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Swollen Lymph Node, Non-tender, Movable. CT Scan Normal. What Could This Be?

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Posted on Mon, 17 Sep 2012
Question: I have a swollen left supraclavicular lymph node. It is small, non-tender, moveable and kind of "squishy" feeling. I also have a small lymph node on the right side of my neck -- these have been present for about a month. I have not been sick.

I also have a swollen lymph node on the front side of my neck (jugular) that has been present for 3 months.

I went to an ENT who said he didn't feel anything "suspcious" but because of my anxiety level would do a CT scan if I preferred.

I went ahead w/ the CT scan that showed the nodes but nothing of "clinical significance".

My ENT said I could "follow up with him in a month if I want to" but said there was no reason. But the nodes still aren't gone 3 weeks later.

What could this be? All I keep reading about is "Virchow's Node" and how this can indicate cancer. Should I have a biopsy? I don't know why my ENT wouldn't suggest one?
doctor
Answered by Dr. Om Lakhani (34 hours later)
Hi XXXXXXX

Thanks for writing in.

A left supraclavicular node (the virchow's node) definitely is significant. It is a window to a possible GI or Gynec malignancy. Sometimes other causes can also cause this node to enlarge - the list is too long.

However I would still suggest an evaluation. A CT is sometimes not enough. I would suggest an FNAC from the left supraclavicular node- that would be conclusive. I would also suggest you consult a XXXXXXX medicine specialist for detailed evaluation and physical examination including a per rectal and per vaginal examination. Since you are not sick and have no symptoms other than the nodes there isn't much to worry however I would still advise an FNAC in my professional judgement.

Hope I have answered your query. If you have any further questions I will be happy to help

Regards
Dr. Om Lakhani
Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Om Lakhani (4 days later)
I attached a photo.. I have 2 swollen lymph nodes.. I know one is on my neck but I don't know if the other is a neck node or supraclavicular. I marked the nodes w/ eyeliner to show location, I used a red arrow to show which ones. I am just wanting to know if the bottom one is clavicle or neck.

doctor
Answered by Dr. Om Lakhani (22 minutes later)
Hi XXXXXXX

I have reviewed the picture you have sent. It is difficult to say without an examination but from the picture it looks more like a posterior cervical Lymph node rather than a supraclavicular. Posterior cervical often drains the scalp , neck and upper thorasic region skin. Often a scalp infection can cause this lymph node to swell. It also drains the neck and Looks pretty benign. With this picture I would say wait and watch. You can follow up with your ENT or a general physician. If the nodes grows or gets tender then a FNAC is required. Else wait and watch.

Hope this helps

Regards
Dr. Om Lakhani
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Aparna Kohli
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Answered by
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Dr. Om Lakhani

Endocrinologist

Practicing since :2004

Answered : 319 Questions

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Swollen Lymph Node, Non-tender, Movable. CT Scan Normal. What Could This Be?

Hi XXXXXXX

Thanks for writing in.

A left supraclavicular node (the virchow's node) definitely is significant. It is a window to a possible GI or Gynec malignancy. Sometimes other causes can also cause this node to enlarge - the list is too long.

However I would still suggest an evaluation. A CT is sometimes not enough. I would suggest an FNAC from the left supraclavicular node- that would be conclusive. I would also suggest you consult a XXXXXXX medicine specialist for detailed evaluation and physical examination including a per rectal and per vaginal examination. Since you are not sick and have no symptoms other than the nodes there isn't much to worry however I would still advise an FNAC in my professional judgement.

Hope I have answered your query. If you have any further questions I will be happy to help

Regards
Dr. Om Lakhani