Swollen lymph nodes • What is behind it?

Several hundred lymph nodes are in the human body. They are natural components of the complex lymphatic system and function as filter stations for the tissue water. Lymph nodes ward off germs and toxins to protect the internal organs from potential pathogens. Since they look very similar to adipose tissue, normal-sized lymph nodes cannot be detected with the ultrasound device. Only when an infection spreads in the body, they swell and can hurt.

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Causes swollen lymph nodes

Swollen lymph nodes often show up in certain parts of the body such as the neck, groin, chest, armpits or behind the ear. There is a simple reason for this: "These regions are particularly palpable," explains Dr. med. Christian Philipp Schurr, specialist in ear, nose and throat medicine at an ENT practice in Munich and member of the German Society for Otolaryngology and Head and Neck Surgery. "There are 150 lymph nodes on each side of the neck alone, but only about three to five of them are noticeable through enlargement." Such an enlargement can have different causes – mostly they are harmless, less often there are serious illnesses behind it.

There are two categories of Lymph node swelling differentiated:

"In most cases, swollen lymph nodes are a Accompanying symptom for harmless inflammation"says Schurr. For example,

as a cause. Inflammation on the tooth or jaw and vaccinations can also lead to palpable nodules on the neck, for example.

Other infectious diseases that cause swollen lymph nodes:

• Respiratory infections
• flu infections and colds
• Cat scratch disease (bacteria get into the human organism from scratch injuries)
• Infections of contaminated food with toxoplasmosis or listeriosis pathogens
• STDs like syphilis
• Appendicitis

People who are at increased risk of HIV (e.g. prostitutes, drug addicts or people with frequently changing sex partners) are checked for the presence of this underlying disease, depending on the duration, size and shape of the swollen lymph nodes.

"In adolescence, the Epstein-Barr virus is often to blame for swelling of the lymph nodes," says the ENT specialist. This virus is mainly transmitted through saliva and triggers Pfeiffer's glandular fever. The infection also owes its colloquial name "kissing disease" to this typical path of infection.

Swollen lymph nodes – signs of cancer?

"In extremely rare cases, cancer can be the cause of the symptoms," says Schurr. The lymph nodes swell because the white blood cells (lymphocytes) change, have spread uncontrollably and have deposited in the lymph nodes. There are several types of malignant lymphoma that can affect glands and tissues – the Hodgkin and non-Hodgkin lymphomas. Chronic lymphocytic leukemia (CLL), i.e. white blood cell cancer, is also associated with an enlargement of the lymph nodes. With breast cancer, however, the lymph nodes under the armpit are often swollen.

But even in the fight against such cancers, the lymph nodes serve an important purpose. Its defense function tries to stop scattering tumors and prevent metastasis. If the warning signal of lymph node swelling is now recognized promptly, this means: "At best, the cancer can only be treated curatively before it spreads because the lymph nodes drew attention to the disease in good time," explains the specialist.

There are other symptoms associated with cancer. These include, for example:

As the German Cancer Research Center (DKFZ) makes clear, the following applies: "None of the signs of the disease alone indicates the presence of lymphoma. Neither do several or all of the symptoms mentioned appear in a person affected." Decisive for the diagnosis are appropriate examinations of cells from removed lymph nodes, from blood and bone marrow or other affected tissues.

When should you see a doctor?

On the one hand, swollen lymph nodes are not automatically a reason for panic, on the other hand, suspected cancer detection should be investigated in good time. A difficult situation for those who are unsettled and who usually notice a lymph node swelling quite accidentally – for example when shaving or feeling asymmetry. Otolaryngologist Schurr knows the concerns of patients and can calm down: "The worries are mostly unfounded. To be on the safe side, you should Any permanent thickening that lasts longer than one to three weeks should be examined by the doctorto get to the bottom of the cause. "

Diagnosis: How the doctor works with swollen lymph nodes

During a medical examination, the expert can palpate swollen lymph nodes. They feel hard and can cause pain when pressed. In contrast, nodes that indicate a tumor are painless.

The Condition of the lymph nodes is scrutinized during an ultrasound examination. Safe, swollen lymph nodes are less than a centimeter in size, have an elongated oval shape and a recognizable Hilus sign. This sign is a kind of gate that acts as the entry and exit point of the lymphatic vessels. In the case of malignant changes, the shape of the lymph nodes is rounded and they can hardly be recognized as typical lymph nodes.

Also be examined the organs for diagnosiswhose tissue water is filtered by the affected nodes. To rule out cancer, blood sampling and a biopsy (taking a tissue sample) can help the doctor to make an assessment.

Treatment: Is therapy necessary for swollen lymph nodes?

Which treatment is initiated depends on the cause. If the flu infection disappears, the swelling of the lymph nodes also subsides after a while. "The primary cause of such colds is always that Triggers the symptoms and not the knot thickening itself treated. Anti-inflammatory or pain-relieving medication can be used for this, "says the ENT specialist. Schurr also knows himself as one of the leading doctors in the department of" Ear, Nose and Throat, Head and Neck Surgery "in the Munich clinic" Josephinum " With surgical interventions for treatment from: "Lymph node removal is initiated as the very last measure according to oncological findings. Fortunately, this is only extremely rarely necessary."

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