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Forum Name: Lymphoma

Question: Lymph Node Enlargement


 Sarrk - Thu Dec 21, 2006 4:08 am

Hello!
Ok, so I am a healthy male, 14, and about 3 days ago, I noticed a lump on the left side of my neck, searching around, I've located the lump to be from the Posterior Cervical node, its about the size of a pea, not visiblely raised from my neck when its upright or titlted to the right, but titlted to the left and you can see the lump, again, its not very big, but it is still there. I'd say the lump is around 90mm, give or take 10, its warm to the touch, but then again, that could've been because I've been poking and prodding it for the last few days. Its not rock hard, I can move it up and down a little bit, but it goes back to its original place, I can squish and prod into it, but again, it does seem to have a point where I either start hurting or it gets harder.

The closest thing I can think of that might've been related to this is about a week ago, I had a tick bite on the back my scalp, I had it removed about two days later once it was discovered.

I looked up further what an enlarged Posterior Cervical node might mean, and so far, I have not experianced any symptoms that might mean Lymphoma or anything else. I have suspisions it might be a harmless infection because of the tick bite, but again, I don't have the qualifications to make that judgement.

If anyone can, please help me diagnose what I might have, its killing me not knowing and the dread keeps building up.
 Theresa Jones, RN - Thu Dec 21, 2006 5:40 am

User avatar Hi Sarrk,
The posterior cervical lymph nodes extend in a line posterior to the sternocleidomastoid muscles but in front of the trapezius, from the level of the mastoid bone to the clavicle (on the side of the neck near the back). They drain the scalp and neck, skin of arms and pectorals, thorax, cervical and axillary nodes.
Stony-hard nodes are typically a sign of cancer, usually metastatic. Very firm, rubbery nodes suggest lymphoma. Softer nodes are the result of infections or inflammatory conditions. Suppurant nodes may be fluctuant. The term "shotty" refers to small nodes that feel like buckshot under the skin, as found in the cervical nodes of children with viral illnesses.
A group of nodes that feels connected and seems to move as a unit is said to be "matted." Nodes that are matted can be either benign (e.g., tuberculosis, sarcoidosis or lymphogranuloma venereum) or malignant (e.g., metastatic carcinoma or lymphomas). 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. In essence, infected Lymph nodes however, tend to be firm, tender, enlarged and warm. Inflammation can spread to the overlying skin, causing it to appear reddened. I would be more inclined to consider the causative factor related to your symptoms to be a direct result of the tick bite. I would however, suggest an evaluation by your physician due to the fact that other illnesses may also arise from ticks. Best wishes.
Sincerely,
Theresa Jones, RN
 Sarrk - Thu Dec 21, 2006 6:04 am

"Very firm, rubbery nodes suggest lymphoma."
Firm as in the actual touch to it? Or Firm as in fixed?

"In essence, infected Lymph nodes however, tend to be firm, tender, enlarged and warm."
Yes, that seems to relate best to what I have, the lump is definitally warm, tender and enlarged.

Do you think you could come up with a risk analysis for Lymphoma given my age, description of the lump and (lack of) symptoms?

Thanks for taking the time to reply to me.
 Sarrk - Thu Dec 21, 2006 8:17 am

One final thing to ask you

If it turns out to be something other than an infection, given that I just noticed the lump 3 days ago, what is the average time that what I might have will progress? I am leaving for the holidays in two days time for two and a half weeks, and I want to know, should I rush to the doctors? Is it going to be alright to leave it as it is for that time? (Except if it grows rapidly, I don't care then if I have to leave vacation)

Thanks again for taking the time to adress my issue, you do wonderful work for those unsure about actually going to a doctor.
 Sarrk - Fri Dec 22, 2006 12:23 am

Ok, since I freak out and instantly assume the worst case scenario, despite my current symptoms and common causes, I needed to find out what exactly I had.

I've now become abit confused between where this node is situated, Its definitally around the middle of my neck, and its either on the Anterior Cervical or the Posterior Cervical side.

I don't know if that changes what I might have or not. Either way, I plan to get this checked out if it doesnt defuse itself over the next 3 weeks.
 Dr. Chan Lowe - Fri Dec 22, 2006 2:29 am

User avatar Have you been ill recently, with a respiratory or other infection? Given your age, the most common cause of lymph nodes as you describe will be infection. Lymphoma, while not incredibly rare, would be much less likely for you. Additionally, the size you describe could be considered within normal limits for a lymph node in the anterior or posterior chain.

