Most swollen glands are infection. The pattern that matters is painless, persistent, and with night sweats or weight loss.
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Lymphoma is cancer of the lymphatic system — the network of glands and vessels that forms part of the immune system. It is one of the more common cancers in young adults, and unusually it is also one of the more treatable, with many types highly curable even when widespread.
Almost everyone has had swollen glands with a sore throat or a virus. They come up, they are tender, and they settle within a few weeks. That is normal and it is not what this page is about.
A gland that is painless, firm, persists beyond three to four weeks, and does not settle — particularly alongside drenching night sweats, unexplained fever or weight loss.
Those three together are called B symptoms, and they are the combination that shifts this from ordinary to worth investigating.
We do not diagnose or treat lymphoma — diagnosis needs a lymph node biopsy.
What we can do is arrange the initial blood tests and recognise the pattern.
A swollen lymph node in the neck, armpit or groin that is:
These three carry particular weight and are worth naming specifically when you see a doctor.
Pain in an enlarged lymph node after drinking alcohol. It is uncommon, but it is highly characteristic of Hodgkin lymphoma and worth mentioning if it happens to you.
Infection accounts for the vast majority, and glands that are tender and settle within a few weeks are behaving exactly as they should.
Stress does not cause lymphoma. Nor do mobile phones, deodorants, or the other things commonly blamed.
For most people diagnosed there is no identifiable cause at all, and that is worth saying — people spend a great deal of energy looking for something they did wrong.
H. pylori eradication can treat a specific type of stomach lymphoma, which is one of the few cancers where treating an infection is the treatment.
Full blood count, inflammatory markers and LDH are usually the starting point, along with tests for infections that cause persistent glands — glandular fever, HIV, toxoplasmosis.
But normal blood tests do not exclude lymphoma. This matters: people are frequently reassured by a normal full blood count when the node itself is the thing that needs examining.
Ultrasound of the node gives useful information about its character. CT and PET-CT are used for staging where lymphoma is confirmed.
Only a lymph node biopsy establishes it, and identifies which of the many types it is — which matters enormously, because treatment and outlook differ substantially between them.
An excision biopsy, taking the whole node, is usually preferred to a needle sample, because the architecture of the node is part of what the pathologist reads.
A bone marrow sample is sometimes needed for staging, though PET-CT has reduced how often.
We cannot examine your glands, and we do not diagnose or treat lymphoma. Diagnosis requires a biopsy and specialist haematology assessment.
A persistent, painless, firm node needs examining and often biopsying, whatever the blood tests show.
If you have been reassured on the basis of a normal full blood count alone, that is worth revisiting — particularly if the node is still there weeks later.
Lymphoma is among the more treatable cancers, with many types highly curable. That is a genuinely different conversation from most cancer pages, and worth holding onto while you are waiting.
Name the B symptoms specifically if you have them — night sweats, fever, weight loss. That combination is what raises the urgency, and it is frequently not mentioned because people do not connect it to the lump.
Go back if the gland is still there. Normal blood tests do not exclude lymphoma, and a persistent node needs examining rather than a repeat blood test.
For most people diagnosed with lymphoma there is no identifiable cause and nothing they could have done differently.
That is worth saying plainly, because a great deal of energy goes into looking for a reason — something eaten, something used, some stress endured — and there usually is not one.
No screening test exists, which makes noticing a persistent gland the whole strategy.
You do not need to check yourself routinely, and doing so tends to cause more worry than it prevents.
What matters is noticing a lump that is still there weeks later — and acting on it rather than checking it daily to see whether it has changed.
This is an NHS pathway and the NHS handles it well. Suspected lymphoma goes down the urgent two-week-wait route, free, with ultrasound, biopsy and haematology assessment. Nothing a private online GP offers improves on that.
What we can genuinely do is arrange the initial blood tests quickly and write the referral the same day.
The most important thing on this page is what a normal blood test does and does not mean. Lymphoma can occur with an entirely normal full blood count — and being reassured on that basis, while a persistent lump remains, is one of the commonest reasons diagnosis is delayed.
If your bloods were normal and the gland is still there weeks later, go back. That advice costs nothing and is the most useful sentence here.
The honest limitation of remote assessment is that we cannot examine the node — its size, firmness, mobility and whether others are enlarged are all part of the assessment. Where that matters, we refer.
Where private care shortens things is an ultrasound while awaiting NHS assessment, though the urgent pathway is already fast.
Worth holding onto: lymphoma is among the more treatable cancers, with many types highly curable even when widespread. That is a genuinely different picture from most cancer diagnoses.
NICE NG12, Suspected cancer: recognition and referral, is the governing guideline. It recommends considering urgent referral for adults with unexplained lymphadenopathy or splenomegaly, taking account of associated symptoms — fever, night sweats, shortness of breath, pruritus, weight loss and alcohol-induced lymph node pain.
NG12 recommends a full blood count as part of initial assessment, while being clear that referral should be based on clinical features rather than blood results alone — the basis for the point above.
NICE NG52, Non-Hodgkin's lymphoma, and NG47, Haematological cancers: improving outcomes, cover diagnosis and management within specialist services, including the recommendation for excision biopsy rather than fine-needle aspiration, since nodal architecture is required for classification.
NICE guidance also covers H. pylori eradication as treatment for gastric MALT lymphoma, one of the few malignancies treated by clearing an infection.
Almost certainly not. Swollen glands are extremely common and are usually the immune system doing its job during an infection.
Tender glands that settle within a few weeks are behaving normally.
Painless, firm, persistent beyond three to four weeks, or growing.
The combination with night sweats, fever or weight loss is what raises concern most — a lump alone, in someone otherwise well, is usually not lymphoma.
Drenching — soaking the bedclothes so they need changing.
Feeling warm, or being a bit sweaty because the room is hot or you are perimenopausal, is not the same thing. The distinction genuinely matters and is worth being precise about.
No — and this is the most important answer on the page.
Lymphoma can occur with an entirely normal full blood count. The node itself is what needs examining.
If you were reassured by bloods alone and the gland is still there, go back.
Yes — more so than most cancers, and this is worth holding onto.
Many types are highly curable, including when widespread, and Hodgkin lymphoma in particular has very good outcomes.
That is a genuinely different picture from most cancer diagnoses.
Generalised itching without a rash is a recognised lymphoma symptom, though it has many far commoner causes — dry skin, liver and thyroid problems, iron deficiency, medication.
Persistent unexplained itching, particularly alongside night sweats or a lump, is worth mentioning.
Yes, genuinely — and it is uncommon enough that most people assume they imagined it.
Pain in an enlarged node after drinking is characteristic of Hodgkin lymphoma. If it happens to you, say so.
No. Stress does not cause lymphoma, and neither do the other things commonly blamed.
For most people there is no identifiable cause, and looking for something you did wrong is a burden you do not need to carry.
Because the structure of the node is part of the diagnosis.
Identifying which type of lymphoma it is matters enormously for treatment, and a whole node gives the pathologist far more to work with than a needle sample does.
August 30, 2026
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
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