Swollen lymph nodes – How dangerous is that?

In most cases, swollen lymph nodes (lymphadenopathy) are not caused by a serious illness, but are a side effect of an infection, such as a cold. Even in the case of a common infection of the respiratory tract (rhinitis, etc.) swollen lymph nodes can be noticed, which are mainly located in the neck area.

Frequently, the affected persons themselves notice that the lymph node is enlarged and hurts. Apart from the lymph nodes in the neck and in the groin, which can be palpated even in healthy people, most lymph nodes can only be palpated if they are enlarged. Nevertheless, one should know that many different diseases can cause swollen lymph nodes, these can be viral and bacterial infections, but swelling is also possible in the context of tumor diseases.

There are tumors (lymphomas), which primarily originate from lymph nodes, as well as malignancies (malignant tumors), which metastasize along the lymphatic tracts (form daughter tumors) and form tumor settlements in the lymph nodes. More information can be found here: Lymph node cancer – what you need to knowLymph nodes are located throughout the body and are responsible for the immune system. Most lymph nodes are between two and ten millimeters in size and are not palpable.

However, the lymph nodes in the neck and groin can be up to two centimeters in size and are therefore also palpable in healthy people. The lymph nodes are interconnected by the lymph channels. In addition to defending against infection, the lymphatic system is also responsible for transporting “squeezed out” fluid from the blood system back into the surrounding tissue.

There are a particularly large number of lymph nodes in the neck, along the neck vessels (directly below the lower jaw), which are responsible for the lymph drainage of the entire head area; they are called “draining” the head region. They are also located in front of and behind the ear, at the back of the head and on or under the chin. There are also many lymph nodes in the armpits, which drain the lymph fluid from the arms and chest area; there are also many lymph nodes in the groin, which receive lymph influx from both legs.

In the abdominal area, the lymph nodes are rather deep in the body, very close to the respective organs. In the blood and lymph channels of the body the defense cells (B lymphocytes and T lymphocytes, which are special white blood cells) circulate and fight bacteria and viruses. In the lymph nodes, different rows of cells present the pathogens that are in the body and thus activate the B and T lymphocytes in this lymph node to defend against infections.

When a lymph node is activated, it produces more cells and swells (reactive lymphadenitis). The T lymphocytes can directly fight and destroy viruses, bacteria and tumor cells, the B lymphocytes produce antibodies and thus contribute to the defense against infection. The causes for sudden swelling of lymph nodes are manifold.

In principle, any infection of any region of the body can lead to swelling. This includes infections that are accompanied by strong symptoms (such as fever, fatigue, etc.) as well as those that hardly cause any symptoms.

Significantly less frequently, malignant diseases such as lymphoma lead to swollen lymph nodes. Below are some common causes of lymph node swelling according to the location of the lymph nodes. In the neck area, swelling of lymph nodes is particularly common.

Many people have cervical lymph nodes that are always palpable due to their size. In the case of infections, painfully swollen lymph nodes are often added. This is often the case with: This also occurs in the context of a herpes virus infection, which is accompanied, for example, by a cold sore on the lips; moreover, in Pfeiffer’s glandular fever (infectious mononucleosis) triggered by EBV (Epstein-Barr virus), which often occurs in children or adolescents and is accompanied by fever, difficulty swallowing, swollen tonsils and possibly abdominal pain due to swelling of the liver and spleen.

Palpable lymph nodes in the axillary region may indicate an infection from the hand to the shoulder or in the chest area. However, possible metastases of breast cancer (mamma carcinoma) should be clarified. Palpable lymph nodes in the groin also occur in healthy people, and painful swellings are often caused by infections in the genital area.

These are, for example: These diseases are often accompanied by pain, itching, discharge and redness.Typical are for example chlamydia infections, syphilis caused by Treponema pallidum, gonorrhea caused by Neisseria gonorrhea or an infection with Candida fungi. Inflammations from the foot to the groin also lead to swelling of the lymph nodes in the groin region. Differential diagnosis may also be a femoral hernia or an inguinal hernia as swelling in the groin and should be distinguished from swollen lymph nodes.

Some diseases can affect different lymph node wards, for which the following examples are given: Whether or not swollen lymph nodes are dangerous depends on the cause. In most cases, it is simply a reaction to a harmless infection. In rare cases, however, it can be a serious disease.

If the swollen lymph nodes persist for a long time and for no apparent reason, a doctor should always be consulted.

