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Forum Name: Lymphoma

Question: Swollen lymph gland - infection?


 freakingmyselfout - Sat Dec 30, 2006 7:16 am

Hi,

I'm in pretty good health; I'm 30, pretty fit and active, and have two small, swollen lymph glands, very close together on the left side of my neck. This in itself is, as I know, no cause for concern, and is likely to be caused by an infection of some sort. However, i've had this problem for the best part of a year, and I've convinced myself that they're getting bigger, albeit very slowly.

I went to see my doctor the other day, who's put me in for a blood test some time next week (something about a white blood cell count?), and he agreed with me that it's probably just an infection and nothing to worry about. But as the swelling is painless (if a little uncomfortable at times), and as I've had it for such a long period of time - and as I'm in good health and have no reason to think that I've got an infection of any sort - I can't help but get a little alarmed when reading all this stuff about cancer on the internet. So my question is essentialy as to whether or not the swelling could be due to an infection if there are immediate signs of any illness and if the swelling has persisted for such a long period of time.

I'm not sure if this is likely to have anything to do with it, but one of my wisdom teeth on the same side of my jaw has not yet come through (all the rest have), and I can sometimes notice an unpleasant smell when cleaning my teeth in the mornings (worse than general morning breath) - could these issues be symptomatic of an infection significant enough to cause the swelling?
 Dr. Safaa Mahmoud - Sat Dec 30, 2006 9:24 am

User avatar Hello,

Abnormal Lymph node enlargement tends to commonly result from infection / immune response, cancer.

Sometimes, following infection, Lymph nodes 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 (hard, fixed, increasing progressively in size). These are also known as 'Shotty Lymph nodes'.

Individuals with history of recurrent upper respiratory, ear, throat dental, and scalp infections tend to have clinically palpable lymph nodes.

So, the probability that the lymph node you have noticed is due to previous infection in the area drained by this lymph node group is highly possible.

Nodes are generally considered to be normal if they are up to 1 cm in diameter.

Of significance, an increase in nodal size on serial examinations. Hence nodes that continue to grow in size are important and those that regress in size after infection control tend to be more reassuring.

Hope this information is useful.
Keep us updated.
Best regards.
 freakingmyselfout - Sat Dec 30, 2006 9:41 am

Thank's very much for the reply - much appreciated. But to re-phrase the question (as from looking at my original post it seems I mangled it slightly), is it not uncommon for a node to be pronounced due to infection over a long period of time, and without any immediately obvious symptoms of infection?

I understand that they may well be swollen as a result of prior infections (which would make sense, as I'm extremely susceptible to tonsilitis and have had it many times in the past), but as the nodes are hard rather than 'rubbery' I can't help but think that the swelling is due to an existing problem rather than to a previous infection - hence my question as to whether an infection caused swelling could be present for a long period of time.

I think the thing might be blocked slightly, or at least not operating as well as it should; the veins above it in my neck seem a little more pronounced than those on the other side. ...is that in any way relevant? (I'd imagine not - if the thing is swollen it's not going to be draining as well as it should do, regardless of the cause).

One last question: I'm due for a blood test, and the doctor mentioned something about a white blood cell count. What would be established by measuring my white blood cell count? If the count is high I'm producing cells to combat an infection - and if the count is low I've got problems with producing the cells?

Thankyou once again for your time. I really do feel fine, I'm in good health, and if I'm being sensible I'm sure this is absolutely nothing to worry about - but I can't help but find it a little disconcerting.
 Dr. Safaa Mahmoud - Sat Dec 30, 2006 10:29 am

User avatar Hello,

You are right if there is no apparent source of infection currently in the head or the neck, it is less likely to be due to reactionary process for an infected drained part.

Thus if you and your Doctor could not find any ocal source for the enlargement, then other causes should be investigated.

Part of the routine work up in such condition is complete blood picture CBC. It gives very important information about your immune system and whether infection else where in the body or blood disorders are there or suspicious.

A thorough clinical examination is essential.

ESR and
Blood sugar level should be assessed too.
Radiological neck and chest examination may be required too.

I advise you to go for blood tests soon and to follow up with your doctor.
Keep us updated
 freakingmyselfout - Sat Dec 30, 2006 10:51 am

Sorry to keep asking silly questions, but is it then the case that there may be an infection present somewhere within the body that I might not be immediately aware of, that this infection could have been around for a while, and that it would not necessarily have to be located within the area immediately corresponding to this node?

Surely I'd feel run down or unwell if I had an infection?

Thanks once again
 Dr. Safaa Mahmoud - Sat Dec 30, 2006 12:39 pm

User avatar Hello,

Some viral infections presents with lymphadenopathy but usually generalized.

I advise you to follow up with your Doctor and to complete your work up. Infection is not the only possible cause for the lymph node enlargement although very common.

Best regards.

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