swollen lymph nodes; 2 centimeters in length or diameter

Question

I read that a swollen lymph node of concern is 2 centimeters or larger. Is this two centimeters in length or diameter, or both? Just would like some clarity.

Answer

I did indeed write in a prior response that lymph nodes, which are 2 centimeters or greater, are more worrisome than lymph nodes which are smaller than this size. Some lymph nodes are really like balls, in which case the 2 centimeter measurement refers to diameter; other lymph nodes are more oblong, in which case, this measurement refers to length.

More importantly, lymph nodes are more worrisome if they occur in the setting of systemic symptoms (fevers, chills, night sweats, weight loss), are progressive in nature (continuing to grow), or if one lymph node is way out of proportion to other lymph nodes. Most lymph nodes in HIV-negative folks tend to resolve, whereas in HIV-positive folks, they tend to hang around for a bit.