Enlarged Neck Lymph Nodes

There are many reasons why the lymph nodes in the neck may become enlarged, but the two most common causes are due to infection and cancers.

Cancers

Another common cause of lymph node enlargement is from cancer. The cancer may arise primarily from the lymph nodes (e.g. lymphoma), but often they have spread to the lymph nodes from somewhere else (e.g. tongue cancer, nasopharyngeal cancer).

1. Primary Malignancies
   These include:
   • Leukaemia
   • Lymphoma
   
   
2. Secondary (Metastatic)
   Malignancies These are cancers that have spread to the lymph nodes from elsewhere in the body. It is important to examine the areas from where the cancers might have spread to look for a primary cancer (e.g. oral cavity, nasopharynx, skin, scalp, ears). Common cancers that can spread to the neck lymph nodes include:
   • Tongue and Oral cancers
   • Skin/Scalp cancers
   • Thyroid cancers
   • Nasopharyngeal cancers
   • Gastrointestinal cancers (e.g. stomach and colon cancers)
   • Breast cancers
   • Lung cancers

Infections

1. Viral Infections
   Lymph nodes in the neck can often be enlarged as a reaction after an upper respiratory tract infection. Many viruses can cause enlargement of the lymph nodes. These include the following:
   • Epstein-Barr Virus (EBV)
   • Cytomegalovirus (CMV)
   • Varicella-Zoster Virus
   • Rubella
   • Human Immunodeficiency Virus (HIV)
   
   
2. Bacterial infections
   Lymph nodes in the neck may also be enlarged from bacterial infections. The source of the infection may not be in the neck itself but may be from the areas of lymph drainage (e.g. throat, skin, ears). It is important to examine the areas where the lymph nodes drain to look for a source of infection.
   Streptococcal infections of the throat (Streptococcal Pharyngitis) can be a source of lymph node enlargement in the neck.
   
3. Other Infections
   Other infections that can cause enlargement of the lymph nodes in the neck include tuberculosis and syphilis.

Other causes

Some other less common conditions in which lymph nodes of the neck can be enlarged include:

• Systemic Lupus Erythematosus (SLE)
• Juvenile chronic arthritis
• Rheumatoid arthritis
• Sarcoidosis
• Kawasaki Disease