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| o777
- Tue Feb 28, 2006 11:48 pm |
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I'm a 18 year old male with a with a somewhat muscular build. I've started noticing these lumps under my skin, similar to swollen lymph nodes. For example I have two on my back, one on my thigh, one on my arm, and I just noticed two on the back of my head. They're about the size of a pea, but some are harder and more round, and some are flatter and softer. They're not painful unless I keep irritating them, in which case they seem to swell and get painful to the touch.
I've had my doctor look at the ones on my back and he said that it's nothing serious but to try to avoid messing around with them. The ones on the back of my head are concerning me, because I was touching and feeling them and they will get a bit painful to the touch, if I leave them alone it subsides.
I'm feel fine otherwise and the lymph nodes in my neck are not enlarged. I always had issues with bad skin, so might that be a factor? Are they easilly removable?
Might this be a sign of a serious illness? If so what?
Thanks.
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| Theresa Jones, RN
- Thu Mar 23, 2006 11:18 am |
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 Hi o777,
The body has approximately 600 lymph nodes, but only those in the submandibular, axillary or inguinal regions may normally be palpable in healthy people [1]. The suboccipital lymph node is located at the junction between the back of the head and neck. It drains the scalp and head. Common causes of enlargement include local infection. Abnormal lymph node enlargement tends to commonly result from infection / immune response, cancer and less commonly due to infiltration of macrophages filled with metabolite deposits (eg, storage disorders). Infected Lymph nodes however, tend to be firm, tender, enlarged and warm. Inflammation can spread to the overlying skin, causing it to appear reddened. Lymph nodes harboring malignant disease tend to be firm, non-tender, matted (ie, stuck to each other), fixed (ie, not freely mobile but rather stuck down to underlying tissue), and increase in size over time. Sometimes, following infection lymph nodes occasionally remain permanently enlarged, though they should be non-tender, small (less the 1 cm), have a rubbery consistency and none of the characteristics described for malignancy or for infection. These are also known as 'Shotty Lymph nodes'. Constitutional symptoms such as fever, weight loss, fatigue or night sweats could suggest disorders such as tuberculosis, lymphoma, collagen vascular diseases, unrecognized infection or malignancy. The presence of fever is commonly associated with infections. To my knowledge lymph nodes are not typically palpable in the back and from your description I would be more inclined to consider, for example, a lipoma, cyst, etc. As for your arm and thigh, depending upon the exact location, would determine the suspicion of a lymph node, in which I can not ascertain from your description. An increase in nodal size on serial examinations is significant.I would suggest an evaluation by your physician to identify if there is reason for concern.
Sincerely,
Theresa Jones, RN
References:
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1. Goroll AH, May LA, Mulley AG Jr. Primary care medicine: office evaluation and management of the adult patient. 2d ed. Philadelphia: Lippincott, 1987.
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