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Forum Name: Lymphoma

Question: Enlarged lymph nodes in neck PLEASE HELP ME


 jaime4297 - Sun Jun 18, 2006 7:36 pm

Hi, I am a 28 year old female, no past surgeries. Diagnosed with fibromyalgia last year, and recently had a baby 6 months ago not on any medication and not much on family history other then Empazyma and I do beleive there was some kind of "womanly cancer" on my father's side somewhere.
Here is my problem, About 2 weeks ago I started having pain in both shoulders, fatique and general achy joints which I beleived was due to the fibro. Well 1 night last week I was rubbing my shoulders and I noticed a lump right near my left collar bone.. I looked it up on the net and of course I see nothing but CANCER.. Apparently this is one of the worst places to have a swollen lymph? I went to GP, who felt this was nothing to be concerned about I requested blood work anyway and I referral to a specialist, he sent me to an ENT.. who felt the same way he did.. no concern.. but because I was so upset he agreed to send me for an MRI with contrast...
Doc said blood work came back fine, and the report of the scan says...... 2 small lesions were found in the supraclavical area, these lesion are totally non-specific most likely 2 tiny lymph nodes, they measure 4-5 mm and he had also said that simiulair nodes were found on the other side as well as in my neck. Now these other nodes I can not feel. (ont he right side) The one I can feel is only felt when I rub it, it rolls up on top of the collar bone and then once I move my finger it will roll right back down.
I am confused as to whether I should seek another opinion on this? Of course I am scared out of my mind on what I have read on here. I am still having pain in my shoulders more on the left then right, it gets worse with movement and it does hurt when I press on that certain spot?
With lymphnoma are these nodes bigger then 4-5mm? or do they start small like this? Is it a good sign the blood work was normal? Please help me.. I am very scared, I have a small baby and a 9 year old and this has gotten me so worked up it is hard for me to focus.
 Theresa Jones, RN - Tue Jun 20, 2006 6:32 am

User avatar Hi jaime4297,
I can certainly understand your concern. Keep in mind that lymph node enlargement has also been associated with Fibromyalgia.
Size: An increase in nodal size on serial examinations is significant.
Nodes are generally considered to be normal if they are up to 1 cm in diameter; however, some authors suggest that epitrochlear nodes larger than 0.5 cm or inguinal nodes larger than 1.5 cm should be considered abnormal [1,2].
Clinical features:
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'.
Location: although the area that you have indicated is disconcerting, lymph node enlargement may also be due to infection related causes as stated above. The left supraclavicular lymph node is located on the left side in the hollow above the clavicle, just lateral to where it joins the sternum. It drains the thorax, abdomen via thoracic duct. Common causes of enlargement include lymphoma, thoracic or retroperitoneal cancer, bacterial or fungal infection. Again, an increase in nodal size on serial examinations is significant. If your diagnostic studies and evaluations have not been alarming to your physicians at this point I would not be overly concerned.
Sincerely,
Theresa Jones, RN

References:
===========
1. Libman H. Generalized lymphadenopathy. J Gen Intern Med 1987;2:48-58.
2. Morland B. Lymphadenopathy. Arch Dis Child 1995; 73:476-9.
 jaime4297 - Fri Jun 23, 2006 4:37 pm

thank you for responding on my enlarged nodes near my collar bone, On my MRI report it stated there were 2 tiny lesion must likely very small lymph nodes 4-5mm in size. When I orginally found the lump I only felt one, now I feel the other one they were talking about. My doctors are doing the wait and see if they get bigger approach right now.
Since I have found these I do not "think" they are getting bigger but I am feeling little bumps all around the area. So my questions are .. How long do you general wait to see if they gte bigger.. meaning if they are cancerous.. how quickly do they generaly grow? And what does a typical cancerous node feel like?
Can repeated touching make them worse or make others enlarged?
As you can tell this is really stressing me out, I am a very nervous person.. I have 2 small children and I am finding it really hard to think of anything other then these damn lymph nodes. I have consulted my family doc, an ENT and my fibromyalgia doctor as well all of them seem to agree on this.. I still feel uncomfortable especaily after reading up on this.. it seems there is nothing other then cancer to make these nodes swell in this area. I have not been sick at all.. the only thing that had happened was I had severe shoulder pain for about a week. Please help me by answering my questions.. thank you somuch for your time.
 Theresa Jones, RN - Sun Jun 25, 2006 7:55 pm

User avatar Hi jaime4297,
As posted previously, sometimes, following infection lymph nodes occasionally remain permanently enlarged, though they should be non-tender, small (less the 1 cm). Keep in mind that 4-5 mm is smaller than 1 cm. 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). Lymph nodes enlarge as a result of even apparently insignificant bacterial/viral infections and indicate a normal body response that the immune system is functioning appropriately. I would not be overly concerned at this point. Best wishes.
Sincerely,
Theresa Jones, RN

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