  • A simple cold
  • For inflammation of teeth
  • For all respiratory tract infections
  • In case of inflammation with sore throat/ear pain or rhinitis
  • In the case of tonsillitis (angina tonsillaris), which is often accompanied by difficulty in swallowing and sometimes by shortness of breath. This is particularly common in children.
  • Inflammation of the external female sexual organs (vulvitis)
  • Inflammation of the vagina (vaginitis)
  • Inflammation of the glans (balanitis)
  • Inflammation of the epididymis, often caused by fungi, viruses or bacteria.
  • Accompanying an infected wound or a bite, e.g. from insects, there may be a swelling of nearby lymph nodes.
  • Many childhood diseases (rubella, measles, chickenpox) are accompanied by swelling of the lymph nodes.

    These are often accompanied by skin rashes (exanthema).

  • Toxoplasmosis, which is caused by the parasite Toxoplasma gondii, is mainly transmitted via cats. It leads to fever, general symptoms and swelling of the lymph nodes. The disease is particularly dangerous for the unborn child during pregnancy.
  • Lymphangitis, colloquially known as blood poisoning, which is actually an inflammation of the lymphatic system, is also associated with swelling of the lymph nodes.
  • HIV infection (Human Immunodeficiency Virus) can also affect the lymph nodes, especially if the patient becomes AIDS (Acquired Immune Deficiency Syndrome).

    In the AIDS stage, patients are very susceptible to infection due to the disruption of the T-lymphocytes. However, flu-like symptoms and swelling of the lymph nodes can manifest themselves shortly after HIV infection.

One of the most common causes of swollen lymph nodes is a cold. A cold causes unspecific inflammatory processes in several places.

For example, the throat, upper respiratory tract and paranasal sinuses are often inflamed. All these processes in the common cold cause swollen lymph nodes. They occur mainly on the side of the upper neck.

Swollen lymph nodes in colds are usually completely harmless. They usually appear on both sides of the neck at the same time. The swelling occurs relatively quickly in contrast to other diseases.

Within a few hours, palpable nodules may appear under the skin. These lymph nodes feel their way roughly and can move under the skin. In addition, the nodes are painful even under slight pressure.

However, swollen lymph nodes do not always have to occur with colds. An important differential diagnosis of a cold with swollen lymph nodes is an infection with the Epstein-Barr virus. The symptoms are similar at the beginning, but the course of the infection is usually more severe and should be treated by a physician.

Lymph nodes can react to an inflamed tooth with swelling. This is a not uncommon symptom of inflammation of the dental apparatus. The swollen lymph nodes are then found on the jaw, under the chin and on the neck.

Not only an inflamed tooth, but also an inflammation of the gums can cause swollen lymph nodes. These can be painful under pressure. After treatment of the symptoms, the affected lymph nodes usually swell again.

Swollen lymph nodes are often observed as a side effect after vaccination. They are an expression of the immune response to the vaccination and usually do not require treatment.Swollen lymph nodes after vaccination occur in close temporal relation to the injection and are usually self-limiting. They may persist for a few days and in some cases may be slightly painful.

Swollen lymph nodes are particularly common after vaccination with a live vaccine. These include yellow fever, measles, mumps or rubella. If in doubt, patients should consult their family doctor.

Tumor diseases that primarily develop in the lymph nodes and can be accompanied by massive lymph node swelling, as well as often with the so-called “B-symptoms”: tumor diseases that originate from lymphatic cells (or myeloid cells of the bone marrow), among others, into which lymph nodes flush out and show different symptoms are In addition, there are systemic diseases that can also have lymph node involvement. In addition, almost all malignant tumors can metastasize to the lymph nodes. This often results in the painless formation of enlarged lymph nodes.

  • Non-Hodgkin lymphomas
  • Hodgkin’s disease
  • Acute leukemias (Acute lymphatic leukemia [ALL], Acute myeloid leukemia [AML])
  • Chronic leukemias (chronic lymphatic leukemia [CLL], chronic myeloid leukemia [CML])
  • Cutaneous T-cell lymphomas (Mycosis fungoides)
  • Sarcoidosis with lymphadenopathy on both sides of the airways (bronchial tubes)
  • Tuberculosis, in principle every lymph node possible
  • Lupus erythematosus

Among other symptoms, HIV often causes swollen lymph nodes. They are among the early symptoms of HIV and can occur all over the body. Swollen lymph nodes can be an indication of HIV, especially if there are additional symptoms such as fatigue, night sweats, unintentional weight loss, fever and severe feeling of illness. But other diseases can also lead to these symptoms. For a diagnosis, a clarification by a physician is therefore always necessary.