Swollen Glands

Lymph nodes are a part of the immune system. They are sometimes called "glands," though the term "glands" more properly refers to many other structures in the body that produce hormones and other substances.

The purpose of lymph nodes is to protect the body from "foreign" invaders. These invaders may be bacteria, viruses, cancer, or other harmful substances. An enlarged lymph node may or may not be painful or tender to the touch.

Signs and symptoms depend on the cause of the swollen lymph nodes. When a healthcare professional is evaluating a swollen lymph node, he or she may want to know:

• When did the swelling start?
• Where is the swelling is located?
• Were there any other symptoms when the swollen lymph node was first noticed, such as fever, weight loss, night sweats, joint pain, trouble breathing, or a skin rash?
• Is there pain in the node? Is it tender to the touch?
• Have there been any recent injuries, including scratches, cuts, abrasions, or insect or animal bites?
• Is there any history of other illnesses or conditions?
• Does anything improve or worsen the symptoms?
• What medications is the person taking?

Other questions may also be asked in some cases, depending on the history and physical findings. These questions may involve a person's sexual history and practices.

Common causes of swollen lymph nodes include:

• colds
• throat infections, such as tonsillitis, or strep throat
• other infections, such as syphilis, rubella, cellulitis, which is a skin infection, infectious mononucleosis, and HIV
• insect bites and stings
• autoimmune disorders, conditions in which a person's immune system attacks his or her own body
• cancers of the blood, called leukemias and lymphomas. Any other cancer that spreads throughout the body can also cause swollen lymph nodes.
• certain medications, such as phenytoin, a medication used to prevent seizures, and hydralazine (i.e., Apresoline), a medication used to treat high blood pressure
• inherited conditions, such as Gaucher disease, a condition that affects metabolism

Other causes are also possible. Sometimes the cause cannot be found.

Prevention is related to the cause. If a person gets cut or injured, careful cleaning and care of the wound may prevent a swollen lymph node. Safest sex practices can virtually eliminate the risk for sexually-transmitted infections. Safer sex practices can reduce, but not eliminate, the risk for STIs such as herpes, syphilis or HIV infection. Routine childhood vaccines can usually prevent some infections, such as rubella. Many cases, such as those due to some cancers or autoimmune disorders, cannot be prevented.

In some cases, the diagnosis is obvious from the history and physical findings. In other cases, further testing is needed. Blood tests are commonly used to help figure out the cause. A blood test called a complete blood count, or CBC, can help figure out if an infection or blood cancer is present. Imaging tests, such as a chest x-ray, can help diagnose some infections and cancers.

In some cases, a biopsy of a lymph node may be needed. This procedure involves either removing a small piece of the swollen lymph node or removing the entire lymph node from the body.

A needle biopsy is often used if the lymph node is close to the skin. The needle can be inserted through the skin and into the lymph node to remove a small piece of the lymph node.

In other cases, the skin may be cut open to remove a larger sample, or the entire lymph node may be removed. The sample or the entire lymph node can then be sent to the lab for further testing and examination under a microscope.

Long-term effects depend on the underlying cause of the condition. A swollen lymph node caused by a cut may heal quickly with no long-term effects. A person who has cancer or certain other underlying conditions may need lifelong treatment.

Swollen lymph nodes are not contagious in and of themselves. However, if the underlying cause is an infection, such HIV, the infection may be contagious.

Treatment is directed at the cause, if the cause is known. Pain medications may be given if the node is painful. Treatment for an infection may include antibiotics or surgery.

Treatment for autoimmune disorders may include anti-inflammatory medications, such as ibuprofen (i.e., Advil, Motrin), or medications to suppress the immune system, such as prednisone. If a medication is the cause, the medication may be stopped.

Those with cancer may need surgery, chemotherapy, or radiation therapy.

Side effects depend on the treatments used. Antibiotics may cause stomach upset, rash, or allergic reactions. Surgery can be complicated by infection, bleeding, or a reaction to the anesthetic. Chemotherapy can cause many side effects, including stomach upset, hair loss, and weakness.

Those with a healed infection or cut may need no further treatment after recovery. Those with cancer, HIV, or autoimmune disorders may need prolonged treatment.

Affected persons can help monitor their nodes and watch for any new symptoms. If red streaks in the skin or severe pain occur, or if any other unusual symptoms develop, these should be reported to the healthcare professional.

Other monitoring depends on the cause. For example, those with HIV may need repeated blood tests to monitor their immune system. The blood levels of some medications need to be monitored in order to prevent overdoses.