Enlarged lymph nodes: what it means and when to worry

The enlarged lymph nodes, popularly known as tongue and scientifically as lymph nodes or lymph node enlargement, indicate, in most cases, an infection or inflammation of the region in which they appear, although they can arise for various reasons, from a simple skin irritation, an infection, diseases of immunity, use of medicines or even cancer.

Lymph node enlargement can be of two types: localized, when the inflamed nodes are close to the infection site, or generalized, when it is a systemic disease or infection that lasts a long time.

The ganglia are spread throughout the body, as they are part of the lymphatic system, an important part of the immune system, since they filter the blood and help eliminate harmful microorganisms. However, when they are enlarged, it is common for them to be visible or palpable in some specific regions, such as groins, armpits and neck. Better understand the function of the lymph nodes and where they are.

In general, the waters tend to have benign and transient causes, and are usually a few millimeters in diameter, disappearing in a period of about 3 to 30 days. However, if they grow more than 2.25 cm, last more than 30 days or are accompanied by symptoms such as weight loss and constant fever, it is important to consult with a general practitioner or infectious disease to investigate the possible causes and recommend treatment..

Inflammation of the ganglia can happen due to an acute or chronic infection, tumor, autoimmune disease or that compromises the immune system, as is the case with AIDS.

What causes enlarged lymph nodes

The causes of lymph node enlargement are diverse, and it must be remembered that there is no single rule for its identification. However, some possible causes are:

1. In the neck

The lymph nodes in the cervical region, but also those located under the jaw, behind the ears and neck, are usually enlarged due to changes in the airways and the head region, such as:

• Respiratory tract infections, such as pharyngitis, colds, flu, mononucleosis, ear infections and flu; Conjunctivitis; Skin infections, such as scalp folliculitis, inflamed acne; Infections of the mouth and teeth, such as herpes, cavities, gingivitis and periodontitis; Less common infections, such as ganglion tuberculosis, toxoplasmosis, cat scratch disease or atypical mycobacterioses, although more rare, can also cause this type of alteration; Autoimmune diseases, such as Systemic Lupus Erythematosus (SLE) and rheumatoid arthritis; Others: some types of cancer, such as head and neck cancer and lymphoma, for example, systemic diseases or reaction to medications.

In addition, systemic infectious diseases such as rubella, dengue or Zika virus can also manifest with enlarged lymph nodes in the neck. Learn more about the diseases that cause water in the neck.

2. In the groin

The groin is the most common place where enlarged lymph nodes appear, as the lymph nodes in this region can indicate the involvement of any part of the pelvis and lower limbs, and it happens mainly due to cancer and infections:

• Sexually transmitted diseases, such as syphilis, soft cancer, donovanosis, genital herpes; Genital infections, such as candidiasis or other vulvovaginitis, and penile infections caused by bacteria or parasites; Inflammation in the pelvis and lower abdominal region, such as urinary infections, cervicitis or prostatitis; Infections or inflammations in the legs, glutes or feet, caused by folliculitis, boils or even a simple ingrown toenail; Cancer of the testis, penis, vulva, vagina or rectum, for example; Others: autoimmune diseases or systemic diseases.

In addition, as this set of lymph nodes is close to a region where inflammation, minor cuts or infections are frequently present, it is common for water to be noticed, even without symptoms.

3. In the armpit

Axillary lymph nodes are responsible for draining the entire lymphatic circulation from the arm, chest wall and breast, so when they are enlarged, they may indicate:

• Skin infections, such as folliculitis or pyoderma; Infections of breast implants; Autoimmune diseases.

The underarm area is also very susceptible to irritation by deodorant or hair removal products, or cuts due to the use of hair removal, which can also be causes of enlarged lymph nodes.

4. In other regions

Other regions may also have enlarged lymph nodes, however, they are less common. An example is the region above the clavicle, or supraclavicular, as it is not a common site for the appearance of enlarged ganglia. In the anterior region of the arm, it may indicate infections of the forearm and hand, or diseases such as lymphoma, sarcoidosis, tularemia, secondary syphilis.

5. In various places on the body

Some situations can cause an enlarged ganglion in different parts of the body, both in more exposed regions and in deeper regions, such as the abdomen or chest. This usually happens due to diseases that cause systemic or generalized impairment, such as HIV, tuberculosis, mononucleosis, cytomegalovirus, leptospirosis, syphilis, lupus or lymphoma, for example, in addition to the use of certain medications, such as Phenytoin.

