Cervical adenopathy is an inflammation of the cervical lymph nodes that are found around the head and neck. The swelling may be the result of an inflammation or infection in the nodules and may be self-limiting or in need of treatment. A doctor can evaluate a patient to determine the cause of the swelling, and establish a treatment plan based on the reasons for the disorder and the patient’s general state.
In adults, healthy lymph nodes are not usually palpable (they can be felt); however, if they are enlarged more than 1 cm in size they will become palpable. In children up to the age of 12 years, cervical lymph nodes up to 1 cm in size can be palpable and this does not have to mean any disease. In children, the most palpable cervical adenopathy is reactive or infectious. In people older than 50 years, the most palpable inflammation is the metastatic enlargement of cancers (squamous cell carcinoma).
There are different types of cervical adenopathy depending on the area where it occurs and other characteristics: left or right, anterior or posterior, lateral (unilateral or bilateral), painful or painless, in children or adults, etc.
What Causes Swollen Lymph Nodes On The Back Of The Head?
Swollen lymph nodes are mainly caused by transitory infections, but in some cases, this is a sign of a serious underlying disease.
It is worth mentioning that swollen lymph nodes are a sign or symptom, not a diagnosis. The causes are varied, and can be classified into inflammatory, degenerative or neoplastic (rarely).
The lymph nodes act as collection points for the lymph, a fluid that circulates throughout the body to support the immune system. The lymph tends to trap foreign bodies, dead cells, and other waste materials. When people are sick, the lymph nodes enlarge naturally, because the immune system is working harder and they may be producing more waste material. Over time, the nodules can eliminate this material and return to its normal size.
Patients can develop cervical adenopathy in association with a variety of disorders such as colds and flu, as well as serious infections. Sometimes cervical adenopathy becomes chronic, as in the case of swelling associated with the human immunodeficiency virus (HIV). In these patients, the nodules may not be able to express the material they contain independently, or they cannot remove it quickly enough to allow the swelling to go down so that the most infectious materials enter the lymph nodes.
The main infections that cause cervical adenopathy are: pericoronitis, staphylococcal lymphadenitis, mycobacterial lymphadenitis, rubella, cat scratch fever, infectious mononucleosis, streptococcal pharyngitis, viral respiratory infection, toxoplasmosis, tuberculosis, brucellosis, herpes simplex, primary infection (herpetic gingivostomatitis), secondary syphilis, cytomegalovirus, human immunodeficiency virus, histoplasmosis and varicella.
The lymph nodes may increase in size due to a malignant disease. This cervical lymphadenopathy can be reactive (due to a reaction to the disease) or metastatic (due to the metastasis of cancer). Alternatively, enlarged lymph nodes may represent a primary malignant tumor of the lymphatic system itself, such as lymphoma (both Hodgkin and non-Hodgkin) and lymphocytic leukemia.
The metastatic lymph nodes enlarge because the tumor cells have detached from the primary tumor and started growing in the lymph node. Since cancer, in general, is more common in older people, this type of lymphadenopathy is more common in those patients. Metastatic lymph nodes tend to feel hard and may be attached to the underlying tissues and may or may not be sensitive. Usually, the lymph nodes that drain directly into the cancer area are affected by the spread, so cancer is detected in the cervical lymph nodes before the main metastatic cancer. In such cases, this discovery leads to a search for primary neoplasia, first in the area near endoscopy, “blind” biopsies, and tonsillectomy on the lymphadenopathy side. If the tumor is not found, the rest of the body is examined for lung cancer or other possible cancers. If a primary tumor is still not detected, the term “hidden primary” is used.
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