Swollen throat glands represent enlargement of the lymph nodes in the neck. Lymph nodes are bean-like collections of lymphocytes -- white blood cells with a prominent role in the immune system. Infections and inflammation commonly cause swollen lymph nodes in the throat. Less commonly, cancerous growth within the lymph nodes provokes the enlargement. Effective treatment of the underlying cause often leads to resolution of lymph node swelling.
Swollen throat glands are often caused by a throat infection, or pharyngitis. Viruses account for roughly 85 to 95 percent of pharyngitis in adults, and 70 to 80 percent in children. Painless or mildly tender swollen glands often occur with viral pharyngitis. Strep throat -- an infection caused by group A streptococcus -- accounts for most bacterial throat infections. Symptoms typically include fever, headache, sore throat, and tender, swollen glands in the neck. School-age children most frequently contract strep throat, although the illness can affect anyone.
Inflammation of the tonsils, or tonsillitis, is another common infection often accompanied by swollen neck glands. The tonsils constitute part of the immune system. These paired collections of immune cells reside in the back of the throat. A variety of viruses and bacteria can cause this ailment, including adenovirus, cytomegalovirus, Epstein-Barr virus, herpes simplex virus and group A streptococcus. Viruses cause 70 to 85 percent of tonsillitis cases. Typical signs and symptoms of include fever, tonsil enlargement, painful swallowing, a raspy voice, malodorous breath and tender, swollen neck lymph nodes.
Infections of other structures of the head and neck can also lead to swollen lymph nodes in the throat area. Ear, scalp, salivary gland, mouth and dental infections can all potentially cause one or more swollen glands in the throat area, as can skin infections of the face and neck. Some systemic infections can also cause swollen neck glands. Infectious mononucleosis, for example, is a viral illness caused by the Epstein-Barr virus. Typical symptoms include swollen neck glands accompanied by fever, sore throat and fatigue, which may last for months. Other systemic infections that frequently cause swollen glands in the throat include acute HIV, cytomegalovirus and toxoplasmosis, among others.
Lymphoma and Leukemia
Lymphoma and leukemia represent two types of cancer involving the lymphocytes. Acute and chronic lymphocytic leukemias arise from cancerous cells in the bone marrow. Lymphomas originate from cancerous cells in the lymph nodes or other lymphatic tissues in the body. Lymphocytic leukemias and lymphomas commonly cause swollen lymph glands that may include those in the neck. Unlike the lymph node swelling associated with strep throat and tonsillitis, the swelling associated with leukemia and lymphoma is typically painless and may affect lymph nodes throughout the body. Additionally, the nodes are characteristically firm and hard with these cancers rather than a normal, rubbery consistency.
The lymphatic system provides a common route for cancerous spread, known as metastasis. As cancerous cells from tumors travel through the lymphatic circulation, they often get caught in the lymph nodes and multiply there. Uncontrolled growth of cancer cells within the lymph nodes typically causes painless swelling. Cancers that commonly spread to the lymph nodes of the neck include those of the larynx, throat, mouth, lung and breast. Metastatic spread to the lymph nodes signifies cancer progression. With breast and lung cancer, spread to the lymph nodes of the neck indicates advanced stage disease.
Warnings and Precautions
Temporary swelling of the lymph glands in the throat occurs relatively commonly, most often due to a transient viral infection. This type of swelling usually clears within 2 to 3 weeks, subsiding after the infection resolves. Persistent, unexplained or progressive swelling of lymph nodes in this area, however, warrants medical evaluation as soon as possible. This is especially important if you may have been exposed to HIV, or are experiencing fevers, unintentional weight loss, easy bruising or other symptoms. Seek immediate medical care if you experience difficulty breathing or have a skin wound involving the scalp, face or neck area with expanding redness, swelling or drainage of pus.
- Family Practice Notebook: Group A Streptococcal Pharyngitis
- Family Practice Notebook: Pharyngitis
- Merck Manual Professional Version: Infectious Mononucleosis
- Textbook of Pediatric Emergency Medicine, 6th Edition; Gary R. Fleisher and Stephen Ludwig
- Centers for Disease Control and Prevention: Get Smart: Know When Antibiotics Work -- Outpatient Healthcare Professionals
- American Family Physician: Lymphadenopathy: Differential Diagnosis and Evaluation
- American Family Physician: Evaluation of Neck Masses in Adults
- Family Medicine: Principles and Practice, 5th Edition; Robert B. Taylor