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Tests and diagnosis
By Mayo Clinic staffYour doctor is likely to take a medical history, ask about when and how your swollen lymph nodes developed, ask about other signs and symptoms, and check your palpable lymph nodes 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.
In addition, your doctor may request laboratory tests to help pin down the diagnosis, including:
- Blood tests. Depending on what your doctor suspects is causing your swollen lymph nodes, he or she may request certain blood tests 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, such as mononucleosis, 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.
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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 he or she may refer you 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 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 anesthesia.
- Fletcher RH. Evaluation of peripheral lymphadenopathy in adults. http://www.uptodate.com/home/index.html. Accessed Nov. 28, 2008.
- Schmitt, DB. Swollen lymph nodes brief version. In: Burley J, et al., eds. Pediatric Advisor. Broomfield, Co.: Clinical Reference Systems; 2008.
- Rubinovitch B, et al. Generalized and regional lymphadenopathy. In: Cohen J, et al. Cohen & Powderly: Infectious Diseases. 2nd ed. St. Louis, Mo.: Mosby; 2004:197.
- Neck swelling. American Academy of Family Physicians. http://familydoctor.org/online/famdocen/home/tools/symptom/514.html#4. Accessed Nov. 28, 2008.
- Lowry PA. Hematologic malignancies. In: Noble J, et al. Noble: Textbook of Primary Care Medicine. 3rd ed. St. Louis, Mo.: Mosby; 2001:1074.
