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Lymphadenopathy

The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on September 21, 2021.

If you’ve ever felt swollen lumps in your neck when you’ve had a respiratory infection or a sore throat, you’ve experienced lymphadenopathy—swollen lymph glands. There are many lymph nodes throughout your body.

These glands also may swell when cancer cells from a tumor move to them. If you’ve been diagnosed with cancer, your doctor may wish to biopsy lymph nodes near your tumor to see whether any cancer cells have migrated there. If cancer cells are found, it could indicate they may be spreading through your blood and causing secondary tumors (metastasis) elsewhere in your body. If surgery is done to remove your tumor, neighboring lymph nodes may be removed, too.

The lymphatic system

In addition to the circulatory system of blood, blood vessels and the heart, another system exists that transports fluid, specialized cells and nutrients throughout your body—the lymphatic system. Lymph, a clear or whitish fluid surrounding your body’s tissues, drains into lymphatic vessels, eventually emptying into the circulatory system.

In addition to lymph, lymph vessels and nodes, the lymphatic system includes your spleen, tonsils, adenoids and thymus gland.

This system plays an important part in fighting infection and disease by filtering out bacteria, viruses, cancer cells and foreign material and attacking them in the lymph nodes. You have hundreds of these small kidney-shaped structures located in clusters under your arms and in your groin, neck, central chest and abdomen. They make more white blood cells when your body senses infection or diseased cells. This immune reaction may cause lymph nodes to swell.

Risk factors and associated cancers

Most cases of lymphadenopathy aren’t caused by cancer. Malignancies are reported in as few as 1.1 percent of primary-care patients with swollen lymph nodes, according to a review in American Family Physician.

Two factors that are more associated with a possible cancer diagnosis: swelling that lasts longer than two weeks, and the appearance of lymphadenopathy in middle-aged and older patients.

Some cancer-related lymphadenopathy cases start with cells that travel from a tumor to one or more lymph nodes. But cancer also may originate in the lymph nodes.

Lymphomas are cancers that begin in lymph nodes. A swelling in the neck, underarm or groin is often the first sign of Hodgkin lymphoma, and is a common early symptom of non-Hodgkin lymphoma.

Other cancers associated with lymphadenopathy are:

Symptoms and complications

Some lymph nodes lie close under the skin; some are buried deep in your body. You may be aware of swollen lymph nodes in your neck, armpits or groin because you see and feel the swelling. You may not be aware of swollen nodes in your chest or abdomen unless they’re detected through imaging or scans.

Sometimes swollen nodes press on other structures, causing pain or discomfort as well as symptoms such as:

  • Swelling of a part of your body because lymph drainage is blocked
  • Blood clot because blood vessels are compressed
  • Difficulty breathing because part of your airway is compressed, in addition to a cough or hoarse voice
  • Tingling and numbness because your spinal cord or nerves are compressed

If doctors remove some of your lymph nodes, it may block the route for lymph to flow out of the area, and fluid can build up in fatty tissue located under the skin. The amount of lymph nodes removed directly relates to the amount of increased risk of this problem, called lymphedema. It commonly occurs in the limbs, but it may happen in the head, neck and torso.

In addition to surgical removal of lymph nodes, radiation therapy may damage nodes or lymph vessels and cause lymphedema.

Lymphedema can be a lifelong condition ranging from a feeling of fullness and tight skin to disabling limits on movement. It also carries the risk of a serious infection in the swollen area called cellulitis.

Treatment and prevention tips for lymphadenopathy

Treatment for cancer-related lymphadenopathy would involve the same therapies used to treat cancer. Lymphadenopathy caused by cancer is a symptom or complication of cancer, not a separate disease. It’s your body reacting to the presence of cancer cells.

Since cancer is the cause, prevention tips would include taking steps to decrease your chances of developing cancer or to catch it early before it spreads to lymph nodes.

Below are some general tips:

  • Adopt a healthy lifestyle by avoiding tobacco, reducing alcohol consumption, eating a balanced diet and limiting sun exposure.
  • Get vaccinated against HPV (human papillomavirus) and hepatitis B virus, both of which may lead to cancer.
  • Undergo screening tests, which may detect early presence of colorectal, breast and cervical cancers.

Lymph node involvement in cancer cases often means extra treatment with radiation and/or chemotherapy.

Enlarged lymph nodes caused by the presence of cancer cells may or may not be surgically removed. Laboratory analysis of biopsied lymph nodes may help your care team determine the stage of the cancer and provide information on its specific characteristics. This data may also aid in tailoring treatment to your individual case, which may include a combination of surgical removal, radiation, chemotherapy and immunotherapy.

Radiation therapy may shrink areas of lymphadenopathy and reduce symptoms, but it carries the risk of causing lymphedema.

In treatment of breast cancer, for example, if cancer cells are found in the axillary lymph nodes under the arm, this area and the affected breast may undergo radiation. Other clusters of lymph nodes located above the collarbone and in the middle of the chest may also be given radiation therapy.

Surgery isn’t often used to treat lymphomas. If a non-Hodgkin lymphoma is affecting only one area, targeted treatment with radiation would be chosen over surgery in most cases.

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