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Swollen lymph node in neck, headache, shoulder and neck hurt, chest pain. Do I have sarcoidosis?

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Practicing since : 2002
Answered : 2397 Questions
I've had a large swollen lymph node in my left neck for about six months I've been put on antibiotics which didn't help. Then finally I got referred to a surgeon who did a catscan which found more swollen nodes in my neck and chest. I am tired all the time like I have to sleep 12 hours a night and take a nap just to get throug the day and I am only 23 years old. My left shoulder back and neck hurt most of the time and I get terrible headaches also I've noticed that I can't drink alcohol anymore it causes me to have severe neck pain and chest pain that makes me feel like I can't breath. The surgeon doesn't seem to be concerned but I can't keep going on so tired. My dd was recently diagnosed with sarcoidosis and I do have an it all over which I read can be related to that I'm just not sure if I should just wait it out for my next appointment or say something
Posted Mon, 30 Apr 2012 in Infections
Answered by Dr. Robert Galamaga 22 minutes later
Hello and thank you for submitting your question.

Your question is a good one and I will work on providing you with some good information and recommendations regarding the symptoms which you are experiencing.

From the information you have submitted it seems as if you have a lymph node which you can feel in addition to other lymph nodes which were found on the CT scan. There are a number of things which can cause enlargement of lymph nodes.

The most common cause is a viral infection. We sometimes referred to this type of infection as mononucleosis. This will typically also carry along with it a significant degree of fatigue. This will also sometimes last for 3 to 6 weeks and sometimes even longer.

I think it is important that your general doctor also check a few different blood tests. I would recommend certainly a complete blood count in addition to a metabolic profile. I would also suggest a Lactate Dehydrogenase (LDH), also a blood test for Epstein-Barr virus as well as Cytomegalovirus (CMV) would be appropriate in order to help determine if there is an infection which is causing your symptoms.

A more worrisome and rare cause of this type of thing would be a type of lymphoma. Again this would be exceedingly rare in your case but certainly is not something that I would want to ignore. Sometimes if lymph nodes remain large over a long period of time the surgeon can remove one of the lymph nodes so that a pathologist can look at it under the microscope. This would help them again rule out any type of worrisome disorder such as lymphoma. Again I don't want you to worry that you have lymphoma, but I want you to know that these are the things that we sometimes consider.

Again I thank you for submitting your question. I hope you found my response to be helpful and informative. If you have any additional concerns I would be happy to address them.


Dr. Robert
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