Therefore, it is necessary to perform imaging and laboratory tests, as well as consultation with the doctor so that the origin of the alteration is found and a treatment aimed at reducing the size of the inflamed nodes is established.

6. When can it be cancer

The swollen lymph nodes can be cancer when they appear in the armpit, groin, neck, or are spread in various parts of the body, have a hard consistency and do not disappear after 30 days. In that case, you should go to the doctor to perform tests and discard all other possibilities. The doctor may order more specific tests such as ultrasound or CA 125, for example, if cancer is suspected in the first consultations. Fine needle aspiration biopsy is one of the tests that can be ordered when there is a cyst composed of liquid or liquid + solid.

After the diagnosis of cancer the doctor will direct the person to the most appropriate health service, and often the cancer can be cured with the appropriate treatment, and started as soon as possible. Certain types of tumor can be removed through surgery and there is not always the need for treatment with radiotherapy or chemotherapy, there are also modern drugs that are able to completely eliminate the malignant cells.

Causes	Characteristics	Tests the doctor may order
Respiratory disease	Swollen lymph nodes in the neck without pain, sore throat, runny nose or cough	Not always necessary
Tooth infection	Swollen nodes in the neck, affecting only one side, sore, and toothache	X-ray of face or mouth may be required
Tuberculosis	Swollen nodes in the neck or collarbone, inflamed, painful and may contain pus. Most common in HIV +	Tuberculin test, lymph node biopsy
HIV (recent infection)	Various lymph nodes swollen throughout the body, fever, malaise, joint pain. More frequent in people with risky behavior	HIV testing
STD	Swollen groin ganglia, pain when urinating, vaginal or urethral discharge, sore in the intimate area	STD specific exams
Skin infection	Visible cut in the region near the enlarged lymph node	Blood test to identify antibodies against the infecting microorganism
Lupus	Various lymph nodes swollen throughout the body, pain in the joints, sores on the skin, reddish color on the cheeks (butterfly wings)	Bloodtests
Leukemia	Tiredness, fever, purple marks on the skin or bleeding	CBC, bone marrow examination
Use of medications such as: allopurinol, cephalosporins, penicillin, sulfonamides, atenolol, captopril, carbamazepine, phenytoin, pyrimethamine and quinidine	Recent infection with antibiotics	At medical discretion
Toxoplasmosis	Swollen lymph nodes in the neck and armpits, runny nose, fever, malaise, enlarged spleen and liver. When exposure to cat feces is suspected	Blood test
Cancer	Swollen ganglion, with or without pain, hardened, which does not move when pushed	Specific exams, biopsy

The characteristics indicated in the table are the most common, but they may not all be present, and only the doctor can diagnose any disease, then indicating the most appropriate treatment for each case.

How to cure inflamed tongues

In most cases, inflamed languages ​​are harmless and do not represent a serious health problem, being caused only by viruses, which heal spontaneously in 3 or 4 weeks, without the need for specific treatment.

Lymphadenopathy does not have a specific treatment, being always directed to its cause. Medications such as antibiotics and corticosteroids should not be used without medical advice as they can delay the diagnosis of serious illnesses.

When it is necessary to see the doctor

The enlarged ganglion is usually characterized by having an elastic and mobile fibrous consistency, which measures a few millimeters and can be painful or not. However, it can present some changes that indicate worrisome diseases, such as lymphoma, ganglionic tuberculosis or cancer, and some are:

• Measure more than 2.5 cm; Have a hard consistency, adhered to deep tissues and do not move; Persist for more than 30 days; Be accompanied by fever that does not improve in 1 week, night sweat, weight loss or malaise; Have epitrochlear, supraclavicular or spread over various parts of the body.

In these situations, care should be sought with a general practitioner or infectious disease, so that clinical evaluation, ultrasound or tomography exams are carried out, in addition to blood tests that assess infections or inflammations throughout the body. When the doubt persists, it is also possible to request a biopsy of the ganglion, which will demonstrate whether it has benign or malignant characteristics, and that the oncologist can be consulted to assess the signs and symptoms of the inflamed ganglion.