Benign vs. Malignant Lymph Nodes

When all is well, it can be rather difficult to locate your tiny lymph nodes. But when lymph nodes near the surface swell, you can easily feel them with your fingers. You might even be able to see them. Lymph nodes that are located deeper in the body can swell without you noticing.

If you do have swollen lymph nodes, it means they’re fighting off illness. As for whether they’re benign versus malignant, you can’t tell by looking at them or feeling them. However, there are other signs that may provide some clues.

Signs of potentially benign lymph nodes

Here are some signs that swollen lymph nodes are likely benign:

• You have other symptoms, such as coughing, body aches, or nausea that indicate a viral infection or other illness.
• The swollen lymph nodes are located near an infected body part, such as the throat, ears, or mouth.
• The swelling is going down as you recover from infection or illness.

Signs of potentially malignant lymph nodes

Lymph nodes are always fighting off invaders, so a few cancer cells may not be enough to cause noticeable swelling. Signs that swollen lymph nodes should be examined by a doctor include:

• You have no obvious illness or infection.
• You have fever and night sweats.
• You’ve recovered from an illness, but your lymph nodes remain tender or swollen for more than 2 weeks.
• The lymph nodes are getting bigger or are hard and immoveable.
• The area around your lymph nodes is red, feels warm to the touch, or is leaking pus or other fluids.
• You’re currently in treatment or recently completed treatment for cancer.

If your lymph nodes are swollen, your doctor will likely start by feeling some of your lymph nodes and looking for other signs and symptoms of illness.

Diagnostic testing

Diagnostic testing may include:

• blood tests to check for infection and underlying conditions
• imaging tests, such as X-ray, CT scan, MRI, or ultrasound to get a better look at the lymph nodes

Biopsy

The only way to know for certain if your lymph nodes are benign versus malignant is to perform a lymph node biopsy. Your doctor may recommend this if:

• Physical examination and diagnostic testing can’t determine the cause.
• You’ve recently been treated for cancer or you’re currently in treatment.

A biopsy involves getting a sample of tissue from the lymph nodes. This can be done with a needle, or the lymph nodes can be removed during surgery. The tissue samples will go to a laboratory where a pathologist will use a microscope to look for cancer cells.

A biopsy often follows a cancer diagnosis, even if the lymph nodes appear normal.

Treatment depends on the cause. For example, a doctor might prescribe antibiotics for a strep infection or antivirals for a serious case of the flu. If it’s due to an immune disorder, you’ll need treatment for that specific condition.

Lymph nodes that swell due to infection or illness should return to normal size as you recover. In the meantime, here are a few other things you can try:

• rest
• drink plenty of fluids
• apply a warm compress several times a day
• avoid squeezing or poking at swollen lymph nodes
• take over-the-counter (OTC) pain relievers or anti-inflammatories

Speak with your doctor before giving OTC medicines, especially aspirin, to a sick child.

If a biopsy confirms cancer cells in the lymph nodes, you may need more tests. That’s because you’ll want to know more about the cancer and how far it may have spread. Lymph node involvement is a key factor in cancer staging and treatment.

Cancer that has spread from the primary site to lymph nodes means there’s a higher risk it will return following surgery. This means you might need additional treatment, such as:

• chemotherapy
• radiation
• immunotherapy
• targeted therapies

Removing lymph nodes can sometimes make it difficult for lymph fluid to drain properly, causing it to back up. This condition is called lymphedema, and it can lead to visible swelling in the affected area. The more lymph nodes that are removed, the more likely it is to become a problem. Lymphedema can become chronic.

The lymph system is part of the immune system. It’s a network of lymph vessels and lymph nodes. There are approximately 800 lymph nodes scattered throughout your body, with more than a third located in the head and neck.

Lymph fluid, which contains white blood cells to fight infection, travels through lymph vessels. The lymph nodes act as filters for germs and foreign substances. When you have an infection, injury, or cancer, lymph nodes swell up as they filter out problem substances.

When your lymph nodes are swollen, you know there’s something going on. But swelling alone isn’t enough to tell you exactly what it is.

Single vs. generalized lymphadenopathy

There’s usually a single area of swollen lymph nodes, such as the neck, underarm, or groin. Sometimes, there are multiple areas of swollen lymph nodes, which is called generalized lymphadenopathy.

Multiple causes of swollen lymph nodes

You can have swollen lymph nodes for many reasons, such as strep throat, an ear infection, or an immune system disease.

Cancer can also cause swollen lymph nodes. Lymphoma is a type of cancer that starts in the lymph nodes. But cancer cells can also spread from another part of the body to lymph nodes, usually the ones that are closest to the primary tumor.

For example, breast cancer may spread to the lymph nodes under the arm or near the collarbone. Once in the lymph system, cancer cells can move through the lymph vessels to distant parts of the body, where they can form new tumors (metastasis).

When it comes to benign versus malignant lymph nodes, you can’t tell by sight or touch alone. But other symptoms can offer clues. Swollen lymph nodes are typically the result of your immune system working hard to fight off infection or illness. They should return to normal as you recover.

You can only determine if the lymph nodes are malignant through biopsy. Results from a biopsy help doctors confirm and stage cancer, as well as determine the best treatment options.

Don’t hesitate to see a doctor if you have any concerns about your lymph nodes or if they’re enlarged for more than 2 weeks.