Some Causes and Features of Swollen Lymph Nodes
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Cause |
Common Features* |
Tests |
Cancers |
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Leukemias (typically chronic and sometimes acute lymphocytic leukemia) |
Fatigue, fever, and weight loss With acute leukemia, often easy bruising and/or bleeding |
Complete blood count and specialized blood tests (for example, peripheral smear and/or flow cytometry) Bone marrow examination |
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Painless lymph node swelling (local or widespread) Nodes often rubbery and sometimes clumped together Often fever, night sweats, and weight loss |
Lymph node biopsy Specialized blood tests |
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Metastatic cancers (often of the head and neck, thyroid, breast, or lung) |
One or several painless nodes in the neck Nodes often hard, sometimes unable to be moved when pushed |
Tests to identify the primary tumor, often including imaging studies, blood tests, and biopsy |
Connective tissue disorders |
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Tender swollen nodes in the neck in a child Fever, usually higher than 102° F (39° C), rash on the trunk, prominent red bumps on the tongue, peeling skin on the palms, soles, and around the nails |
Only a doctor's examination |
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Painless lymph node swelling that may be widespread Often cough and/or shortness of breath, fever, malaise, muscle weakness, weight loss, and joint pains |
Chest imaging (plain x-ray or CT) Sometimes lymph node biopsy |
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Systemic lupus erythematosus (lupus) |
Widespread node swelling Typically painful and sometimes swollen joints Sometimes red rash affecting the nose and the cheeks and other skin sores |
A doctor's examination plus blood tests |
Infections |
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Dental infection |
Neck nodes on one side are affected (often tender) Painful tooth |
Only a doctor's or dentist's examination |
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HIV (immediately after the person became infected—the primary infection) |
Generalized lymph node swelling Usually fever, malaise, rash, and joint pain Often in a person known to have been exposed to HIV or to having exposure to a high-risk activity (such as being stuck with a needle used by another person or high-risk sexual activities) |
HIV blood testing |
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Swelling on both sides, typically in the neck but sometimes under the arms or in the groin Fever, sore throat, and severe fatigue Typically in an adolescent or a young adult |
Blood test for mononucleosis |
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Sexually transmitted diseases (STDs, particularly herpes simplex, chlamydia, and syphilis) |
Except for the secondary stage of syphilis, only swollen nodes in the groin Often urinary symptoms (such as pain during urination) and urethral or vaginal discharge Sometimes sores on the genitals For the secondary stage of syphilis, often widespread sores on the mucous membranes and widespread lymph node swelling |
STD testing |
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Skin and soft tissue infections (for example, cellulitis, abscess, cat-scratch disease), including direct lymph node infection |
Usually a visible cut or infection of the skin near the swollen node |
Usually only a doctor's examination Sometimes blood tests to identify antibodies to the infecting organism |
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Swollen nodes on both sides of the neck and under both arms Sometimes flu-like symptoms and an enlarged liver and spleen Often history of exposure to cat feces |
Blood tests |
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Tuberculosis affecting the lymph nodes |
Usually swelling of nodes in the neck or above the collarbone Sometimes lymph nodes inflamed or draining Often in a person who has HIV infection |
Tuberculin skin testing or blood tests for tuberculosis Usually lymph node biopsy |
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Upper respiratory infection (including sore throat) |
Neck nodes are affected with only little or no tenderness Sore throat, runny nose, or cough |
Only a doctor's examination |
Other |
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Drugs: Common drugs include allopurinol, antibiotics (for example, cephalosporins, penicillin, and sulfonamides), atenolol, captopril, carbamazepine, phenytoin, pyrimethamine, and quinidine |
History of using a causative drug Except for phenytoin, rash, joint and muscle pain, and fever |
Only a doctor's examination |
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Silicone breast implants |
Node swelling under the arms in a woman with breast implants |
A doctor's examination and often tests for other causes of node swelling |
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* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present. |
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CT = computed tomography; HIV = human immunodeficiency virus; STD = sexually transmitted disease. |
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