Lymphadenopathy

What are lymph nodes?

Lymph nodes are a normal part of the immune system. Lymph nodes are small, typically pea sized glands that are present in all parts of the body. There are approximately 600 lymph nodes in the body with only the lymph glands in the neck, arm pits and in the groin that can be usually felt.

What is Lymphadenopathy?

Lymphadenopathy refers to a condition or disease affecting the lymph glands of the body resulting in the lymph nodes that are abnormal in either size, consistency (how they feel to touch) or number.  Lymphadenopathy can be either local (affecting only one area of lymph nodes) or generalized (affecting other areas of lymph nodes in the body).

What causes lymphadenopathy?

The majority of causes of lymphadenopathy are not serious and are usually caused by infections. Viral infections are often a cause for lymph nodes increasing in size. Lymph nodes that increase in size of number because of a viral infection usually return to normal size in week or two.

There are other more serious causes of lymph nodes increasing in size or number. Some cancers can begin in lymph glands or spread to lymph glands from other sites in the body. Cancer presenting a lymph gland enlargement is fortunately uncommon with one study with over 2500 patients who went to their doctor with large lymph glands showing only 1% of patients having cancer as the cause for the large lymph glands. Cancer  is even less commonly diagnosed in younger patients presenting with lymph gland enlargement.

What tests need to be done to find out why I have got enlarged lymph glands?

It will be important for you to see your doctor and explore if you have any other symptoms that may suggest a cause for your lymph glands increasing in size (e.g. recent cold or infection, any other symptoms such as loss of weight). Your doctor will then exam the area to find out what size the lymph glands are, if they are painful and what the consistency of the lymph glands are (e.g. soft, hard, can be moved under the skin etc). Your doctor will also look to see if any other changes associated with the lymph glands enlarging (e.g. skin changes, areas of local infection).

Sometimes a period of waiting and watching for the lymph glands to return to normal size is necessary before doing any tests.

Other times your doctor may arrange blood tests or scanning tests to get more information about the cause for the lymph glands to be increased in size. Blood tests looking for recent viral infections may be helpful and an ultrasound of the lymph node may be helpful in making sure the large lymph gland is not caused by anything serious.

In a few cases, a biopsy of the gland may be needed if the cause for the lymph gland increasing in size is no known. This is usually done by a surgeon who will remove the lymph gland and send it to the laboratory for testing. This type of surgery is usually very short and safe but is only needed occasionally to sort out why lymph glands are enlarged

Resources used to produce this information sheet.

1. Ferrer, R Lymphadenopathy: Differential Diagnosis and Evaluation Am Fam Physician. 1998 Oct 15;58(6):1313-1320.
2. Fijten GH, Blijham GH. Unexplained lymphadenopathy in family practice. An evaluation of the probability of malignant causes and the effectiveness of physicians' workup. J Fam Pract 1988;27: 373-6.