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Why Are My Lymph Nodes Swollen -Doctor Micheal

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Lymph nodes are important for your immune system. When you have an infection, your lymph nodes can swell up as part of your body's natural defense. But there are many other reasons that lymph nodes can swell. There are numerous lymph nodes in a young adult. They are normally just tangible as small firm non-tender masses less than 0.5 cm in diameter, especially in children or they are not palpable at all. In several diseases clinically the lymph nodes enlarge and become tangible and visible.

Why Are My Lymph Nodes Swollen

What is Abnormal Lymph Node Swelling? 

Any tangible lymph node anywhere in the body is indicative of a problem. In general; 

  • Nodes larger than 1cm, 
  • Any lymph node in the supraclavicular region, 
  • Scalene node, 
  • Any generalized lymphadenopathy, 
  • Hard and fixed nodes are all significant. 

Equally important is the clinical setting to decide the significance or lack of significance of lymphadenopathy. Lymph node enlargement may be due to diseases primarily affecting the lymph nodes as lymphoma, Lymphatic leukemia, tuberculosis, and lymphogranuloma venereum may be secondary to disease in their areas of drainage. The former could be generalized whereas the latter is always localized.

Why are my lymph nodes swollen -Lymphadenopathy?

Lymph node swelling can be either Generalized or localized.

Major common Causes of Generalized Lymphadenopathy

  • Infections:

Miliary tuberculosis, infectious mononucleosis, Human immunodeficiency virus (HIV) infection, German measles, filariasis, secondary syphilis, trypanosomiasis (not present in India).

  • Other inflammatory diseases:

Systemic lupus erythematosus, rheumatoid disease, hypersensitivity reactions.

  • Neoplastic diseases:

Lymphomas, acute leukemias, chronic lymphatic leukemia, blast crisis of chronic myelogenous leukemia.

  • Other conditions:

Sarcoidosis, adverse reactions to drugs like dilantin sodium.

What causes Lymphadenopathy

Major common Causes of Localized Lymphadenopathy

Cervical Lymph Nodes,

Enlargement of anterior cervical nodes, submandibular nodes, and submental nodes may be due to;

1.Primary lesions in the tonsils, mouth, or teeth. 

2. Tuberculosis affects the anterior cervical groups more often. 

3. Posterior cervical groups are affected in lesions of the scalp, secondary syphilis and leukemias. 

4. In lymphomas both anterior and posterior groups may be affected. 

5. Supraclavicular nodes are affected in pulmonary lesions such as malignancy. 

6. In African trypanosomiasis enlargement of posterior cervical nodes is characteristic (Winterbottom’s sign).

7. The paratracheal nodes (scalene nodes, situated in between the scalene muscles and behind the sternal head of the sternocleidomastoid) are involved early in metastatic pulmonary carcinoma.

8. In advanced malignancy of the esophagus the lower cervical nodes may be enlarged. Tuberculosis can present with isolated scalene node enlargement as well.

Axillary Nodes

These may be enlarged in infections of the upper extremities such as infected scabies. Occasionally small axillary nodes may be seen in normal children and manual laborers. In women neoplasms of the breast have to be particularly looked for. Lymphomas, filariasis (especially B. malayi), and tuberculosis may involve the axillary nodes.

Epitrochlear (Supratrochlear) Nodes

These are enlarged secondary to sepsis in the hands and forearm. They may be enlarged in;

1. Non- Hodgkin’s Lymphoma, 

2. Secondary syphilis and 

3.Acute leukemias. 

4. Tuberculosis can present with enlargement of any lymph nodes.

Mediastinal Nodes

These are enlarged I; 

1. Lymphomas ( Cancer of the lymph nodes )

2. Acute lymphatic leukemia (T-cell type)

3. Secondary deposits from pulmonary neoplasms and extensive metastases from abdominal and testicular tumors. 

4. Tuberculosis and sarcoidosis can present with mediastinal lymphadenopathy and constitutional symptoms especially in primary tuberculosis.

Abdominal Lymph Nodes

Regional groups are enlarged as a result of metastases from the areas of drainage. 

For example;

1. Pyloric nodes and nodes in the porta hepatis may be secondary to gastric carcinoma (cancer of the stomach) or tumors of the hepatobiliary tract. 

2. Para-aortic nodes may be secondary to testicular or abdominal tumors. 

3. Mesenteric nodes may be secondary to neoplasms of the intestines, iliac nodes and pelvic nodes may be secondary to lesions of the cecum, ileocecal region, pelvic organs and prostate. 

4. Massive lymphadenopathy may occur in lymphomas and secondary malignancy. 

5. Tuberculosis affecting the mesenteric nodes produce mild to moderate lymphadenopathy.

Inguinal Nodes

Characteristically inguinal adenopathy is seen in; 

1. Syphilitic chancre over the penis, 

2. Lymphogra-nuloma

3. Venereum, 

4. Filariasis, 

5. Other infective and malignant lesions of the penis and vulva, 

6. Melanoma in the feet and bubonic plague (rare).

Size of the Nodes

In systemic illnesses such as secondary syphilis, German measles, infectious mononucleosis, and AIDS the size is small or only moderate (1–2 cm). Large sizes are attained in lymphomas, metastatic, Malignancy ( Migrating cancers ), lymphogranuloma venereum, and diphtheria. The presence of large nodes in the upper part of the neck in faucial diphtheria gives rise to a “bull neck” appearance. This is seen only rarely at present.

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