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Painful lymph node on back of head5/2/2024 Regional lymph nodes draining the area of a localized infection typically remain invisible but may become enlarged and tender on palpation. For example, a soft, tender lymph node palpable near the angle of the mandible may indicate an infected tonsil, whereas a firm, enlarged, non-tender lymph node palpable in the axilla of a female patient may be a sign of breast cancer. Nodes may become enlarged, fixed, firm, and/or tender depending on the pathology present. Lymphadenopathy usually indicates an infection or, less commonly, a cancer in the area of lymph drainage. However, larger nodes (>1 cm) in the neck, axillae, and inguinal areas are often detectable as soft, smooth, movable, non-tender, bean-shaped masses imbedded in subcutaneous tissue. Lymph nodes are normally invisible, and smaller nodes are also non-palpable. Only nodes near the surface can be inspected or palpated. Most lymph channels and nodes reside deep within the body and, therefore, are not accessible to physical exam ( Figure 1). As the collected fluid passes through lymphatic channels on its way back to the systemic circulation, it encounters multiple nodes consisting of highly concentrated clusters of lymphocytes. The lymphatic system has two main functions: to return extracellular fluid back to the venous circulation and to expose antigenic substances to the immune system. Source: Richard Glickman-Simon, MD, Assistant Professor, Department of Public Health and Community Medicine, Tufts University School of Medicine, MA
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