I would give it a few weeks to go down. If the node becomes larger and more painful I would recommend having it checked out. Occasionally the anterior cervical nodes, and much more rarely the posterior cervical nodes, can become infected with a bacteria and need antibiotics. However, the nodes tend to be significantly enlarged, tender, warm and occasionally the overlying skin may be red.

If the node is not resolving, or if you are still concerned I'd recommend evaluation by a doctor. There is nothing like a hands on evaluation to put the mind at ease.

Hope this helps.
 Sarrk - Fri Dec 22, 2006 5:24 am

I did have a bit of a cold and a sore throat a while ago/

One thing I want to know, If this does turn out to be Lymphoma, how long does it take to be "cured"? What are the methods? Seeing how this node just popped up that date, could it be possible to just have it removed and the Lymphoma is gone? How long does it take for Lymphoma to progress to a later stage?

Another question, every time I look around for my problem, I keep getting slammed back with the result Cancer this is very very discouraging and concerning, it keeps me awake at night thinking I have cancer, especially at my age. I suppose what I want to know is, under the Lymph Node directory thing you have here, how common exactly is "Common" when it comes to the causes you have there? Are the descriptions of the node feelings always rock solid? Does "rubbery" always mean Lymphoma?

So far the nodes feeling seems to be warm at times, tender, but also feeling abit rubbery or "chewy" I am still hoping it is an infection, how long does it usually take for the node to return to a normal size

Anyway, whatever the case, you guys have relieved a bit of stress Ive had on my mind, I still fret a fair bit, but as long as it isnt growing, I'm happy.

Ill report back if anything happens, thanks for so much.
 Dr. Chan Lowe - Fri Dec 22, 2006 11:00 pm

User avatar Regarding your questions as to the "cure" time for lymphoma, there is a significant variability in treatment length and cure rates because lymphoma is a general term. There are many types of lymphoma, each carrying its own specific treatment regimen and outcomes. In general, for leukemias and lymphomas in pediatric groups the out comes are quite good.

With enlarged lymph nodes due to colds, it can take several weeks for lymph nodes to reduce in size. Some may never fully reduce to the size they were before. Lymph nodes that feel rubbery are NOT always a sign of lymphoma. In fact, that would still be much, much less common than enlargement due to infection. Lymph nodes that are hard and do not move are more suspicious. Also, they tend to be painless with cancer.

I suspect the bad cancer data that you find frequently while searching the web is generally related to adult lymphoma that tends to have a less favorable outcome than in pediatrics.

The best thing for you would be to have the nodes examined by your doctor. If there is any suspicion of a lymphoma, your doctor will order the appropriate tests. Again, simply by your description and statistics, you have an incredibly low chance of having lymphoma. In medicine, we never say zero but you are very close to that.

Hope this helps you a bit.
 Sarrk - Wed Jan 17, 2007 5:09 am

Ok, so far I think its been 5 weeks or so? The node seems smaller by a bit than when I first noticed it and is more mobile, but feeling around I noticed some strange things, first is, theres a smaller node located underneith the large one, It doesnt seem to be matted, but I cant tell. Ive heard that some people can feel some of thier nodes, is this the case?

Second, I've also noticed two nodes underneith my jaw, they move together, but don't always stay in the same formation, but one thing's for sure, I cant push them away from eachother, I'm thinking that they're either matted or whats connecting them is lymph tubes? The distance between them is about 1.5 cm. The nodes appeared about 10 days back, after a coldsore on my lips, and at the time, the lymph nodes were painful and were shotty

Anyway, no fevers itching, sweats or anything else related to lymphoma (apart from the node)

Thanks for taking the time to reply.
 Sarrk - Wed Jan 17, 2007 5:16 am

Another question, You say that nodes under 1cm are fine, is that when its not enlarged? or is that a standard size for enlargements, because right now, the node is at about 1 cm, and in the beginning, I do believe that it was 1.3 cm, not 0.9 cm

Anyway, apologies for the change in original size.
 Sarrk - Sat Feb 10, 2007 7:28 pm

How long does it usually take for a lymph node to go down? I've had these for around 3 months no and only slight changes in size have occured

If this is lymphoma, how long does it take before it gets worse after the first lymph node?

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