Doctors' Answers to "Frequently Asked Questions" - Lymph Nodes

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Calcified Lymph Node [posted 1/12/99]
Question: I have a pea sized firm module on the front left side of my throat. I have been to several doctors and have been informed that it is a calcified lymph node. The node has been there for approximately 15 years with no change. Sometimes when I eat something sour there is a sharp, split second pain in the general area of the nodule. There have never been any diagnostic tests performed, except routine blood work. In your opinion, should I be concerned about this nodule and are these nodules common?

Answer: No problem. Most people will have one somewhere if you look.

Persistent Swollen Node [posted 10/16/98]
Question: I am a 35 year old female. I have had a very hard, non- moveable, nontender lymph node behind my left ear for about 2-3 years. It is swollen, about 3-5 cm insize, and starting to bother me where my glasses go behind my ear. My MD has referred me to an ENT. I initially went to the MD for fatigue and several infections such as UTI's and sinus problems. Does it sound like it should be removed and biopsied? Also, is an ENT the specialist who should perform the biopsy? Thank you for your input and time.

Answer: If it hasn't changed in a couple of years probably no reason to biopsy it. However, it may need to be removed due to comfort/irritation. I would have a ENT or a general surgeon do it.

Swollen Lump On Head/Neck [posted 8/14/98]
Question: I have had a swollen gland/lump in the back of my head/neck just above my hairline. The lump feels hard and is about peanut size. It is mildly tender to the touch. I noticed it about a month ago and thought that it had gone away. I noticed it again over the weekend. I have experienced no cold, flu, or infections. I am in good health. Could this be a swollen lymph node? What should I ask my doctor? I have an appointment this week to have it looked at.

Answer: Most probably a swollen lymph node. Other possibilities are a sebaceous cyst. Both are self limited, but the cyst will occasionally need to be drained.

Swollen Lymph Node
Question: I am having recurrent swelling in the lymph nodes on the right side of my neck and around my ear. I have had my wisdom teeth pulled to try to get rid of the discomfort, but to no avail. I have been on several medications. It feels better for about two months and then comes back. My real question is "Who should I see?" I have been to several general doctors, but none of them seem concerned. What should I ask to be tested for? One doctor already did a CBC and said nothing was wrong.

Answer: Enlarged lymph glands that do not recede should be biopsed after 3 months or so.

Axillary Lymph Node Swelling
Question: I have had axillary swelling since September of last year. It moves from side to side and sometimes there is a cyst-like mass that can be felt. At first I thought it was related to the severe breast tenderness that I have around my period. My primary did a breast exam and found nothing. He said he didn't think it was a lymph node and referred me to a surgeon. The surgeon also did a breast exam which was normal. He said it was probably an enlarged lymph node or could be a sebaceous cyst or at the very bottom of the list cancerous (which he did not think it was). He said I could have it removed if I wanted to. Whatever it is, it is very painful and since it occurs on both sides, I am wondering if it is enlarged lymph node. However, I don't see the point of removing an enlarged lymph node because this still isn't going to tell you what the infection is if there is one. The pain will subside and then reoccur. What does axillary lymph node swelling mean? (what are the possible infections this could suggest? Do you think I should have it/them removed?

Answer: Lymph nodes are the filtration centers, if you will, of the lymphatic system. This system is responsible, to a large extent, for removing excess fluid and waste from the tissues which it serves. Lymph nodes can be found in many regions of the body, among them in the axillary region, and enlargement of lymph nodes is a common condition. The causes vary from infection, which can be limited to the area filtered by the node, or systemic-wide infection, to disorders of the endocrine system, skin conditions, and malignancy. Infections range widely from viral, including mononucleosis, tuberculosis, bacterial, or other less common pathogens. The list of possibilities can be narrowed by considering the nature of the lymph node swelling. Is it one node or many? What node group(s) is/are involved (what part(s) of the body is effected)? Is the node tender or painless? What is the texture, size and mobility of the node? What does the area the node is responsible for draining look like? Are there other symptoms, such as fever, fatigue, pain elsewhere, or other symptoms which can direct your health care provider towards a diagnosis. All of these factors, as well as any other possible medical problems you may have will affect your providers approach to your condition and whether or not to biopsy the enlarged lymph node. Your peace of mind should be factored into the decision, as well, and a discussion with your provider regarding your concerns would be beneficial.

Lymphoma
Question: What is lymphoma?

Answer: This is a type of cancer of the lymphatic system. This is the system which consists of the lymph nodes as well as the spleen.


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