Enlarged Cervical Lymph Nodes

Doctor examining a young boy for lymph node swelling.

Definition:

What Are They? 
Cervical lymph nodes are simply lymph nodes located in the neck region. Lymph nodes are small structures located all over the body. They are part of the lymph system and have an important role in the immune system. They occur at somewhat regularly spaced intervals, or chains, in the neck.

Why Are They There?
Most of the time, people don't notice their lymph nodes because they are too small and nondescript to be felt.

But, on occasion, and especially when due to a viral or bacterial upper respiratory infection, an individual will notice bumps beneath the skin of the neck. Those bumps along the sides and rear of the neck are the cervical lymph nodes – and in that case, they are swelling in response to the infection.

What Causes Them?
Lymph nodes swell for many different reasons. Most of the time, lymph node swelling in the neck area is not necessarily an ominous finding, and the bumps will go away on on their own, once the infection subsides. Infectious mononucleosis, or mono, commonly produces cervical lymph node enlargement. Rarely, swollen cervical nodes is a sign of a cancerous process. Lymphoma is a cancer of the lymph system. It can affect any of the body's lymph nodes, and cervical lymph nodes are commonly affected.

Why Are They Cervical? 
People may more readily link the cervix to the uterus, and procedures such as the Pap smear, or maybe the process of cervical dilation during labor and delivery or childbirth.

Cervix is actually the Latin term for neck, and it is used in medicine also to describe various neck-like structures of the body, thus the uterine cervix. Cervical is used as an adjective in describing things in the neck region, thus there are cervical vertebrae – the backbones in your neck; and cervical collars – those soft neck braces people sometimes buy at the drug store to try to get through a bout of neck pain.

Also Known As: Neck nodes

Causes of Cervical Lymph Node Swelling

The most common cause of cervical lymph node swelling is not lymphoma. In children, infections, and especially viral upper respiratory tract infections such as rhinovirus, influenza virus or adenovirus are most common. Other viruses such as the Epstein-Barr virus of mononucleosis, the varicella-zoster virus and HIV may be associated with neck lymph node swelling in children and adults.

Both bacteria and viruses can produce swollen lymph nodes in the neck region. When the cause is bacterial, likely culprits include certain types of Strep and Staph infections.

In addition to the neck, lymph nodes commonly swell in other areas such as the groin and underarms. Usually, just one area of nodes swells at a time. When more than one area of lymph nodes is becomes involved, it’s called generalized lymphadenopathy.

Malignancy is just one item in a long list of potential causes of swollen cervical lymph nodes. A variety of different cancers can spread to the lymph nodes to produce cervical lymph node swelling. Lymphoma is cancer that actually begins in the lymph nodes.

Lymphoma and Cervical Lymph Nodes

Painless swelling of one or more lymph nodes – often the cervical lymph nodes – is a key warning sign for lymphoma, and it may be one of the few outward signs of lymphoma early on.

Hodgkin’s lymphoma, or HL, and non-Hodgkin’s lymphoma, or NHL, are the two main categories of lymphoma. Generalized lymph node swelling refers to swollen nodes that arise in distinct areas of the body, sometimes all over the place, not seeming to follow a recognizable pattern. This more haphazard type of lymph node swelling is rarely seen in malignancies, however, it is usually seen in non-Hodgkin's lymphoma, according to Mohseni and colleagues. In contrast, HL is distinguished by the localized involvement of the lymph nodes. HL usually follows a predictable, organized procession from one lymph node area to the next.

HL is rare in children younger than 10 years old. Most children with HL have painless lymph node swelling, and involvement of cervical lymph nodes is common. When children have NHL, clinical involvement in the head and neck is seen in only 5 to 10 percent, and most often it involves symptomatic cervical lymphadenopathy.

Overall, when lymph node involvement is limited to the neck, Hodgkin's disease, non-Hodgkin's lymphoma, and squamous cell carcinoma of the head and neck and metastatic carcinomas are common malignancies in the neck region.

A Word from Verywell: Nomenclature and Cervical Cancer

When it comes to "cervical" + "lymph nodes," one might start to wonder about the potential for confusion in medical scenarios; stories about the amputation of the wrong limb may come to mind.

The terms cervix and cervical also refer to the neck-like structure that connects to the lower end of the womb, or uterus, to the vagina. While lymph nodes may become involved with the malignancy in cases of cervical cancer, when this happens, they are not called "cervical lymph nodes" – thankfully, other names for these structures are in use, such as paracervical, parametrial and hypogastric, etc.

Sources:

Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A. Peripheral Lymphadenopathy: Approach and Diagnostic Tools. Iran J Med Sci. 2014;39(2 Suppl):158-170.

Meier JD, Grimmer JF. Evaluation and management of neck masses in children. Am Fam Physician. 2014;89(5):353-8.

Louissaint A, Jr., Ferry JA, Soupir CP, Hasserjian RP, Harris NL, Zukerberg LR. Infectious mononucleosis mimicking lymphoma: distinguishing morphological and immunophenotypic features. Modern pathology. 2012;25(8):1149-1159.

Continue Reading