What does a swollen gland on one side of the neck mean

Almost everyone will experience a swollen lymph node at some point. That’s because these structures are designed to filter germs and other impurities from the body.

Lymph nodes become swollen as they trap viruses, harmful bacteria and damaged cells, then attempt to destroy them with lymphocytes, the white blood cells that fight off infection.

But swollen lymph nodes can also be a sign of cancer, including a type of blood cancer called lymphoma. So, when are swollen lymph nodes just a sign of infection, as opposed to a symptom of lymphoma? We checked in with lymphoma and myeloma specialist Felipe Samaniego, M.D.

How often do swollen lymph nodes appear as the first sign of lymphoma in undiagnosed patients?

That’s kind of hard to say. By the time we see most patients here at MD Anderson, they’ve already been diagnosed elsewhere or been told there’s a strong possibility that whatever it is that they have is cancer.

That being said, in the greater community, swollen lymph nodes among undiagnosed patients tend to fall into one of two categories:

1. Lymph nodes that patients notice or that a doctor sees or feels during a physical exam
2. Lymph nodes that are found during an MRI or a CT scan because the patient is complaining of something else, such as chest pain or a lump in their breast

What are the most common places in the body where swollen lymph nodes occur as a sign of lymphoma?

Most will be in the neck, because the mouth and throat — or oropharyngeal tract — are the main gateway for things to get inside our bodies. So, we need to have a good defense system there.

But patients can find swollen lymph nodes in other places, too — especially where they lie close to the skin’s surface, like the groin area (where the leg meets the trunk) and the axilla, or armpit.

Lymphoma is actually detected pretty frequently during mammograms, because the field of view also covers the armpit, so it reveals swollen lymph nodes in that area.

Occasionally, patients may develop swollen lymph nodes all over their bodies, but this is relatively rare.

Is there a way to tell the difference between cancerous swollen lymph nodes and non-cancerous ones?

Anyone who’s really concerned about a swollen lymph node should go see their doctor. But here are some general guidelines:

• Size: Lymph nodes are made to change in size because they’re doing a job. They grow larger as the number of cells caught inside of them increases and shrink back down to normal as that number drops. But the normal size of an average lymph node is under 1.5 centimeters, or about ¾ of an inch or smaller. So, if something is larger than that or growing continuously, it needs to be checked out.
• Age: Infections are a frequent cause of swollen lymph nodes among young people. So, if you’re a teen or a college student, my first thought would be something like strep throat or mononucleosis. Cancer is more likely in older people, though I’d still want to rule out an infection first. Even among older groups, probably less than half the people who have swollen lymph nodes will have them because of cancer.
• Consistency: Press the tip of your nose with your finger and you’ll have a pretty good idea of what a typical lymph node should feel like. Tumors tend to be harder and more solid, like what you’ll feel if you push on your chin with your finger.
• Sensitivity: Some people think cancer always hurts, but that’s not true. Tenderness tends to be a sign of an infectious process, because the immune system has been challenged. But lymph nodes that are swollen due to lymphoma are usually not painful.

What are other common symptoms of lymphoma?

In lymphoma’s earliest stages, patients often report itchy, inflamed skin or unexplained rashes. In more advanced cases, where patients have large tumors, we start seeing weight loss, fevers, night sweats, and fatigue. Some experience painful muscle aches after drinking alcohol, too, though that is fairly unusual.

When should someone see their doctor about a swollen lymph node?

Swollen lymph nodes usually just mean your body is working the way it’s supposed to. But if a swollen lymph node keeps getting bigger or doesn’t resolve on its own within two weeks, get it checked out.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.

Swollen glands; Glands - swollen; Lymph nodes - swollen; Lymphadenopathy

Lymph nodes are present throughout your body. They are an important part of your immune system. Lymph nodes help your body recognize and fight germs, infections, and other foreign substances.

The term "swollen glands" refers to enlargement of one or more lymph nodes. The medical name for swollen lymph nodes is lymphadenopathy.

In a child, a node is considered enlarged if it is more than 1 centimeter (0.4 inch) wide.

