Cervical Lymphadenopathy (Swollen Lymph Nodes in the Neck)

Lymphadenopathy is the commonest swelling in the neck. It means that the lymph nodes in the neck are larger than they should be.

Some of these swellings point to a very ordinary illness. Others are the sign of an important condition that must be looked at at once. Enlargement of a lymph node caused by inflammation is called lymphadenitis.

By age group

The diseases that cause a lump in the neck are distributed differently across age groups.

Childhood. Lymphadenopathy is commonest in childhood, and swellings in the neck are very frequent then. They appear in the middle of the neck or at the sides, just under the jawbone, in front of or behind the ear, singly or several at once.

Childhood also brings swellings that come from development. When some tissues stop developing, or develop wrongly, at a certain stage in the womb, the result can show itself as a lump in the neck. These developmental conditions are not limited to childhood, though childhood is when they appear most. They range in size from a few millimetres to a mass that fills almost the whole neck.

Young adults. The commonest neck masses are the same as in childhood: the lymph nodes, which are part of the immune system, enlarging because of infection. The patient or a relative notices a swelling in the mirror, or the patient feels pain on swallowing, tenderness when the area is touched, or redness over it.

Older adults. Benign swellings are still far commoner than malignant ones. Even so, the proportion caused by malignant disease is higher than in the other age groups.

Conditions of the salivary glands around the mouth also appear as swellings in the head and neck: stones, enlargement of the gland, and benign or malignant tumours of the gland tissue.

What to do

Anyone of any age who notices a swelling in the head or the neck should first see a specialist in Ear, Nose and Throat Diseases and Head and Neck Surgery.

The specialist performs a full ear, nose, throat, head and neck examination. As the patient needs, that examination usually includes an endoscopic examination of the back of the nose, the pharynx, the larynx and the entrance to the gullet.

Treatment

The great majority of head and neck masses form as a result of infection or another inflammatory condition. Medical treatment of these masses usually succeeds very well. The right medicines, at the right dose and for the right length of time, are a requirement.

When an infectious or inflammatory condition does not answer medicines, the first treatment is surgery. Benign and malignant tumours in the head and neck region are treated accordingly.