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- Tue Jan 23, 2007 5:33 pm
I am a 21 year old male. I am in good health but I do have Hypertension due to polycistic kidney disease. There is no history of Lymphoma or cancer in my family and I have not had any surgeries in the past. I am very scared because about a month ago I noticed a very large and easily distinguashable mass in my right neck. The mass started decreasing but I saw a ent doctor because I was still very worried. The ent gave me an Antibiotic and did a ct scan which revealed 7 mildly enlarged nodes in the middle portion of the right side of my neck. I also noticed that were a few enlarged nodes a little bit lower on my right neck (not supracavicular however). It has been about 25 days and the neck mass is almost gone. However, the enlarged nodes that are a lilttle bit below where the neck mass is are still there and have not decreased. I saw my general doctor and he said it is just an infection but I still do not feel reasured since these nodes have not gone away. I am really really afraid of Lymphoma. Why do you think those bottom nodes havent gone away yet? I feel a little bit better that the neck mass is almost gone but even it isnt 100% gone. Could this be one of the slow indolent lymphomas? Is it common in an infection for the neck mass to regress very slowly and for at least 3 or 4 more nodes a little bit underneath to persistently be swollen? Or do you think that the fact that the neck mass has almostly dissapeared means its unlikely to be lymphoma? Would it be possilbe in an infection to see as many as 4 or 5 nodes enlarged for a long time(they are not so enlarged as to you can see them but when I pres down on the skin I can feel them and they are larger than a pea size) Please help me, I am soo afraid.
| Dr. Safaa Mahmoud
- Sun Jan 28, 2007 4:30 pm
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, etc tend to have clinically palpable lymph nodes in their neck.
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 high. In fact this is supported by the history you gave as the main big lymph node swelling almost disappeared after treatment with antibiotic.
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.
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