Home
About Us
Our Services
New Patients
Forms & Policies
Medical Resources
   Emergencies
   Medical Conditions
      Abdominal Pain, Recurrent
      Acne
      Acute Ear Infections and Your Child
      Acute Lymphoblastic Leukemia
      Acute Otitis Media
      Acute Strep Throat
      Addison
      ADHD and Your School-aged Child
      AIDS/HIV
      Allergies in Children
      Anaphylaxis
      Anemia and Your Young Child
      Anesthesia and Your Child
      Ankle Sprain Treatment (Care of the Young Athlete)
      Antibiotics and Your Child
      Anxiety
      Appendicitis
      Asthma
      Asthma and Exercise (Care of the Young Athlete)
      Asthma and Your Child
      Asthma Triggers
      Atopic Dermatitis (Eczema)
      Attention-Deficit Hyperactivity Disorder
      Attention-Deficit Hyperactivity Disorder (ADHD)
      Breast Enlargement, Premature
      Breath-Holding Spells
      Bronchiolitis
      Bronchiolitis and Your Young Child
      Care of the Premature Infant
      Celiac Disease
      Chickenpox
      Chickenpox Immunization
      Chickenpox Vaccine, The
      Coarctation of the Aorta
      Colds
      Common Childhood Infections
      Congenital Hip Dysplasia
      Constipation
      Constipation and Your Child
      Coxsackie A16
      Croup
      Croup and Your Young Child
      Croup: When Your Child Needs Hospital Care
      Crying and Your Baby: How to Calm a Fussy or Colicky Baby
      Cyclic Vomiting Syndrome (CVS)
      Depression
      Developmental Dysplasia of the Hip
      Diabetic Mother, Infant of
      Diaper Rash
      Diarrhea and Dehydration
      Diarrhea, Vomiting, and Water Loss (Dehydration)
      Ear Infection
      Ear Infections
      Eating Disorders
      Eczema
      Eczema (Atopic Dermatitis)
      Enlarged Lymph Nodes
      Erythema Multiforme
      Eye Problems Related to Headache
      Febrile Seizure
      Febrile Seizures
      Fetal Alcohol Syndrome
      Fever
      Fever and Your Child
      Fifth Disease
      Fifth Disease (Erythema Infectiosum)
      Flu
      Flu, The
      Food Allergies and Your Child
      Food Born Illnesses
      Fragile X Syndrome
      Gastroenteritis, Viral
      Gastroesophageal Reflux
      Giardiasis
      Guide to Children's Dental Health, A
      Hand Foot and Mouth
      Hand-Foot-and-Mouth Disease
      Head Lice
      Headache Related to Eye Problems
      Hemangioma
      Hepatitis A
      Hepatitis A Immunization
      Hepatitis B
      Hepatitis B Immunization
      Hepatitis C
      Hib Immunization
      High Blood Pressure
      Hip Dysplasia (Developmental Dysplasia of the Hip)
      HIV/AIDS
      How to Take Your Child's Temperature?
      Hyperactivity
      Hypertension
      Hypothyroidism
      Immunization
      Infant of a Diabetic Mother
      Infectious Mononucleosis
      Influenza Immunization
      Influenza-Seasonal
      Inhaled and Intranasal Corticosteroids and Your Child
      Kawasaki Syndrome
      Language Development in Young Children
      Lead Poisoning
      Leukemia
      Lung Hypoplasia
      Lyme Disease
      Lymphadenopathy
      Measles
      Mental Health
      Middle Ear Fluid and Your Child
      MMR Immunization
      Molluscum Contagiosum
      Mumps
      Obesity in Childhood
      Osgood-Schlatter Disease
      Otitis Media, Acute
      Pneumococcal Conjugate Immunization
      Pneumonia and Your Child
      Polio Immunization
      Premature Thelarche
      Prematurity
      Prematurity, Retinopathy of
      Pulmonary Hypertension
      Pulmonary Hypertension (PPH & SPH)
      Retinopathy of Prematurity
      Rheumatic Fever, Acute
      Ringworm (Tinea)
      Roseola
      Rotavirus
      Rubella (German Measles)
      Safety of Blood Transfusions
      Scabies
      Seasonal Influenza (Flu) 2014–2015
      Separation Anxiety
      Sinusitis
      Sinusitis and Your Child
      Sleep Apnea and Your Child
      Smoking
      Speech Development in Young Children
      Stevens-Johnson Syndrome
      Strep Throat
      Strep Throat-Acute
      Strep Throat-Recurrent
      Stuttering and the Young Child
      Swine Flu
      Swine Flu (H1N1) FAQ
      Swine Flu (H1N1) Vaccine
      Swollen Glands
      Tattoos
      Tear Duct, Blocked
      Tetralogy of Fallot
      Thyroid Problems
      Tinea (ringworm infection)
      Tonsils and the Adenoid
      Toxic Shock Syndrome
      Toxoplasmosis
      Turner Syndrome
      Type 2 Diabetes: Tips for Healthy Living
      Underdeveloped Lungs
      Urinary Tract Infection
      Urinary Tract Infections in Young Children
      Varicella or Chickenpox
      Varivax Immunization
      Vesicoureteral Reflux
      Wheezing-Infant
      Whooping Cough (Pertussis)
      Wilson Disease
   What's Going Around?
   Pediatrics
Contact Us

Practice News

Anywhere Family Practice is thrilled to announce the addition of Dr. Julie Johnson to our team.
We will be transitioning to a new patient portal in April. Watch for new updates on this website!

Is Your Child Sick?TM

 

Are You Sick?

Lymphadenopathy

Edythe A. Albano, M.D.
Associate Professor of Pediatrics
University of Colorado Health Sciences Center
Pediatric Oncologist
The Children's Hospital
Denver, CO

What are swollen glands?

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.

top

What causes enlarged lymph nodes?

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 examination.

top

Who gets enlarged lymph nodes?

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 neck.

top

What are the common findings?

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 months.

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.

top

How is an enlarged lymph node diagnosed?

Generally, enlarged lymph nodes are evaluated by a physical examination. Your doctor will note:

  • the size and the location of the enlarged lymph node;
  • if one or more lymph nodes are involved;
  • if the node is tender
  • if it is associated with redness of the overlying skin; and
  • how it feels, e.g., soft, firm, rubbery, or hard.

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.

top

How is an enlarged lymph node treated?

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:

  • the lymph node is large (greater than 3 centimeters, or 1 1/4 inches);
  • there are other abnormal physical examination findings, e.g., an enlarged liver and/or spleen;
  • the blood count is abnormal; or
  • the chest x-ray shows enlarged nodes.

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.

top

What are the complications?

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.

top

How can enlarged lymph nodes be prevented?

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:

  • the lymph nodes are larger than 3 centimeters, or 1 1/4 inches;
  • there are signs or symptoms of an infection, such as a sore throat, a fever, or an earache;
  • the lymph nodes are felt above the collarbone, regardless of their size; or
  • you have persistently enlarged nodes, lasting three or more weeks.

top

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