Swollen Lymph Nodes on the Neck

swollen on the neck are a clinical sign that can be found in different conditions, including for example pharyngitis, tonsillitis, laryngitis, gingivitis, dental abscess, influenza, mononucleosis, AIDS, cancer of the compartment mouth-throat, non-Hodgkin's lymphomas, insect bites on the neck and rheumatoid arthritis.

Shutterstock

Basically, the swollen lymph nodes on the neck may be a response of the human body to the presence of infectious states, tumors, trauma and autoimmune diseases.
Characterized by one or more painful swellings, swollen lymph nodes on the neck are easy to diagnose; their identification, in fact, requires a simple palpatory examination of the region between the head and the clavicles.

Brief review of what lymph nodes are

The lymph nodes are small ovoid organs of the lymphatic system, having a very important immune role; in fact, they act as collection points for part of the B and T lymphocytes (cells of the immune system), in order to intercept and destroy any germs, foreign substances and / or neoplastic cells circulating in the lymph (the lymph is the fluid similar to the plasma, which flows along the lymphatic vessels and receives waste substances present in the tissues).
Acting in a similar way to purifiers, lymph nodes are often referred to as biological filters.

swollen is a typical sign of a variety of medical conditions, including infectious conditions, autoimmune diseases, neck trauma and even cancers.
Since in medicine the enlargement of the lymph nodes is more properly called lymphadenopathy, the enlarged lymph nodes on the neck can be defined with the expression "lymphadenopathy of the neck".

Brief clarification on terminology

Before continuing with the reading, two terminological notes are required:

• Lymphadenopathy, enlarged lymph nodes and enlarged lymph nodes are synonymous.
• The "adjective" lymph node "indicates" all that is attributable to the lymph nodes ".

Outline of anatomy relating to the lymph nodes of the neck

According to a more generic classification, under the heading "neck lymph nodes" belong the lymph nodes that reside:

• Behind the ears (posterior auricular lymph nodes);
• In correspondence of the occipital bone of the skull (occipital lymph nodes);
• Under the ear and next to where the mandible engages with the temporal bone of the skull, forming the temporomandibular joint (jugulo-digastric lymph node);
• Under the mandible (submandibular lymph nodes);
• Just above the collarbone (supraclavicular lymph nodes);
• On the actual neck (superficial cervical lymph nodes, deep cervical lymph nodes and posterior cervical lymph nodes).

Shutterstock

According to a more specific classification, on the other hand, the definition "lymph nodes of the neck" only includes the lymph nodes located in the anatomical region called the neck (ie the actual neck mentioned above "indeed). Therefore, based on this classification, the lymph nodes of the neck are only the superficial cervical lymph nodes, the deep cervical lymph nodes and the posterior cervical lymph nodes.
In this article, the term "swollen lymph nodes on the neck" refers to lymphadenopathy of the lymph nodes of the neck falling within the first classification, the most generic and with the most extensive meaning.

Did you know that ...

When the enlarged lymph nodes on the neck are exclusively the cervical ones, doctors speak of cervical lymphadenopathy.

, palatine tonsils and larynx;

Gingivitis, dental abscesses and pericoronitis. Gingivitis is inflammation of the gum; dental abscess is an unusual accumulation of bacteria, white blood cells, plasma and pus around the tissues surrounding a tooth; finally, pericoronitis is the acute inflammation of the portion of the gum surrounding an erupting tooth;

Otitis, or inflammation of the ear;

Common viral diseases, such as rubella, chicken pox, influenza and mononucleosis;

AIDS, ie HIV-borne viral infection;

Non-Hodgkin's lymphomas. Non-Hodgkin's lymphomas are cancers of the lymphatic system that arise due to the uncontrolled proliferation of B lymphocytes and / or T lymphocytes, located in the lymph nodes and in the primary and secondary lymphoid organs;

Tumors of the mouth-throat compartment, such as mouth cancer, throat cancer and tongue cancer;

Rheumatoid arthritis and systemic lupus erythematosus. Examples of autoimmune diseases, rheumatoid arthritis and systemic lupus erythematosus are, respectively, a joint pain and a multi-system condition (ie affecting multiple organs);

Insect stings or bites located in the neck.

