There are thousands of collections of immune cells throughout the body called lymph nodes. Hundreds of these lymph nodes are present in your child’s neck and face. Lymph nodes act as surveillance sites for your child’s immune system. As a result, when an infection is present, lymph nodes can become enlarged as an immune response is mounted. This can occur with certain viruses and with bacterial infections. Often, after an infection has passed, a lymph node or group of nodes that reacted to the infection can remain enlarged for months (reactive adenopathy). While this is a normal process, reactive adenopathy needs to be differentiated from worrisome processes that also can affect lymph nodes.
For example, the lymph node itself can become infected, a condition called lymphadenitis, or can progress to form a fluid filled collection called an abscess. In rare circumstances, childhood cancers can be present in lymph nodes and lead to enlargement of the lymph nodes. There also are several rare syndromes that can present with enlarged neck lymph nodes.
If your child has a lump or bump on the neck, this may represent an enlarged lymph node. After careful examination of the head, neck, ears, nose and throat, additional testing may be needed to more completely evaluate the lump. This could include blood tests and often an ultrasound exam will be ordered. At times, a CT scan or magnetic resonance imaging (MRI) scan may become necessary. The management of enlarged lymph nodes depends on the reason that they have become enlarged. Treatment can include watchful waiting, antibiotic treatment or other medical treatments. Sometimes, surgical removal of the enlarged lymph node will be necessary to confirm the reason for enlargement.
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