When assessing lymph nodes on the face and neck, which of the following findings are concerning? Select all that apply.

A. Tenderness in lymph nodes is not necessarily concerning. It may be due to inflammation or infection, which can cause the lymph nodes to be tender as they react to the presence of pathogens. Tenderness alone is not always indicative of a serious condition. B. A hard lymph node is concerning because it may suggest malignancy or a chronic infection. Hard, firm, and rubbery nodes can be associated with cancers, such as lymphoma or metastasis from other cancers. Therefore, hard lymph nodes should be evaluated further. C. Lymph nodes up to 1 cm (10 mm) can be considered normal, depending on the location and individual characteristics of the patient. A 4 mm lymph node is typically not concerning, especially if it is non- tender and mobile. Larger nodes, especially those over 1 cm, are more concerning. D. Lymph nodes that are immovable or fixed to surrounding tissues are concerning and may suggest malignancy. Cancerous nodes tend to be harder, larger, and fixed in place, which makes them less mobile. Any immovable lymph node requires further investigation. E. Non-palpable lymph nodes are normal and generally not a concern. Lymph nodes that are not palpable typically do not signify a problem, as they may be too small to be felt or located deep within the tissues.