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What causes small lymph nodes around the groin and other body parts?

Apr 2013
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General Surgeon
Practicing since : 2009
Answered : 5641 Questions
Hi - I wonder if you can help me... I have been suffering from lower back pain for a couple of months. The pain isn't constant but within a few minutes of walking anywhere it seems to start and standing for long periods is also uncomfortable. I often feel the urge to stretch as the muscles feel tense but leaning forward intensifies the pain.I have also had a slightly numb/heavy feeling on the left side of my back. Not numb to touch but almost as if the muscles feel frozen. I have attributed all this to a combination of having moved to a new area where I am always walking up hill combined with the fact that I have been very busy at work and haven't managed to exercise much at all in the past few months. However, I am now concerned because I have noticed a small lump in my back in the area where I was having the strange sensation. The lump is about 2-3 inches to the left of my spine above my hip bone. It is hard to tell how big it is as it moves as soon as I touch it. However it does feel like it is connected to the muscle as opposed to being just under the skin. I have to press quite hard to feel it and I would say it is slightly mobile but very much feels like part of the underlying structure. It is painless to touch but I did touch it quite a lot when I first discovered it which made the surrounding area quite painful. I realise that I should see my GP about this and I have made an appointment but it is a week away and this is causing me quite a lot of anxiety so I thought I'd see what you think. I have done a bit of googling and the term 'episacral lipoma' comes up a lot but I'm not sure if the characteristics fit because from all accounts I have read it sounds like they tend to be a bit lower down and directly below the skin. I last contacted you about some lymph nodes in my groin. These are still there but they are still small. I have a couple of other small palpable nodes - one under my right arm and the other in the side of my left breast. I have shown these to two separate GPs and both said they weren't large enough to be of concern but being the 'catastrophiser' that I am I have got it into my head that this could be another lymph node. I know it is not common to feel lymph nodes in this area but is it possible? Sorry to sound so manically neurotic! I'm in a bit of a strange frame of mind at the moment because two people I know have died of cancer this year having discovered their illnesses too late to be successfully treated and I think this has made me hyper-alert to every little symptom I have. Many thanks in advance for your help. Best wishes, Anna I have made an appointment with a physiotherapist
Posted Fri, 3 Jan 2014 in Bones, Muscles and Joints
Answered by Dr. Ivan R. Rommstein 18 hours later
Brief Answer: Hi XXXXXXX and welcome to XXXXXXX Detailed Answer: Thanks for the query. Considering your description,there is no need to be worried at all. You are to young too be concerned about such serious diagnoses. Cancers may develop in any man and in any age,but being hypohondriac will just have bad effect on your quality of life. Generalized lymph node swelling due to malignant disease is seen only in terminal malignant patients or in some type of lymphomas. So if there is cancer which caused metastases into lymph node,you would already have clear symptoms of primary cancer since such lymph node invovement is late sign of cancers. Do you have any other difficulties( pelvic pain,lung symptoms, stomach pain, weight loss)? Your lump near spine sounds like being subcutaneous lesion. Most commonly this is lipoma,but it can be fibroma,cyst, ateroma or any other benign tumor. There are also some tumors made of muscle cells found in this area. It doesnt actually matter what type of lesion it is exactly since the management and prognosis is the same. These lumps usually grow slowly and it isnt symptomatic unless it become inflamamted or extremely enlarged. The possiblity of malignant tumor in this area is negligible. Such subcutaneous cancers such as sarcomas or myosarcomas are extremely rare and there would be rapid grow with signs of inflammation around it and intensive pain. People can normally feel lymph nodes in neck,armpits and inguinal region.Some of these are enlarged our whole life and some become larger due to infections. It is true that sometimes it becomes enlarged due to cancer,but of course this is the last thing to think of and some other signs are necessary to make doctors suspicious about it. So I dont see a reason for some specific diagnostic tests,but for your satisfaction you can do ultrasound and needle biopsy if you are not afraid of needle. I am sure it will show normal cells in any lumps or lymph node that you can feel, but some people want proof that this is not malignant so needle biopsy is performed.I wouldnt do it in your case. If this would still bother you then there is always an option of surgical removal under local anasthesia. I am sure that this lump near spine cant related to your back pain. It should compress medula spinalis or surrounding nerves but it is not possible unless there is huge malignant process. Lipomas or fibromas rarely cause some significant pain,but sometimes it can irritate some small skin nerves. . In your case it sounds to me more like neuromuscular pain due to fybromialgia or lumbago. All you need is a good physical therapy. Of course, stress and concerns can only make thing worse and I am sure that pain will subside when you relax physically and mentally. Exercise will always help. Try to go swimming,running, do stretching exercises or yoga. The only test I would advice is basic blood work where blood cancers can be ruled out. everything else isnt necessary at this point. Wish you good health. I ll be glad to answer any further question. Regards
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