What is done about an enlarged lymph node?
Your lymph nodes usually worry us when they enlarge for no apparent reason. If you have an enlarged lymph node in your neck but do not feel ill and have not recently had an infection such as a cold, flu or a dental infection, you absolutely must see a doctor and have some tests done.
To diagnose what may be causing the swollen lymph nodes, we first want to know, from your medical history, when and how your lymph nodes enlarged and whether you have any other signs or symptoms.
During the examination, we check the lymph nodes for size, tenderness, warmth and texture, because the location of your swollen lymph nodes and your other signs and symptoms offer clues to the underlying cause.
First, a complete blood count and the infection markers CRP and sedimentation rate are requested; these tests help us to assess your general health and to detect a range of disorders, including infections and leukaemia. Depending on the suspected cause, specific blood tests may also be requested, such as antigen-antibody tests for certain viruses. If tuberculosis is suspected, a tuberculin skin test is performed.
Next, a neck ultrasound is needed to assess all the lymph nodes in the neck and their structure. Beyond this, if anything suspicious is seen in the neck, an MRI and CT scan of the neck may be requested. A chest X-ray is also requested if a lung-related condition is suspected.
The next step is an ultrasound-guided biopsy with a fine or core needle. However, as these needle biopsies do not always give a definitive result, it is often necessary to remove your enlarged lymph node in the operating theatre in order to reach a diagnosis.
Treatment is then directed at the cause once it has been found.