The lymphatic system has two main functions. Its network of vessels, valves, ducts, nodes, and organs helps balance the body's fluid by draining excess fluid, known as lymph, from the body's tissue and returning it to the blood after filtering it. Some types of blood cells are also made in the lymph nodes. The lymphatic system also plays an important role in the body's immune system. Infection, even a trivial infection is, the most common cause of swollen lymph nodes. Let's look at a cut section of a lymph node to see what happens. Afferent means towards. Afferent lymph vessels bring unfiltered fluids from the body into the lymph node where they are filtered. Efferent vessels, meaning away from, carry the clean fluid away and back to the bloodstream where it helps form plasma. When the body is invaded by foreign organisms, the swelling sometimes felt in the neck, armpits, groin, or tonsils comes from the microorganisms trapped inside the lymph nodes. Eventually, these organisms are destroyed and eliminated by cells that line the node walls. Then the swelling and pain subside.

The lymphatic system filters fluid from around cells. It is an important part of the immune system. When people refer to swollen glands in the neck, they are usually referring to swollen lymph nodes. Common areas where lymph nodes can be easily felt, especially if they are enlarged, are the groin, armpits (axilla), above the clavicle (supraclavicular), in the neck (cervical), and the back of the head just above hairline (occipital).

Swollen lymph nodes, sore throat, fatigue and headache are some of the symptoms of mononucleosis, which is caused by the Epstein-Barr virus. It is generally self-limiting and most patients can recover in 4 to 6 weeks without medicines.

The lymphatic system is a complex system of fluid drainage and transport, and immune response and disease resistance. Fluid that is forced out of the bloodstream during normal circulation is filtered through lymph nodes to remove bacteria, abnormal cells and other matter. This fluid is then transported back into the bloodstream via the lymph vessels. Lymph only moves in one direction, toward the heart.

Lymph nodes produce immune cells to help fight infection. They also filter the lymph fluid and remove foreign material, such as bacteria and cancer cells. They can become swollen from inflammatory conditions, an abscess, cancer, and most commonly from infection. Common areas where lymph nodes can be felt include the groin, armpit, behind the ears, back of the head, sides of the neck and under the jaw and chin.

Lymph nodes play an important part in the body's defense against infection. Swelling might occur even if the infection is trivial or not apparent. Swelling of lymph nodes generally results from localized or systemic infection, abscess formation, or malignancy.

Considerations

Common areas where the lymph nodes can be felt (with the fingers) include:

• Groin
• Armpit
• Neck (there is a chain of lymph nodes on either side of the front of the neck, both sides of the neck, and down each side of the back of the neck)
• Under the jaw and chin
• Behind the ears
• On the back of the head

Causes

Infections are the most common cause of swollen lymph nodes. Infections that can cause them include:

• Abscessed or impacted tooth
• Ear infection
• Colds, flu, and other infections
• Swelling (inflammation) of gums (gingivitis)
• Mononucleosis
• Mouth sores
• Sexually transmitted illness (STI)
• Tonsillitis
• Tuberculosis
• Skin infections

Immune or autoimmune disorders that can cause swollen lymph nodes are:

• HIV
• Rheumatoid arthritis (RA)

Cancers that can cause swollen lymph nodes include:

• Leukemia
• Hodgkin disease
• Non-Hodgkin lymphoma

Many other cancers may also cause this problem.

Certain medicines can cause swollen lymph nodes, including:

• Seizure medicines, such as phenytoin
• Typhoid immunization

Which lymph nodes are swollen depends on the cause and the body parts involved. Swollen lymph nodes that appear suddenly and are painful are usually due to injury or infection. Slow, painless swelling may be due to cancer or a tumor.

Home Care

Painful lymph nodes are generally a sign that your body is fighting an infection. The soreness usually goes away in a couple of days without treatment. The lymph node may not return to its normal size for several weeks.

When to Contact a Medical Professional

Contact your health care provider if:

• Your lymph nodes do not get smaller after several weeks or they continue to get larger.
• They are red and tender.
• They feel hard, irregular, or fixed in place.
• You have fever, night sweats, or unexplained weight loss.
• Any node in a child is larger than 1 centimeter (a little less than half inch) in diameter.

What to Expect at Your Office Visit

Your provider will perform a physical examination and ask about your medical history and symptoms. Examples of questions that may be asked include:

• When the swelling began
• If the swelling came on suddenly
• Whether any nodes are painful when pressed

The following tests may be done:

• Blood tests, including liver function tests, kidney function tests, and CBC with differential
• Lymph node biopsy
• Chest x-ray
• Liver-spleen scan

Treatment depends on the cause of the swollen nodes.

References

Tower RL, Camitta BM. Lymphadenopathy. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 517.

Winter JN. Approach to the patient with lymphadenopathy and splenomegaly. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 159.

Version Info

Last reviewed on: 1/29/2022

Reviewed by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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