To diagnose what might be causing your swollen lymph nodes, your doctor may need:
Jan. 02, 2014
- Your medical history. In addition, your doctor will want to know when and how your swollen lymph nodes developed and if you have any other signs or symptoms.
- A physical exam. Your doctor will also want to check lymph nodes near the surface of your skin for size, tenderness, warmth and texture. The site of your swollen lymph nodes and your other signs and symptoms will offer clues to the underlying cause.
- Blood tests. Depending on what your doctor suspects is causing your swollen lymph nodes, certain blood tests may be done to confirm or exclude the suspected underlying condition. The specific tests will depend on the suspected cause, but most likely will include a complete blood count (CBC), which helps evaluate your overall health and detect a range of disorders, including infections and leukemia.
- Imaging studies. A chest X-ray or computerized tomography (CT) scan of the affected area may help determine potential sources of infection or find tumors.
Lymph node biopsy. If your doctor can't pin down the diagnosis, it may be helpful to remove a sample from a lymph node or even an entire lymph node for microscopic examination.
The method of biopsy may be fine-needle aspiration (FNA), which your doctor may perform during an office visit, or you may be referred to a surgeon or radiologist for this procedure. In FNA, the doctor inserts a thin, hollow needle into the lymph node and removes (aspirates) cells, which are then sent to a lab for study. Ultrasound — a noninvasive procedure that uses sound waves to create images of organs and tissues — may be used to guide the needle and ensure accuracy.
In some cases, you may require an excisional biopsy. This type of biopsy — also called surgical biopsy — removes a portion or all of a lymph node through an incision for analysis. A surgeon performs this procedure while using local or general anesthetics.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Aug. 25, 2013.
- Fletcher RH. Evaluation of peripheral lymphadenopathy in adults. http://www.uptodate.com/home. Accessed Aug. 25, 2013.
- Lymphadenitis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/dermatologic_disorders/bacterial_skin_infections/lymphadenitis.html. Accessed Aug. 25, 2013.
- Motyckova G, et al. Why does my patient have lymphadenopathy or splenomegaly? Hematology and Oncology Clinics of North America. 2012;26:395.