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Forum Name: Lymphoma

Question: Enlarged right neck node and lip sore


 SeahawkFan - Thu Feb 02, 2006 12:57 am

I am 17 years old, about 5'9 225 lbs and am rarely sick. However I noticed a few weeks ago an englarged lymph node on the right side of my jaw. A few inches under my earlobe right along my jawline. I have heard that enlarged lymph nodes are usually caused by infection but have had no symptoms of any infection or sickness. The one thing I think that it could be due to is a small cut or possible a sore that I had on the inside of my lower lip. I thought the sore was probably caused by me cutting myself with my tooth. It didn't go away for about 5 days to a week. I thought it might have been a kankner (sp?) sore, but wouldnt know because I have never had before. The sore in my mouth was rather painful and annoying for its size, why was probably about the size of the head of a pen or so.

I only have one swollen node about the size of my fingernail. Which doesnt seem to be either growing or shrinking (though it could be just at a slow rate). I noticed it being swollen about a week or so after my lip got better, but it could have been swollen before or during, I just might not have noticed. It is kind of tender when I push on it with my finger. It is somewhat firm I guess, but not rock hard. It can also be moved with my finger.

I am mainly concerned with ruling out anything really serious such as lymphoma. Though I am not sure how common that is at my age, and since I just kind of noticed the node being swollen about the same time as my lip was bothering me. Any ideas as to what could be the cause of my swollen node? Any input would be greatly appreciated.
 Dr. Tamer Fouad - Thu Feb 02, 2006 1:33 pm

User avatar Hello,

The submandibular lymph nodes are located along the underside of the jaw on either side. They drain the tongue, submaxillary gland, lips and mouth, conjunctivae. Common causes of enlargement include infections of head, neck, sinuses, ears, eyes, scalp, pharynx.

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 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'.

In primary care settings, patients 40 years of age and older with unexplained lymphadenopathy have about a 4 percent risk of cancer versus a 0.4 percent risk in patients younger than age 40.[1]

Given the limitations of the internet in clinical evaluation, you are advised to seek medical attention. If after evaluation the lymph node enlargement is unexplained, then your doctor may choose to put you under observation for 3 to 4 weeks and then re-evaluate these nodes. The doctor may also recommend a course of antibiotics based on his evaluation.

References:
==========
1. Fijten GH, Blijham GH. Unexplained lymphadenopathy in family practice. An evaluation of the probability of malignant causes and the effectiveness of physicians' workup. J Fam Pract 1988;27: 373-6.

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