Swollen glands and fever are common when your body is fighting an infection. A sore throat, dental infection, flu, tonsillitis or another viral illness can cause lymph nodes in your neck, armpits or groin to become enlarged. In many cases, they gradually shrink as the infection settles. The problem is when they do not.
Lymphoma, a cancer of the lymphatic system, can sometimes begin with symptoms that resemble an infection. This can make the early signs easy to dismiss, particularly when fever or swollen lymph nodes appear during or after an illness.
A swollen lymph node does not mean you have lymphoma. Most enlarged nodes are linked to infections or other non-cancerous conditions. What matters is how the swelling behaves over time and whether other symptoms appear.
How long should a swollen gland last?
After an infection, lymph nodes can remain enlarged for several weeks even after you start feeling better. They should generally become smaller as the underlying illness resolves.
If a lymph node continues to grow, remains noticeably enlarged for several weeks, feels firm or fixed in place, or appears without an obvious infection, it deserves medical assessment. The location also matters. A persistent lump above the collarbone, for example, is more concerning than a small, tender node that appeared during a throat infection.
Tenderness can also provide a clue. Nodes that become painful during an acute infection often settle as the infection improves. Lymphoma-related nodes are often painless, although symptoms can vary.
Fever that keeps returning needs attention
Fever associated with an infection usually improves as the infection is treated or clears. If you continue to have unexplained fever, particularly when it keeps returning without another obvious cause, your doctor may look beyond a routine infection.
Some people with lymphoma develop what doctors call B symptoms. These include unexplained fever, significant night sweats and unintentional weight loss. Having one of these symptoms does not establish a diagnosis. They can occur with infections and several other conditions too.
Pay attention to the pattern
Your symptoms over several weeks can be more useful than any single symptom.
For example, suppose you had a throat infection and developed tender neck glands. The fever disappears, your throat improves, and the nodes gradually become smaller. That pattern is generally more consistent with an infection.
Now consider a different pattern. You feel otherwise well, but a painless neck or armpit lump continues to enlarge. You develop repeated fevers, drenching night sweats or unexplained weight loss. That combination should be assessed rather than repeatedly treated as an infection.
What happens during an evaluation?
Your doctor will usually begin by examining the lymph nodes and asking about the duration of the swelling, recent infections, fever, weight changes, night sweats and other symptoms.
Depending on the findings, blood tests or imaging may be advised. If a lymph node looks suspicious, a biopsy may be needed. A biopsy examines the cells in the node and is important because lymphoma cannot be confirmed from symptoms or a routine blood test alone.
You do not need to panic over a swollen gland. You do need to notice when the original illness has passed, but the swelling has not followed the same course. If a lump is growing, persists without a clear reason, or is accompanied by unexplained fever, night sweats or weight loss, arrange a medical evaluation rather than assuming another infection is responsible.
The author is a consultant in medical oncology and a bone marrow transplant physician at Manipal Hospitals, Vijayawada.
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.
