Swollen Neck Lymph Nodes Causes, Location, Treatment

What are neck lymph nodes?

Lymph nodes are tiny bean-like clusters of cells located in multiple regions of the body. They measure a few millimeters in size and are mainly concentrated in regions like the neck, armpit, chest cavity, abdomen and groin. Lymph nodes are part of the body’s immune system and are composed mainly of immune cells called lymphocytes, which are responsible for the production of antibodies and defense against various pathogens and cancer cells.

The widely distributed clusters of lymph nodes in the body are interconnected through lymphatic vessels, which transport a fluid known as the lymph. This whole network of lymph nodes and the connecting lymphatic vessels, collectively known as the lymphatic system, is a primary defense mechanism of the body against infectious agents, foreign particles and cancers.

What causes swollen lymph nodes in the neck?

Lymph nodes are usually a few millimeters in size, and are difficult to feel by touch in their normal condition. However, these tiny lymph nodes become swollen and palpable in cases of infection, cancers, and autoimmune diseases. Some drugs and vaccines can also lead to temporarily swollen lymph nodes.

Lymph nodes in the neck are easily palpable when they get swollen. Therefore, they are important indicators of an underlying disease. It should be noted that not all cases of swollen lymph nodes are due to disease conditions. Swollen lymph nodes in the neck could also occur in healthy children showing no signs or symptoms of any underlying disease. Nevertheless, checking for swollen lymph nodes in the neck region is an important diagnostic test.

Swollen lymph nodes in the neck can be caused by a multitude of factors as listed below:

  1. Bacterial infections:
    – Streptococcal throat infections that cause sore throat
    – Tooth infections
    – Ear infections
    – Infected wounds in the head and neck region
    – Tuberculosis
    – Infections caused by animals (e.g. cat scratch disease)
    – Sexually transmitted diseases such as syphilis
  2. Inflammation of structures in the head and neck region such as tonsils (tonsillitis), sinuses (sinusitis), and epiglottis (epiglottitis).
  3. Viral infections such as mumps, measles, rubella, and mononucleosis (kissing disease).
  4. Parasitic infections such as toxoplasmosis.
  5. Autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus (SLE).
  6. Immunodeficiency diseases like AIDS.
  7. Side-effects of drugs such as carbamazepine and phenytoin.
  8. Certain vaccines such as typhoid vaccine, and MMR vaccine for measles, mumps, and rubella

Tests for Swollen Neck Lymph Nodes

Swelling in the lymph nodes located in the neck can occur either independently or in conjunction with other lymph nodes spread across the body. Lymph nodes in the neck are clustered into six different locations. Depending on the location of the swollen lymph nodes in the neck, a preliminary diagnosis can be made of the underlying cause.

Location of Neck Lymph Nodes

The positions of the six lymph node clusters in the neck are as follows:

  • Posterior cervical: These are located in the posterior neck region and extend from the back of the lower jaw to the collar bone. Posterior lymph nodes of the neck become swollen when the upper respiratory tract gets infected.
  • Anterior cervical: These are located in the front wall of the neck. Some of these are located near the surface (superficial) and others are situated in a deeper location. These anterior lymph nodes drain lymph from the tonsils, throat, and thyroid gland.
  • Tonsillar: As the name suggests, these lymph nodes in the neck drain lymph from the tonsils, in addition to the back of the throat. Tonsillar lymph nodes are situated below the lower jaw bone.
  • Sub-mental: These lymph nodes lie in the neck region under the chin. Sub-mental lymph nodes drain lymph from the cheeks, lower lip, teeth, tongue, and the base of the mouth.Swelling of the sub-mental lymph nodes indicate tooth infections, toxoplasmosis, and mononucleosis.
  • Sub-mandibular: These lymph nodes are located under the lower jaw bone. They take up lymph from the tongue, lips, base of the mouth, and the conjunctiva of the eye. Swollen sub-mandibular lymph nodes indicate infections in the eyes, ears, neck, head, sinuses, and the throat.
  • Supra-clavicular: Clavicles refer to the collar bones. The supra-clavicular lymph nodes lie in the pits located above the collar bones on both sides of the body.
    – The right supra-clavicular lymph nodes circulate lymph from the lungs, esophagus (food pipe), and the mediastinumregion. These lymph nodes get swollen in certain cancers such as Hodgkin’s lymphoma and the cancers of the lung and the gastrointestinal tract.
    – The left supra-clavicular lymph nodes drain lymph from the chest and the abdominal regions. These lymph nodes become enlarged in cases of retroperitoneal or thoracic cancers, breast cancer and lymphoma. Enlargement of left supra-clavicular lymph nodes can also be the earliest sign of undiagnosed stomach cancer.

Firmness and Movement

How the swollen lymph nodes in the neck feel upon palpation is also a useful indicator of the possible underlying cause. Swelling due to infections might cause the lymph nodes to be painful, soft, and free to move around upon palpation. A cancerous cause is indicated by swollen lymph nodes in the neck that are painless, hard, and resistant to being moved upon palpation. Accompanying whole body symptoms such as night sweats, fever, fatigue and weight loss can also help in the diagnosis. Biopsy might also be required.

What should be done in the case of swollen lymph nodes?

In most cases, swollen lymph nodes in the neck are not a cause for alarm. They usually go away on their own without any treatment. Never attempt to squeeze a lymph node as this can worsen the inflammation and even force microbes in the node to disperse.  A lymph node is not the same as muscle spasm (“knots”). Do not attempt to massage the area deeply.

Swollen lymph nodes that persist could be a cause for concern as they may indicate an underlying disease that could worsen considerably if left untreated. Therefore, swollen lymph nodes must be checked by your doctor for confirmation of the underlying cause. Based on the final diagnosis,a doctor will prescribe the appropriate line of treatment that needs to be instituted.

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