Generality
The lymph nodes swollen on the neck are a clinical sign that can be seen on the occasion of different conditions, including for example pharyngitis, tonsillitis, laryngitis, gingivitis, dental abscess, flu, mononucleosis, AIDS, tumors of the mouth-throat compartment, non-Hodgkin's lymphomas, insect bites on the neck and rheumatoid arthritis.
In essence, the enlargement of the lymph nodes on the neck can be a response of the human body to the presence of infectious states, tumors, traumas and autoimmune diseases.
Characterized by one or more painful swellings, the enlarged 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.
Short review of what the lymph nodes are
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 the waste tissue present tissues).
Acting similarly to purifiers, lymph nodes are often referred to as biological filters.
What are Neck Lymph Nodes?
The enlarged lymph nodes on the neck, or swollen neck lymph nodes they are a typical sign of various medical conditions, including conditions of infectious origin, autoimmune diseases, traumas with a site on the neck and, even, tumors.
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 necessary:
- Lymphadenopathy, swollen lymph nodes and enlarged lymph nodes are synonymous.
- The adjective "lymph node" indicates "everything attributable to the lymph nodes".
Outline of anatomy related to the lymph nodes of the neck
According to a more generic classification, under the heading "lymph nodes of the neck" belong the lymph nodes that reside:
- Behind the ears ( posterior auricular lymph nodes );
- At the occipital bone of the skull ( occipital lymph nodes );
- Below the ear and next to where the mandible is attached to the temporal bone of the skull, forming the temporomandibular joint ( jugulo-digastric lymph node );
- Below the jaw ( submandibular lymph nodes );
- Just above the clavicle ( supraclavicular lymph nodes );
- On the neck itself ( superficial cervical lymph nodes, deep cervical lymph nodes and posterior cervical lymph nodes ).
According to a more specific classification, instead, to the definition "lymph nodes of the neck" belong exclusively the lymph nodes with seat on the anatomical region called neck (that is the actual neck just mentioned). Therefore, according to 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 words "swollen lymph nodes on the neck" refers to the lymphadenopathy of the lymph nodes of the neck falling within the first classification, the more generic and the more extended meaning.
Did you know that ...
When the enlarged lymph nodes on the neck are exclusively the cervical ones, the doctors speak of cervical lymphadenopathy.
Causes
The main causes of enlarged lymph nodes on the neck include:
- Pharyngitis, tonsillitis and laryngitis, that is, respectively, inflammation of the pharynx, 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 that surrounds a tooth that is undergoing eruption;
- Otitis, or inflammation of the ear;
- Common viral diseases, such as rubella, chickenpox, influenza and mononucleosis ;
- AIDS, that is HIV-supported viral infection;
- Non-Hodgkin's lymphomas . Non-Hodgkin's lymphomas are tumors 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;
- Mouth-throat tumors, 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 suffering of the joints and a multi-systemic condition (ie involving more organs);
- Insect stings or bites in the neck.
Pharyngitis
Inflammation of the pharynx (ie the back of the mouth) is the condition commonly known as sore throat.
A cause of sore throats can be viruses (including Rhinoviruses, Coronaviruses and Adenovirus), bacteria (including Streptococcus beta hemolytic group A, 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 is mainly characterized by superficial, deep and posterior cervical lymph nodes and submandibular lymph nodes.
Tonsillitis
Tonsillitis recognizes its main causes in viruses, such as Rhinoviruses, Coronaviruses, Adenovirus and Epstein Barr virus, and in bacteria such as Streptococcus beta hemolytic group A and Streptococcus pyogenes .
In the presence of tonsillitis, the phenomenon of swollen lymph nodes on the neck usually has superficial and deep cervical lymph nodes, submandibular lymph nodes and the jugulo-digastric lymph node.
Laryngitis
The inflammation of the larynx and vocal cords contained in the larynx is due to various factors, including viruses (eg: Rhinovirus, influenza virus, varicella virus, Coronavirus and Adenovirus), bacteria (eg: Bordetella pertussis ), fungi ( ex: Candida albicans and Aspergillus ) and excessive use of the voice.
When there is laryngitis, the presence of enlarged 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 causative / favoring role.
In their presence, the phenomenon of swollen lymph nodes in the neck sees the participation above all of 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 predilection for wet environments.
When there is otitis, the presence of swollen lymph nodes on the neck recognizes its most important actors especially in the posterior auricular lymph nodes and in the upper cervical lymph nodes.
Rubella, chickenpox, flu and mononucleosis
The viral pathogens responsible for rubella, varicella, 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 swollen lymph nodes on the neck usually gives a prominent role to superficial, deep and posterior cervical lymph nodes.
AIDS
In AIDS, swollen lymph nodes on the neck, together with swollen lymph nodes on 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 phase following the so-called AIDS latency phase .
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, at the lymph node level (ie in the lymph nodes).
Did you know that ...
Non-Hodgkin's lymphomas are related to cervical lymphadenopathy, axillary lymphadenopathy and inguinal lymphadenopathy.
