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Is a lump in neck under jaw line a swollen lymph node ?

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I am a 24 yo male- 235 lbs- 5' 10''. I have a lump in my neck under my jaw-line on the left side. It feels like it may be the lymph node. The lump is about 4cm in diameter. There is also pressure under my tongue on the left side. It feels like the swelling is pushing up into my mouth. There is a lot of tenderness and pain when I touch the swollen area with my tongue. When I try to put food in my mouth or even think about eating the swelling gets larger and the pain more severe. The symptoms showed three years ago when I had a root canal done to my tooth- on the bottom row left side. After the root canal the swelling began until a small opening formed and liquid started to come out. The symptoms showed again last year, when I felt severe pain under my tongue- it felt like something under my tongue got knotted. There was reddening in the same area. Yesterday the symptoms showed again when I was eating a salad- the knot feels like it is still there. It hurts to swallow and I cannot eat much. The swelling subsides after a couple hours from eating or the thought of eating (from 4cm to 1.5 cm). What do you think the diagnosis might be based on this information.
Posted Sun, 15 Apr 2012 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Naveen Kumar 12 hours later
Hi

Thanks for the query

The swelling in the submandibular region could be either a submandibular lymph node or a submandibular sialadenitis (infection of the submandibular salivary gland) with the blockage of the salivary gland duct or a combination of both.

1. The initial symptom you described – a lump with a 4cm diameter, could be a lymph node.
Yes, the lump you palpated superficially is a lymph node and cannot be a salivary gland as the gland lies much deeper. The lymph node could have got enlarged because of the root canal treatment or by the infection of the salivary gland.


2. When I try to put food in my mouth or even think about eating the swelling gets larger and the pain more severe.

This could be due to the sialadenitis of the submandibular salivary gland. The gland swells whenever there is collection of saliva behind a blocked salivary gland duct. As the secretions increase during intake of food, there is a swelling behind the obstruction causing pain and if the block persists for long the tract might get infected and hence appearance of lymph node.

You require a thorough examination by a good ENT specialist as well as an ultrasound of the submandibular region followed by antibiotics and anti-inflammatory medicines. Drink plenty of water this helps in relieving the obstruction.

Hope I have answered your query, if you have any more doubts, I am available for the follow ups.

Regards.
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