Lymph Glands and Lymph Nodes

Terms Lymph Gland and Lymph Node are used interchangeably here and refer to the same thing.

Enlargement of lymph glands is a common medical problem. Patients themselves can easily notice enlarged lymph glands. Enlargement of lymph glands may or may not indicate a serious illness. This pamphlet is intended to increase your knowledge about enlarged lymph nodes in adults and it dose not replace seeing a doctor or obtaining medical opinion from a qualified physician. You must see a doctor if you have any concerns about your health. This pamphlet does not address any issues in pediatric age group.



Our Website, www.tirgan.com. is a great resource to you for understanding of the technical terms that you may encounter here. Remember that you should discuss your medical problems with a physician and this pamphlet is not meant to substitute obtaining professional medical help from your doctor.



M. Hossein Tirgan, MD


Introduction:



Human body has numerous lymph nodes. Some are located under the skin and if enlarged, they can be easily noticed or palpated. Term Palpation means touching and feeling something with our fingers. We notice most of the enlarged nodes by palpation. Other lymph nodes are located inside chest, abdomen and pelvis and are very hard to palpate unless they are extremely large.



Most commonly, an enlarged lymph gland is noticed under the skin. The areas that contain lymph glands and are easily palpable are neck, the area behind the clavicles (collar bone), areas under the arms and groins. Enlarged lymph nodes can also be palpated in the area near the elbow as well.



Sometimes a lump may be palpated under the skin in other areas. Not every palpable lump is a lymph node. The location of lumps, their physical character and consistency and how hey feel under hands help in differentiating them from lymph nodes.



What are the other kinds of lumps that can be palpated under the skin?

There are a few other conditions that present themselves with lumps under the skin such as Lipomas and benign Cysts and nodules. Not every lump is a lymph node. Palpable lymph nodes are limited to the neck, under the arms, groins and rarely in the elbow region.



Lipomas are by far the most common form of lumps under the skin and are due to fatty tissue overgrowth. They are completely benign and cause no harm. They can be palpable everywhere in the body, mostly in the back, chest, abdominal area and arms and legs. They feel very soft, are mobile and may be even flat. Some people have more than one Lipoma and some may even have many Lipomas in various places. Lipomas grow extremely slowly and remain the same size as they have been in the past. They are painless and non-tender.



Cysts are small collection of fluids and may be seen in limited areas in the body. They can be of various sizes and most commonly are soft and can be compressed by the palpating fingers. Some cysts are located under the skin and some are within the thickness of skin itself. If the fluid in the cyst is under pressure, the cyst may feel tense and hard. Cysts are rather uncommon. They can be seen in the breasts or sometimes associated with a joint, referred to as synovial cyst and sometimes in the neck. Cysts can be emptied by inserting a needle inside them. Fluid and material that is removed should be sent for pathological evaluation. Some cysts completely disappear after this procedure.



Cancer Nodules are seen in patients who have advanced stages of cancer. Cancers can also spread to the skin or under the skin and look like a lump. Such lumps grow rather constantly and the overlying skin may be red. Such lumps are hard and may even involve the skin and be immobile. Depending on circumstances, such nodules may need to be biopsied or removed.





How can we determine if a lymph node is cancerous or not?



If the lump is determined to be a lymph node, the next step would be to find and establish the cause for its enlargement. Not every palpable lymph node is cancerous. The following is a clinical guideline that we use in evaluating enlarged lymph nodes. If the node is felt to be suspicious for a cancerous or other important illnesses, it must be further evaluated by performing blood tests, a needle biopsy or surgical removal.

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