Mouth-throat compartment tumors
In tumors of the mouth, throat, tongue and the like, swollen lymph nodes on the neck are the result of the massive accumulation of neoplastic cells at the lymph node level.
In general, oral cavity tumors affect the deep cervical lymph nodes; however, in some circumstances, they also affect the other cervical lymph nodes (the superficial and the posterior) as well as the submandibular ones.
Rheumatoid arthritis and systemic lupus erythematosus
In rheumatoid arthritis and systemic lupus erythematosus, swollen lymph nodes in the neck are the consequence of the abnormal behavior of immune cells when an autoimmune disease is underway.
Autoimmune diseases, in fact, are particular clinical conditions, whose symptoms and signs are due to a malfunctioning of the immune system: the immune cells, instead of merely performing their normal action against external threats (viruses, bacteria, etc.), are aggressive towards the organism they should protect.
Insect bites
The bites or insect bites on the neck or in its vicinity cause swollen lymph nodes on the neck, when an infection arises from them, which produces an inflammatory response and recalls immune cells at the lymph node level.
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Symptoms
The enlarged lymph nodes on the neck are responsible for an often painful swelling .
The pain deriving from the enlarged lymph nodes on the neck can be a constant presence or only appear when palpation of the swelling occurs.
Sharp or gradual enlargement: what can it mean?
Enlarged lymph nodes in the neck can result from an acute enlargement process - where by acute is meant fast in occurrence - or by a process of gradual enlargement.
In general, the enlargement process of the lymph nodes of the neck is acute, when the underlying cause is an infection or a trauma, while it is gradual, when the underlying cause is a tumor or an 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 triggering condition of the lymph node enlargement.
Entering more specifically, among the symptoms and signs in question, they certainly deserve a quotation:
- Throat pain;
- Runny nose (rhinorrhea);
- Reddened throat;
- Dry throat;
- Itching in the throat;
- Temperature;
- Otalgia (ear pain);
- Closed nose and consequent breathing difficulties;
- Hoarseness;
- Decline of the voice;
- Cough;
- Difficulty chewing;
- Difficulty chewing;
- Jaw pain;
- General fatigue;
- Toothache.
Complications
In the presence of enlarged lymph nodes on the neck, the possible appearance of complications depends on the severity of the triggering cause of the lymph node enlargement and the remaining symptomatology. 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 subjected to the right care.
When should I go to the doctor?
The enlarged lymph nodes on the neck are a sign not to be underestimated but, on the contrary, to be submitted 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 swallowing and mastication difficulties, intense throat pain, etc.);
- Accompany with toothache.
Diagnosis
To detect the presence of enlarged lymph nodes on the neck, the palpatory examination of the neck is sufficient, performed during a classic physical examination .
What is the next step?
Once the presence of enlarged lymph nodes on the neck has been ascertained, the doctor initiates the investigations necessary to identify the cause triggering the process of lymph node enlargement. Diagnosis of the causes of swollen lymph nodes on the neck is essential for the most appropriate therapy planning.
The diagnostic procedure that allows to go back to the causal factors of a lymphadenopathy of the neck always starts from the anamnesis and from the narration of the associated symptoms, carried out by the patient; therefore, depending on the circumstances and what emerges from the surveys just mentioned, it can continue with:
- Blood tests ;
- A pharyngeal swab ;
- Diagnostic imaging tests (X-rays, magnetic resonance imaging, CT scans, etc.) with particular reference to the oral cavity and neck;
- An endoscopy of the first aero-digestive and laryngeal pathways .
Therapy
In the presence of enlarged lymph nodes on the neck, the treatment adopted varies according to the triggering cause.
In practical terms this means that the presence of swollen lymph nodes on the neck due to Rhinovirus pharyngitis requires treatment different from a neck lymphadenopathy due to a throat tumor.
In the next section, this article will consider the therapy provided in some of the most important circumstances responsible for enlarged lymph nodes on the neck.
Examples of treatment in the presence of swollen lymph nodes on the neck
- If the swollen lymph nodes on the neck derive from a common flu, the treatment includes: rest until the entire symptomatology disappears, taking analgesic and antipyretic drugs (aspirin, NSAIDs or paracetamol) to control fever, generous intake of liquids and, finally, the consumption of easily digestible meals.
- If the swollen lymph nodes on the neck depend on a throat tumor, the therapy includes chemotherapy and radiotherapy, for less severe cases, and tumor removal surgery, for the most critical cases.
- If the swollen lymph nodes on the neck are due to severe pharyngitis, the patient will benefit from rest, from the intake of many liquids, from the execution of gargles based on heated water and salt, from the intake of anti-inflammatory and analgesic drugs, and from the practice of hot-humid inhalations.
- If the enlarged lymph nodes on the neck are related to a bacterial tonsillitis, the treatment involves the administration of antibiotics, combined with rest and a generous fluid intake.
Clinical meaning
The clinical relevance of swollen lymph nodes on the neck depends on the severity of the triggering condition; in other words, the more the clinical significance of the triggering cause is important, the more the swollen lymph nodes on the neck must cause concern and call attention to the doctor.
