Cancerous vs. Reactive Lymph Nodes: 8 Distinguishing Features

Clinical differentiation guides biopsy decisions:

Feature	Malignant	Reactive/Benign
Size	Often >1.5–2 cm	Usually <1 cm (pea)
Consistency	Firm, rubbery, hard	Soft, compressible
Mobility	Fixed, matted to fascia	Freely mobile
Tenderness	Typically non-tender	Often tender
Growth	Rapid (weeks)	Slow, fluctuates with infection
Laterality	Often unilateral	Often bilateral
Skin changes	Possible fixation, ulceration	None
Systemic symptoms	Weight loss, night sweats	Acute infection signs

Gold standard: Excisional biopsy + histopathology. Imaging (US, CT, PET) stages but does not diagnose.