Pharyngitis

Inflammation of the pharynx (ie the back of the mouth) is the condition commonly known as a sore throat.
Viruses (including Rhinoviruses, Coronaviruses and Adenoviruses), bacteria (including Streptococcus group A beta hemolytic, Streptococcus pneumoniae And Haemophilus influenzae) and non-infectious agents (such as, for example, allergies, gastroesophageal reflux and inhalation of irritants).
In a context of pharyngitis, the presence of swollen lymph nodes on the neck mainly involves the superficial, deep and posterior cervical lymph nodes, and the submandibular lymph nodes.

Shutterstock

Tonsillitis

Tonsillitis recognizes its main causes in viruses, such as Rhinoviruses, Coronaviruses, Adenoviruses and Epstein Barr viruses, and in bacteria, such as Streptococcus beta hemolytic group A e Streptococcus pyogenes.
In the presence of tonsillitis, the phenomenon of enlarged lymph nodes on the neck usually has the superficial and deep cervical lymph nodes, the submandibular lymph nodes and the jugulo-digastric lymph node as main actors.

Laryngitis

Inflammation of the larynx and vocal cords contained in the larynx is attributable to various factors, including viruses (eg: Rhinovirus, influenza virus, varicella virus, Coronavirus and Adenovirus), bacteria (eg: Bordetella pertussis), mushrooms (ex: Candida albicans And Aspergillus) and excessive use of the voice.
When there is laryngitis, the presence of swollen lymph nodes on the neck tends to have the upper and deep cervical lymph nodes as protagonists.

Gingivitis, dental abscesses and pericoronitis

Gingivitis, dental abscesses and pericoronitis are inflammations in which bacteria play a fundamental causal / favoring role.
In their presence, the phenomenon of enlarged lymph nodes in the neck sees the participation above all of the submandibular lymph nodes and deep cervical lymph nodes.

Ear infection

Otitis media is almost always a consequence of bacterial infections, sustained by pathogens such as Haemophilus influenzae, Moraxella catarrhalis And Streptococcus pneumoniae; otitis externa, on the other hand, is more often the result of mycosis (fungal infections) or, in any case, pathogens with a preference for humid environments.
When there is an otitis, the presence of swollen lymph nodes on the neck recognizes, above all, in the posterior auricular lymph nodes and in the upper cervical lymph nodes its most important actors.

Rubella, chicken pox, flu and mononucleosis

The viral pathogens responsible for rubella, chicken pox, influenza and mononucleosis are, respectively, rubella virus, varicella-zoster virus, influenza virus and Epstein-Barr virus.
On the occasion of these known viral diseases, the presence of enlarged lymph nodes on the neck usually gives a prominent role to the superficial, deep and posterior cervical lymph nodes.

AIDS

In AIDS, swollen lymph nodes on the neck, together with swollen lymph nodes in the armpit and in the retro-nuchal compartment, are a characteristic sign of the early stage of infection, an early stage which is equivalent to the stage following the so-called latency stage of AIDS. .

Non-Hodgkin's lymphomas

In non-Hodgkin's lymphomas, swollen lymph nodes on the neck represent one of the effects of indiscriminate and unregulated reproduction of B and T lymphocytes in the lymph nodes (ie in the lymph nodes).

Did you know that ...

Non-Hodgkin's lymphomas are related to cervical lymphadenopathy, axillary lymphadenopathy, and inguinal lymphadenopathy.

Tumors of the mouth-throat compartment

In cancers of the mouth, throat, tongue and the like, the enlarged lymph nodes on the neck are the result of the large accumulation of neoplastic cells in the lymph node.
Usually, oral cavity tumors affect the deep cervical lymph nodes; however, in some circumstances, they also affect the other cervical lymph nodes (superficial and posterior) as well as the submandibular.

