How are enlarged lymph nodes diagnosed?

What Is Done for an Enlarged Lymph Node?

Our 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, the flu, or a dental infection, you MUST see a doctor and have some tests done.

To diagnose what may be causing swollen lymph nodes, we first want to know from your medical history when and how your lymph nodes became enlarged and whether you have any other signs or symptoms.

During the examination, we check the lymph nodes for size, tenderness, warmth, and texture. This is 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 assess your general health and detect a range of disorders, including infections and leukemia. Specific blood tests may also be requested depending on the suspected cause, 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 evaluate all the lymph nodes and structures in the neck. In addition, when something suspicious is seen in the neck, a neck MRI and CT may be requested. A chest X-ray is also requested when a lung-related condition is suspected.

In the next step, a biopsy with a fine or core needle under ultrasound guidance is required. However, because these needle biopsies do not always give a definitive result, in order to reach a diagnosis the enlarged lymph node often needs to be removed in the operating room.

Treatment is then carried out according to the cause, once the cause has been identified.