune disorders that can cause swollen lymph nodes include rheumatoid arthritis and HIV. Cancers that can cause swollen glands include leukemia, Hodgkin's disease, or non-Hodgkin's lymphoma.

Which lymph nodes are swollen depends on the type of problem and the body parts involved. Identifying the location can help determine the possible cause.

Swollen lymph nodes may also be caused by some medications (like phenytoin for seizures) or certain vaccinations (namely, typhoid).

Soreness in lymph glands usually disappears in a couple of days without treatment, but the nodes may not return to normal size for several weeks after the infection has cleared. Generally, if glands are painful, it is because they swell rapidly in the early stages of fighting an infection.

Call your doctor if:

• Your glands don’t get smaller after several weeks or continue to get larger.
• Your swollen glands are red and tender.
• Your glands feel hard, irregular, or fixed in place.
• You have a fever, night sweats, or unexplained weight loss.
• Any node in a child is larger than 1cm in diameter.

Your doctor will perform a physical examination, checking all of your palpable lymph nodes for size, texture, warmth, tenderness, and other features.

Your doctor may ask the following medical history questions:

• Which nodes are affected?
• Is the swelling the same on both sides?
• When did the swelling begin?
• How long has it lasted (how many months or weeks)?
• Did it begin suddenly or did it develop gradually?
• Is the swelling increasing in size?
• Are the number of nodes that are swollen increasing?
• Are any of the swollen nodes painful or tender when you gently press on them?
• Is the skin over or around the nodes red?
• Have you had any other symptoms?

The following diagnostic tests may be performed:

• Blood tests including liver function tests, kidney function tests, and CBC with differential
• lymph node biopsy
• chest x-ray
• liver-spleen scan

Vincent MT. Pharyngitis. Am Fam Physician. 2004; 69(6): 1465-1470.

Bisno AL. Infectious Diseases Society of America. Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Clin Infect Dis. 2002; 35(2): 113-125.

Abeloff MD. Clinical Oncology. 3^rd ed. Amsterdam, Netherlands: Elsevier; 2004.