Rheumatoid arthritis and systemic lupus erythematosus

In rheumatoid arthritis and systemic lupus erythematosus, swollen lymph nodes on the neck are the result of abnormal immune cell behavior when an autoimmune disease is ongoing.
Autoimmune diseases, in fact, are particular clinical conditions, the symptoms and signs of which are due to a malfunction of the immune system: the immune cells, instead of merely carrying out their normal action against external threats (viruses, bacteria, etc.), are aggressive towards the organism they should protect.

Insect bites

Insect stings or bites on or near the neck cause swollen lymph nodes on the neck, when an infection arises, which produces an inflammatory response and draws immune cells to the lymph node.

Other causes of swollen lymph nodes on the neck:

• Histoplasmosis (fungal infection)
• Brucellosis (bacterial infection)
• Toxoplasmosis (parasitic infection)
• Secondary syphilis (bacterial infection)
• Herpes virus infections
• Cytomegalovirus infections
• Leukemia (blood cancers)
• Sinusitis
• Tuberculosis
• Laryngeal cancer
• Malignant chest tumor
• Reactions to drugs or vaccines

resulting from swollen lymph nodes on the neck can be a constant presence or manifest only on palpation of the swelling.

Acute or gradual enlargement: what can this mean?

Swollen lymph nodes on the neck can result from an "acute enlargement process - where acute s" means quick to occur - or from a gradual enlargement process.
Generally, the process of swollen lymph nodes in the neck is acute when the underlying cause is an infection or trauma, while it is gradual when the underlying cause is a tumor or autoimmune disease.

Associated symptoms

The symptoms and signs that may accompany the presence of swollen lymph nodes on the neck are numerous and depend on the condition triggering the enlarged lymph node.
Going more specifically, among the symptoms and signs in question, they certainly deserve a mention:

• Pain in the throat
• Runny nose (runny nose)
• Red throat;
• Dry throat;
• Itching in the throat
• Fever;
• Ear pain (ear pain);
• Stuffed nose and consequent breathing difficulties;
• Hoarseness;
• Drop in voice
• Cough;
• Difficulty chewing
• Difficulty chewing
• Pain in the jaw
• Generalized fatigue;
• Toothache.

Complications

In the presence of swollen lymph nodes on the neck, the possible occurrence of complications depends on the severity of the cause triggering the enlarged lymph node and the remaining symptoms. In other words, swollen lymph nodes on the neck can be associated with complications if the underlying condition is clinically relevant.
Examples of conditions that cause lymphadenopathy of the neck and from which, given their severity, complications can arise are: throat cancer, mouth cancer, tongue cancer, AIDS and cases of infections not treated properly.

When to see a doctor?

Swollen lymph nodes on the neck are a sign that should not be underestimated but, indeed, should be brought to the attention of the attending physician, when:

• They are persistent;
• They are accompanied by the enlargement of other lymph nodes (eg axillary lymph nodes, inguinal lymph nodes, etc.);
• They are accompanied by a rich and / or severe symptomatology (eg: high fever, severe difficulty in swallowing and chewing, intense pain in the throat, etc.);
• They are accompanied by toothache.

and from the account of the associated symptoms, made by the patient; therefore, based on the circumstances and what emerges from the investigations just mentioned, it can continue with:

• Blood tests;
• A throat swab
• Diagnostic imaging tests (X-rays, magnetic resonance, CT scan, etc.) with particular reference to the oral cavity and neck;
• An "endoscopy of the upper aero-digestive tracts and of the larynx.

and antipyretics (aspirin, NSAIDs or paracetamol) to control fever, generous fluid intake and, finally, the consumption of easily digestible meals.

If the swollen lymph nodes on the neck are due to throat cancer, therapy includes chemotherapy and radiotherapy, for less severe cases, and surgery to remove the tumor, for more critical cases.

If the swollen lymph nodes on the neck are due to severe pharyngitis, the patient will benefit from rest, drinking plenty of fluids, gargling with heated water and salt, taking anti-inflammatory and analgesic drugs, and from the practice of hot-humid inhalations.

If swollen lymph nodes on the neck are related to bacterial tonsillitis, treatment involves giving antibiotics, combined with rest and generous fluid intake.

Antonio Griguolo

Graduated in Biomolecular and Cellular Sciences, he obtained a Specialized Master in Journalism and Institutional Communication of Science