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- Wed Aug 31, 2005 8:15 am
I was diagnosed with Mononucleosis/EBV last July (of 2004). I had a really bad case of it as I am still recovering and can not function as before. Although I am not as tired now, the fatigue lasted a good 7-8 months before I could function somewhat normally. During this time I have had chronic swollen groin lymph nodes. Some days it is more swollen then other days but the lumps never go away. Also, I have had a chronic sore throat for the last year, and recently had my tonsils removed which were very cryptic with actinomyces. The report reads "marked chronic follicular lymphoid hyperplasia." Although it has only been a few weeks, I feel so much better. I am less fatigued and my throat does not hurt, at least where it used to. I don't know if there is any relationship between tonsils and prolonged Mono. I am, however, very concerned that my groin nodes are still swollen bc I have read that there are some studies showing links with hodgkins/non-hodgkins lymphoma and Mono. All of my lab work is normal (CBC/diff, LFT's). Are the symptoms normal considering my history?
Any input would be greatly appreciated. Thank you for your time.
| Theresa Jones, RN
- Mon Dec 19, 2005 7:13 am
The inguinal lymph nodes are situated in the crease between the leg and pelvis (more on the outside of that crease, i.e. laterally). They drain the penis, scrotum, vulva, vagina, perineum, gluteal region, lower abdominal wall, lower anal canal. Common causes of enlargement include infections of the leg or foot, STDs (e.g., herpes simplex virus, gonococcal infection, syphilis, chancroid, granuloma inguinale, lymphogranuloma venereum), lymphoma, pelvic malignancy, bubonic plague.
There are many causes of generalized lymphadenopathy of which the mononucleosis type syndromes are the most common. They usually present with fatigue, malaise, fever and atypical lymphocytosis on examination of the blood picture. Splenomegaly may be present in 50% of patients due to Epstein-Barr virus infection. These cases can be diagnosed using the monospot test, IgM EA or VCA. So in answer to your question, the previous infection with "mono" may very well be resposible for lymph node enlargement in the inguinal region. 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'. Suppurant nodes may be fluctuant. An increase in nodal size on serial examinations is significant. Lymph nodes that continue to enlarge despite treatment with a course of antibiotics warrants re-evaluation, etc.
Theresa Jones, RN