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Date of last update: 10/21/2017.

Forum Name: Lymphoma

Question: Unexplained lymph node enlargement - where to go from here?

 Sev - Sat Oct 27, 2007 12:25 pm


I am a 24 yr old female. About a month ago I had a small cold, which went away. Immediately after, I had a slight sore throat, at which point I noticed that the lymph node under my chin on the left side of my neck was swollen. The sore throat went away, but the enlarged node remained. I went to see a doctor, they told me to wait it out. When it didn't go away, they put me on antibiotics, and having just finished the prescription, it doesn't seem to have made a difference.

It has now been about 4 weeks. If I turn my head so as to maximize how much it sticks out and measure along the widest diameter, it measures 4 cm across. I've been measuring it for the last week or so, and the diameter itself seems unchanging, but the funny thing is that some weeks it looks more bloated ("taller") than others. It doesn't hurt when I touch it. I do not have any other symptoms whatsoever or swelling anywhere else. I do not have any past serious diagnoses/surgeries, and am currently just on the pill. There have been cases of cancer in my family.

I was also referred to a general surgeon for a biopsy, who said the only type of biopsy possible was excisional, since the node was too small, and hence suggested waiting until the antibiotics were done. In the meantime, I just had a chest XRay and ultrasound on the node itself done, the results of which I don' t have yet.

My next appointment with the general surgeon is in about 2 weeks. I don't like the thought of an excisional biopsy unless I have reason to believe it's something serious. Should I be asking for a referral to an oncologist or otolaryngologist before I see the surgeon again and have to consider such an option?

Thank you in advance for your time,
M. M.
 Dr. Chan Lowe - Fri Nov 02, 2007 1:18 pm

User avatar Hi Sev,

It sounds like you may have an enlarged lymph node that has remained swollen after the cold had resolved. This is relatively common.

Given that you were referred to a surgeon your doctor must have felt that it was larger than he would like. In this case, having it evaluated is reasonable.

If the lump is not changing and is rubbery/mobile feeling it may also be reasonable to wait a few months to see if it improves. Without evaluating you in person I cannot say for sure this is a good option. I would suggest discussing this with the surgeon when you see him again.

Best wishes.
 Sev - Mon Nov 05, 2007 10:34 am

Hmmm. Thank you, in response to your post, the node is hard (as opposed to rubbery I believe). The result of the chest XRay came back negative, and the ultrasound on the node itself revealed that the surface of the node was smooth, which apparently is a good thing, but found that the content of the node was heterogeneous (ie there's a mix of things in there, water, etc). They also gave a number of possible explanations for this heterogeneous content, and I've got a CT booked for this Wed in order to further have it investigated.

All this is fine and well, except I'm a little freaked now, because we had monitored the node every day for about a week and it remained constant in size, and this was up till 8-9 days ago, at which point we stopped checking for a few days. When we measured it again earlier this week, it was up from 4 cm to 4.3 cm or so, and i've had symptoms of a sore throat for a few mornings now. Recall that all this started with a cold about 6 weeks ago, so I'm not sure if the same virus is acting up again, or whether I should be wary of something more serious (i.e. apparently slow steady growth may indicate a tumour). As I mentioned, I've got a CT Wed and a followup appointment with the surgeon this coming Mon Nov 12, but I don't know if I should be trying to speed up the process at all, i.e. go to an emergency room or let the surgeon know about my recent symptoms to get an earlier appointment?

Thanks again for your time,
 Dr. Chan Lowe - Tue Nov 06, 2007 7:54 pm

User avatar Hi again,

I would not rush the issue. Waiting until Wednesday should be fine. The CT will give you some good information.

Best wishes.

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