Lymphadenopathy

Lymphadenopathy is swelling of the lymph nodes, which are bean-shaped organs in the underarm, groin, neck, chest, and abdomen. They filter lymph fluid as it circulates through the body. Lymphadenopathy can occur in one part of the body or it may be generalized, with node enlargement in several areas. The cervical lymph nodes in the neck are the most common site of lymphadenopathy.

Symptoms of Lymphadenopathy

In children, it is normal to be able to feel some lymph nodes as small, movable lumps under the skin. But if the nodes become enlarged, there may be an underlying problem. The following are the most common symptoms of lymphadenopathy:

• Swollen, enlarged lumps in the neck, back of the head, or other locations of lymph nodes
• Tenderness of the nodes, although the nodes may not be painful if the child is no longer ill
• Fever
• History of illness 

The symptoms of lymphadenopathy may look like other neck masses or medical problems. Always consult your health care provider for a diagnosis.

Causes of Lymphadenopathy

The lymphatic system is part of the immune system and functions to fight disease and infection. As infection-fighting cells and fluids build up, the lymph nodes enlarge to many times their normal size. Nearly all children will develop lymphadenopathy at some time, as the condition commonly occurs in response to an infection from a virus, such as an upper respiratory infection. Bacterial infections, such as strep throat, can also cause lymphadenopathy.

Since enlarged lymph nodes are often near the source of infection, their location can help determine the cause. For example, an infant with a scalp infection may have enlarged lymph nodes at the back of the neck. However, the lymphadenopathy may be generalized, with lymph node enlargement in more than one area, which is typical of a viral illness.

Sometimes, one or more lymph nodes themselves become inflamed and enlarged, a condition called lymphadenitis. Lymph nodes can also enlarge due to cancer in the lymphatic system, such as Hodgkin disease.

Diagnosing Lymphadenopathy

Diagnosis of lymphadenopathy is often based on the presence of other conditions, such as an infection. It is important to determine if the child has been exposed to any diseases, such as varicella (chickenpox), or has been bitten by an animal (cat) that may transmit an illness called cat-scratch fever. The size and location of the nodes when the swelling began, and the presence of pain are helpful in determining the cause.

In addition to a complete medical history and physical exam, other tests may include a lymph node biopsy, in which a sample of tissue is removed from the lymph node and examined under a microscope. Further tests may be necessary for specific diseases or infections that may be related to the lymphadenopathy.

Treatment for Lymphadenopathy

Your doctor will work with you to develop the best possible treatment plan, which may include:

• Antibiotic medications (to treat an underlying bacterial infection)
• Continued evaluation (to check the size and location of the enlarged nodes)
• Medications or procedures (to treat other conditions that may have caused the lymph node enlargement)

Why Choose Columbia

At Columbia University, our specialists provide you with the information and guidance to choose the right lymphadenopathy treatment for you. Our expert team draws on the best available therapies to personalize the most effective care plan with the least possible impact on your daily life and activities.