Swollen glands are caused by lymph nodes in the neck.
Lymph nodes are part of the normal body architecture and drain fluid an inflammatory cells from the head and neck. During times of infection lymph nodes typically become larger and painful.
Lymphadenopathy, or enlarged lymph nodes may be a normal response to infection, or a sign of sign of something more concerning such as cancer or lymphoma.
Lymphadenopathy is evaluated in the office with a complete head and neck examination. If lymph nodes are detected, often times an ultrasound or CT of the neck is performed to evaluate the size and location of lymph nodes. These studies help to characterize lymph nodes that are evident and help in finding lymph nodes that may not be palpable.
A lymph node biopsy is the next step in evaluation of a neck mass. A fine needle aspiration is a small procedure in which a needle is passed through the skin into the lymph nodes. An ultrasound may be used to guide the needle into the lymph node. Cells of the lymph nodes are examined underneath a microscope by a pathologist and a diagnosis is made.
If an additional biopsy needs to be performed an open biopsy, or removal of a lymph node through the skin may need to be performed.
This may be performed in the office or in the operating as an outpatient procedure.
If a lymph node biopsy shows cancer, additional testing must be performed to determine where the cancer originates, amount of spread, and how disease is best treated.