The possible causes of enlarged cervical lymph nodes with flat pattern include cervical lymph node tuberculosis, lymphadenitis, lymph node metastasis of malignant tumor, lymphoma and so on. 1. Cervical lymph node tuberculosis: Mycobacterium tuberculosis can easily invade lymphatic tissues and cause lymph node enlargement, and cervical lymph node tuberculosis is common in children and young people. The main manifestation is that the lymph nodes in the neck are enlarged, hard and painless, and can be pushed. In later stages, the lymph nodes may merge with each other to form a lump. 2. Lymphadenitis: Cervical lymphadenitis is often the result of the spread of neighboring infections, such as tonsillitis, gingivitis, stomatitis and so on. Patients will have enlarged lymph nodes in the neck, accompanied by pain and pressure. Usually, the lymph node enlargement can be relieved by itself after the primary infection is controlled. 3. Lymph node metastasis of malignant tumors: Neck lymph nodes are easy to be metastasized by many malignant tumors, such as thyroid cancer, nasopharyngeal carcinoma, lung cancer, breast cancer and so on. The invaded lymph nodes are enlarged, hard and flat in early stage, and then gradually increase in size, fusion and irregular shape. 4. Lymphoma: lymphoma belongs to malignant tumor of blood system, which often takes enlargement of superficial lymph nodes as the first manifestation, especially Hodgkin’s lymphoma which occurs in cervical lymph nodes. Patients mainly manifested as painless progressive enlargement of cervical lymph nodes, which can be flat in early stage, and then gradually increase in size and fusion. It is recommended to go to the hospital as soon as possible to get a clear understanding of the nature of the lymph nodes and then give targeted treatment.