What is a lymph node?
Lymph nodes ("glands") are the small filter stations of the immune system. The body contains hundreds of them, and a large share are in the head and neck region. Their job is to filter microbes, abnormal cells and foreign material, and to launch the immune response.
Why do neck nodes swell?
Infections are the most common cause. During throat infections, dental and gum disease, upper respiratory infections and some viral illnesses, lymph nodes enlarge as they do their job — usually felt as tender, soft, mobile swellings. Once the infection settles, the nodes generally shrink within a few weeks. In children and young people, small mobile nodes that can be felt are very often normal.
Which features are warning signs?
Certain features suggest that a swelling may be more than a simple reaction to infection and needs further investigation: swelling lasting longer than two weeks or steadily growing, a painless, hard mass fixed in place, size above 2 cm, swellings in several regions, accompanying night sweats, unexplained weight loss, prolonged fever, difficulty swallowing or hoarseness. In older individuals with a history of smoking or alcohol use, any newly noticed neck mass must always be evaluated.
How is the diagnosis made?
Evaluation begins with a detailed ENT examination and, where needed, endoscopic inspection of the nose, throat and larynx. Ultrasound of the neck is usually the first imaging choice; CT or MRI may be requested in selected cases. Fine-needle aspiration biopsy samples cells from suspicious nodes; occasionally surgical removal of the node is needed for a definitive diagnosis.
Treatment
Treatment depends entirely on the cause. For infection-related enlargement, the cause is treated and the node followed; an abscessed node may need drainage. If another underlying disease is found, treatment is planned accordingly. The most important message is this: early evaluation of persistent neck swellings directly affects treatment success in potentially serious disease.
This article is for general information purposes only; please consult your physician for diagnosis and treatment.