Determining whether an enlarged lymph node is benign or malignant can be done through three major aspects: its clinical presentation, imaging and pathologic examination. 1. Clinical manifestations The clinical features of benign lymph node enlargement are that the number of enlarged lymph nodes is usually small, the volume is small, such as the size of a grain of rice or soybean, and it is also more limited, with good mobility, smooth surface and pressure pain. Often there may be inflammation of the surrounding tissues or obvious pain, such as cervical lymph node enlargement is often accompanied by sore throat, tonsillitis and so on. Malignant lymph node enlargement is characterized by painless, progressive enlargement, can increase to walnut, egg size, part of the fusion, usually poor mobility, not easy to push, and adhesion with the surrounding tissue, the surface is not smooth. Some patients may develop from localized lymph node enlargement to generalized lymph node enlargement. 2.Imaging examination Ultrasonography is helpful in the differential diagnosis of benign and malignant lymph node enlargement. When benign lymph nodes are enlarged, there is often no obvious blood flow signal in them, while malignant lymph node enlargement often has obvious blood flow signal. 3.Pathologic examination Pathological examination is the gold standard for the diagnosis of benign and malignant lymph nodes, which mainly includes needle aspiration cytology or lymph node excision biopsy, which can finally determine the nature of the lymph nodes. If there are enlarged lymph nodes, it is recommended to consult a doctor in time and find out the cause of the disease under the guidance of the doctor and then follow the doctor’s instructions.