Enlarged lymph nodes, swollen lymph glands

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The human body has about six hundred lymph glands (lymph nodes). These lymph nodes are palpable when they are enlarged. The lymph nodes in the groin, armpits and neck are palpable felt when enlarged. However some lymph nodes are not palpable when they are enlarged. These are the lymph nodes deep in the abdomen and in the mediastinum. Normal lymph nodes are not palpable. When lymph nodes are palpable (feel like a bean), they are therefore enlarged. In most cases a enlarged lymph node is harmless.

What is a lymph node (lymph gland)?
Lymph nodes (lymph glands) are can be found in the entire body. Lymph nodes are a sort of node of afferent lymphatic vessels. Lymph nodes contains numerous lymphocytes. Lymphocytes are white blood cells. White blood cells are cells of the immune system. Any harmful substances such as pathogens in the lymph fluid have to be destroyed by the lymphocytes. When there are more lymphocytes needed, the activity of the lymph node increases. The result of this increased activity is an enlarged lymph node. The cause of an enlarged lymph node is often innocent.

In fact, a lymph gland is not an actual gland, but a collection of lymphocytes. These lymphocytes are B-lymphocytes and T-lymphocytes. Glands in the human body can be divided in:

  • Endocrine glands such as the pancreas (pancreas produces insulin and glucagon), adrenal gland (the adrenal gland produces adrenaline and cortisol)
  • Exocrine glands such as salivary glands, sweat glands and sebaceous glands

Enlarged lymph nodes, swollen lymph glands

Enlarged lymph nodes can be felt at the back of the head, beneath the jaw, in the armpits and/or groin area. People with enlarged lymph nodes usually have only one enlarged lymph node. However, it is also possible that people have several enlarged lymph nodes in different parts of the body. An enlarged lymph usually arises in the vicinity of an infection, eg, common cold, or a wound. Usually the cause of an enlarged lymph node innocent. If in the neighborhood of the enlarged lymph node no wound or infection is present, one must determine if there are more enlarged lymph nodes.In rare cases, enlarged lymph nodes can indicate a serious condition. Enlarged lymph nodes can indicate lymphoma or metastasis (spread) of a malignant (cancerous) process to the lymph nodes. So it is very important to quickly distinguish between innocent enlarged lymph nodes or enlarged lymph nodes which may indicate a serious condition. This distinction between an innocent or possibly serious cause of an enlarged lymph node is not always easy. The physician can look for possible innocent disease that are present such as a sore throat. The physician can also look at the position where the enlarged lymph node is found, the size of the lymph node, the consistency of the lymph node and patient characteristics.

Causes of enlarged lymph nodes
Below is a list of common possible causes of enlarged lymph nodes;

Enlarged lymph nodes due to inflammation
Inflammation can cause enlarged lymph nodes. The infection can be caused by viruses, bacteria, parasites and fungi. Swelling of the lymph nodes in the neck are very common. This could be caused by viruses of the upper respiratory tract infections or pharyngitis. Swelling of glands in the neck is also typical of mononucleosis or kissing disease (infectious mononucleosis), and cytomegalovirus.

System Disorders
You can think of rheumatoid arthritis (RA) and systemic lupus erythematosus. It is rare that these enlarged lymph nodes are the first symptom.

Metastasis in the lymph node
Cancer cells can from a malicious process in lymphatics and thus grow in the lymphatic system. Through the lymph nodes and lymph vessels, the cancer cells can travel to another part of the body. This process is called metastasis.

Cancer (malignancy) of the glands themselves
These include non-Hodgkin’s and Hodgkin’s lymphomas and lymphoid leukemia. These cancers are cancers of the lymph nodes.

Enlarged lymph nodes and cancer
Often the cause of enlarged lymph nodes is innocent. However, you can be worried when you have enlarged lymph nodes. Often people think that enlarged lymph nodes are caused by cancer (lymphoma). When enlarged lymph nodes are found in addition to the following symptoms, the cause can be cancer:

  • Unexplained weight loss
  • Decreased appetite
  • Fatigue
  • Malaise
  • Fever
  • Night sweats
  • Uneasy feeling
  • Unexplained redness
  • In several places enlarged, hard lymph nodes

Other serious illnesses can also cause enlarged lymph nodes. Contact your physician when you are worried.
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References:

  • E. Rubin, Farber, JL, Pathology (1999), Lippincott-Raven, Philadelphia, New York
  • H. de Vries, de Jongh, TOH, Grund Meijer, HGLM, Diagnosis of everyday complaints (2003), Bohn Stafleu of Lofhum, wooden
  • EH of Lisdonk, van den Bosch, WJHM, Lagro-Janssen, ALM, Diseases in general practice (2003), Elsevier Health, Maarssen