How do you examine lymph nodes?

From the Guidelines

To examine lymph nodes, start by using a systematic approach with gentle palpation, assessing the axillary, supraclavicular, and inguinal nodes, as recommended by the Society of Gynecologic Oncologists 1. When examining lymph nodes, it is essential to use a gentle and systematic approach to avoid missing any potential abnormalities.

• Begin with the head and neck region, examining the preauricular, postauricular, occipital, tonsillar, submandibular, submental, anterior cervical chain, posterior cervical chain, and supraclavicular nodes.
• Then proceed to the axillary, epitrochlear, and inguinal regions, as these are common areas for lymph node assessment 1.
• Apply light to moderate pressure in a circular motion, noting any nodes that are enlarged (greater than 1 cm), tender, fixed, hard, or matted together.
• Normal lymph nodes are usually soft, mobile, non-tender, and less than 1 cm in size.
• When examining specific regions, position the patient appropriately - have them relax their neck muscles when examining cervical nodes, and raise their arms slightly when checking axillary nodes.
• Document the location, size, consistency, tenderness, mobility, and any overlying skin changes of abnormal nodes.
• Lymph node enlargement may indicate infection, inflammation, or malignancy, with concerning features including very firm consistency, fixation to underlying tissues, rapid growth, and persistent enlargement without associated infection.
• A general physical examination targeted to symptoms, including lymph node assessment, is crucial in posttreatment surveillance and diagnosis of recurrence in women with gynecologic malignancies 1.

From the Research

Examining Lymph Nodes

To examine lymph nodes, it is essential to understand their role in the body and their connection to cancer treatment and progression 2, 3.

• Lymph nodes are small, bean-shaped structures that are part of the body's lymphatic system, which helps to fight infection and disease.
• They can become swollen or enlarged if they are infected or inflamed, or if they contain cancer cells.
• A lymph node biopsy or lymphadenectomy may be performed to diagnose or treat cancer 2.

Steps to Examine Lymph Nodes

While there are no specific studies that provide step-by-step instructions with pictures on how to examine lymph nodes, the following general steps can be taken:

• Palpation: A healthcare professional may use their fingers to feel the lymph nodes in the neck, underarm, or groin area to check for swelling or tenderness.
• Imaging tests: Tests such as ultrasound, CT, or MRI scans may be used to visualize the lymph nodes and check for any abnormalities.
• Biopsy: A sample of tissue may be taken from a lymph node to examine for cancer cells.

Importance of Lymph Node Examination

Examining lymph nodes is crucial in cancer diagnosis and treatment, as it can help to determine the stage of cancer and guide treatment decisions 3.

• Lymph node metastasis can indicate the spread of cancer to other parts of the body.
• Immunotherapy efficacy is increasingly being attributed to the initiation of systemic immune responses within lymph nodes 2.
• Understanding the mechanisms of chemotherapy-induced immune suppression is crucial for optimizing treatment strategies and improving patient outcomes 4.

Related Topics

Other topics related to lymph node examination include:

• The role of inflammation in cancer development and progression 5.
• The potential effects of antibiotic therapies on oncologic treatments, especially immunotherapies 6.
• The importance of understanding the immune system's response to cancer treatment and how it can be optimized to improve patient outcomes 4.