To understand one's health status, undergoing a physical examination is a good method. Generally, most of the results from a physical examination are understandable, but many people do not understand the meaning of some of the results shown. For instance, the result of "lymph nodes not palpable" is a common finding after lymph node examination and is considered normal.

Is It Normal for Lymph Nodes to Be Unpalpable?

During a routine physical examination, lymph node examination is included as part of the full-body check-up. The normal finding is that there are no palpable superficial lymph nodes throughout the body. Lymph nodes are small, oval or bean-shaped lymphatic tissue bodies that vary in size and are grayish-red when fresh. They are interspersed in the course of lymphatic vessels and connected to them. One side of a lymph node is convex, and the lymphatic vessel connected to this side is called the afferent lymphatic vessel. The other side is concave, forming the hilum of the lymph node, and the lymphatic vessel connected to this side is called the efferent lymphatic vessel. Each lymph node has fewer efferent vessels than afferent vessels, and the efferent vessel of one lymph node can be the afferent vessel of another.

Causes of Lymph Node Swelling

1. Various infections: Bacterial infections, such as acute inflammation in the mouth and face, often cause enlargement of the mandibular lymph nodes. The enlarged lymph nodes are soft, mobile, and accompanied by pain and fever. They usually gradually return to normal as the inflammation resolves. Viral infections, such as measles and infectious mononucleosis, can also cause lymphadenopathy. Additionally, allergic reactions and insect bites can also lead to lymphadenopathy.

2. Chronic lymphadenitis: This condition is often associated with obvious foci of infection and usually manifests as localized lymphadenitis with tenderness. The diameter of the enlarged lymph nodes is generally no more than 2-3 centimeters, and they may shrink after anti-inflammatory treatment. Enlarged inguinal lymph nodes, especially flat lymph nodes that persist without change, are often of no significant importance. However, unexplained enlargement of lymph nodes in the neck or above the clavicle may indicate systemic proliferative diseases of lymphatic tissue, which should be taken seriously and further investigated.

3. Tuberculous lymphadenitis: This condition is commonly seen as enlarged lymph nodes in the neck, which may or may not rupture. Symptoms such as fever, excessive sweating, and fatigue are common, especially in young adults. It often accompanies pulmonary tuberculosis. The texture of the lymph nodes is uneven, with some parts being softer (caseous necrosis) and others harder (fibrosis or calcification). They may adhere to each other and to the skin, resulting in limited mobility. Patients with this condition often have positive tuberculin tests and tuberculin antibodies in their blood.