What is that Lump Under the Skin? What is the Difference Between a Lip

By Selena Belisle, CE Institute LLC

The human body is made up of hundreds of lymph nodes. They filter harmful substances such as viruses and bacteria from our lymphatic fluid (aka lymph), before it enters the cardiovascular system. Lymph nodes are an important part of our natural defense system or human immunity.

Unfortunately, lymph nodes are a common place where cancer spreads as well. That’s why oncologists regularly biopsy a sentinel node in the same region as other cancers, to determine if an existing cancer has metastasized.

In the medical illustration below, the lymphatic system is represented in red in the human body. The little bean shaped balls on the lymphatic vessels represent lymph nodes in various regions. Clusters of lymph nodes are commonly found within the joints of the skeletal system:

Swollen lymph nodes typically exhibit themselves within lymph node regions, which can be viewed on the following medical illustration of the lymphatic system:

Lipomas are fatty lumps that form under the skin and usually over the muscle. While all abnormal growths are cancers by definition, lipomas are not harmful and do not metastasize like a harmful cancer might.

Telling the difference between a swollen or damaged lymph node versus a lipoma can be difficult, because they are visibly similar in size, shape and texture under the skin. Both could cause an obstruction of circulation, with the swollen lymph node being medically worse of the two, especially if it is a sentinel node. In some cases, swollen or damaged lymph node(s) can lead to a condition called lymphedema.

Medical institutions may claim that lipomas are softer and more mobile under the skin than a damaged lymph node; however, with almost 40 years of tactile palpation skills, I can state that it's impossible to determine the difference between the two by viewing or feeling them. They're both usually quite firm or hard, and neither is very mobile under the skin either.

Pressing on either may or may not cause pain, and is ill-advised regardless of what the diagnosis is. It is contraindicated to apply pressure on abnormal growths/cancers or any form of swelling, especially while the skin remains intact. Removing a damaged lymph node or lipoma would require surgery with sterilization methods to prevent infection and other medical problems.

You likely wouldn’t know the difference between a swelling lymph node or lipoma without a client telling you, or a medical diagnosis. Lipomas often develop slowly over time, while a swollen lymph node might appear more quickly, due to trauma or an acute infection.

Lymph nodes can also temporarily swell when they’re exposed to harmful viruses, bacteria and other agents, as the immune cells multiply within the nodes to kill the infection. This would be different from a permanent swelling of a lymph node which may appear visually similarly to a lipoma.

Here are some examples of each:

The picture at the top of his article depicts swollen lymph nodes, and here are some more images of swollen lymph nodes below around cervical area:

Here are some images and examples of lipomas:

This woman has a lipoma next to her axillary lymph node region. This lipoma could be easily confused as a swollen lymph node because of the proximity to her axillary nodes plus the tiny surgical incision over it appears similarly to an "old-school" biopsy too:

Medical practitioners viewing the lipoma in the image above may automatically assume that is a swollen of infected lymph node when one considers the proximity of it to other lymph nodes. The medical illustration below depicts axillary region lymph nodes and vessels with breast cancer:

These lipomas represent an individual with familial lipomatosis:

This is a real life medical image of a lipoma that has been excised from the human body:

Lymph nodes could also swell with cancer of the lymphatic system, otherwise known as lymphoma. Below is a medical image of cancer within a lymph node:

Sarcomas can also exhibit as a lump under the skin. Sarcomas are a group of cancers that start in soft tissues and the skeletal system. While any new abnormal growth or lump under the skin is often concerning, when a sarcoma is left undiagnosed or untreated, a sarcoma will likely continue to increase in size, beyond how most swollen lymph nodes or lipomas would present. Below is an image depicting a child with giant cell sarcoma, also known as GCS:

Sarcomas are a fairly rare type of cancer which affects less than 1% of adults. Children are more widely affected by sarcomas. 15% of childhood cancers are said to be sacrcomas. The image below shows an adult survivor of childhood sarcoma. The sarcoma and her entire deltoid muscle were surgically removed when she was a teenager, and then treated with radiation. While we do not have an image of her sacroma before it was surgically removed, this is how she appears over a decade after her successful oncology treatment:

If you are practicing Manual Lymphatic Drainage or any type of massage, bodywork or healthcare service and detect a new lump, especially in an area of swelling, it would be important to discuss this with the client, especially if they are unaware of it. Seeking a medical diagnose for any new or suspicious lumps with early medical intervention might be life saving in more serious cases like lymphoma, and may provide better medical treatment options with cases such as filariasis, which is a parasitic infection of the lymphatic system, particularly within the lymph nodes.

Learning what the abnormal growth is might change your treatment plan as a licensed massage therapist or medical provider. Lymphoma with local oncology radiation would receive different local care than a lipoma, etc.

While all of these lumps could cause circulation impairments, defining/discussing them and then definitely learning what they are through a medical diagnosis will help you provide the correct treatment to your client when they have new or suspicious lumps.

What is that Lump Under the Skin? What is the Difference Between a Lipoma and Swollen Lymph Node?

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