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If there's anything that is comforting to know about a lump that appears suddenly (in a day or two, or faster) under your chin, or on the side of your neck, or behind your ears, in your groin, under your armpits, or at the back of your neck, it's that it's not likely to be cancer. In these locations, any kind of swelling is far more likely to be a swollen lymph node, a condition know as lymphadenopathy. When a lump in these locations suddenly appears, it's almost always due to the fact that your immune system is doing its job.

The lymph nodes are connected by lymphatic channels that carry lymphatic fluid. This fluid is a filtrate from your blood. It is studded with a group of especially large white blood cells known as macrophages. These immune cells are large enough to surround a bacterium completely and consume it, breaking it down into nutrients that allow the white blood cell to pursue other microbial invaders. The lymph nodes also contain B cells and T cells that secrete proteins that kill microbes that attempt to enter the body through the skin or through the digestive tract.

It's not unusual to have swollen lymph glands. At one time or another before adulthood, between 38 and 45 percent of children will have an infection that causes one or more lymph glands to swell. After the age of 20, the lymph glands begin to atrophy, although they can still be activated by leukemia, lymphoma, or neuroblastoma, or by autoimmune diseases such as rheumatoid arthritis or lupus, or by HIV. However, the mere fact that you have a swollen lymph gland doesn't mean you have one of these dread diseases.

There are some key points to keep in mind in understanding how your doctor diagnoses swollen lymph glands:

  • The lymph glands in children and teenagers are naturally enlarged. A gland of a size that would be diagnosed as lymphadenopathy in an adult may be considered healthy in a child or teen.
  • Swollen lymph glands can be intensely painful. They may be red and tender to the touch.
  • When the underlying problem is infection, there is usually an identifiable "watershed" of infection that drains lymph into the swollen gland. For instance, gum infections might cause swelling below the chin.
  • When the underlying problem is cancer, it's usually the supraclavicular (over the clavicle bone) or epitrochlear (located just above the elbow on the inside of the arm) glands that are involved, not the chin or behind the ears. Cancerous lymph glands are more likely to be hard and immovable rather than soft and "squishy," although this is not a hard and fast rule.

There are a number of things not to do with a swollen lymph node. Don't lance it. That would only release the bacteria, or viruses, or parasites it has isolated from the rest of your body, and keep the gland from doing the rest of its work. Also, lancing deep enough to drain a lymph gland would really hurt.

Don't take antibiotics not prescribed by a doctor, and don't expect a doctor to prescribe an antibiotic without doing a needle biopsy and having the lab run a culture (a process that takes two or three days). Antibiotics don't work for a lot of the kinds of microorganisms that cause lymph gland swelling, and only encourage antibiotic resistance for others.

Don't do vigorous exercise when you have a swollen lymph gland. If you also have a swollen spleen, an injury could be fatal.

Don't take anything for your lymph gland. It has to be allowed to do its work. Taking medication for pain is OK, but only the minimum needed for comfort. Don't let yourself become addicted to any medication.

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