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What teh the treatment for swollen lymph node

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Internal Medicine Specialist
Practicing since : 2007
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My partner has discovered a lump/possible swollen lymph node on the right side of her neck, above the collar bone. The lump,firm & approximately 1.5 cm up the side of her neck & maybe 1cm wide, is painless but has a degree of mobility when manipulated from certain positions.She has been suffering a bit of congestion in her chest - maybe from a cold that has yet to really take hold( also occasional sneezing & slight sore throat that comes & goes ) for the last week or so.For what it's worth I also have been "stalked" by a cold with similar symptoms. My partner is 42 years old & a regular smoker. Both parents died of cancer, one recently. We tried to arrange an appointment with our local GP, but were told to give it a couple of weeks to see if the lump disappeared in the assumption that it was probably resulting from the slight cold mentioned above. The fact that it was non-tender wasn't unusual,he claimed. I forgot to mention that, outside of the recent, vague cold symptoms, she's not felt unwell.She has suffered a loss of appetite, but only since discovering the lump prior to the weekend - so probably anxiety related ( she is very concerned).No obvious weight loss. Ears more waxy than usual, if that's relevant.No drenching night sweats, but slight dampness over the last few nights, nonetheless (though not last night).
Posted Mon, 17 Feb 2014 in Ear, Nose and Throat Problems
Answered by Dr. Kavita Paul 52 minutes later
Brief Answer: Examine axilla and inguinal region for any lump Detailed Answer: Hi, I appreciate your concern . A single mobile small lymph node in neck is a common occurrence in upper respiratory infections.Since your partner had a history of Flu/cold ,so i think that it might be related to it. If i see such a patient in my clinic, I generally advice the patient to watch there appetite, monitor weight regularly and report in case of any new complaints. Since she has family history of cancer , i would advice you that you kindly examine her axillary and inguinal region for any lump.Also tell her to examine her breast for any lump. In case there is appearance of any new lymph nodes or the present lymph node increases in size, then she might need investigations like Complete Blood Counts ,Body Imaging, Fine needle aspiaration (FNAC) or Biopsy of the lymph node.Since she is a smoker and has a painless lymph node in her neck,the possibility of any lung involvement due to long term smoking is always there. A Chest X ray would be a good initial screening test. Meanwhile watch for any weight loss,change in bowel habits, excessive fatigue,bodyaches etc. For her chest complaints, you can give her antiallergics alongwith decongestants. Lozenges can be taken to soothen her throat. Warm saline gargles are also helpful.Take well balanced diet rich in fruits and vegetables. Hope its helpful.Kindly ask in case of any queries. Dr. Kavita Paul
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Follow-up: What teh the treatment for swollen lymph node 24 hours later
Hi, thank you for your helpful reply. Today we saw a private GP - didn't want to wait 2 weeks as suggested by our local GP. After asking the relevant questions about lifestyle, medical history etc he examined my partner( felt the lump, all the lymph node areas you suggested, listened to her chest & so on). He was of the opinion that: 1. The lump was prominent enough & immovable enough to warrant further investigation from an ENT specialist. 2. He didn't think it was related to her(supraclavicular?) lymph node - no other lymph nodes on her body were enlarged,either. 3.On the brief examination he gave her,at least, there wasn't any other symptoms to suggest links to lung cancer. 4.Ultimately, he wasn't sure what it was & suggested that it could be anything from a benign fatty deposit to something more sinister with malign implications. A few questions - can lipomas be hard or do they always present as soft & squishy? Could it be some sort of fatty deposit & what would cause this? If the lump is malignant, what's the likely cause? Finally, what procedure is the ENT specialist likely to carry out? Many thanks
Answered by Dr. Kavita Paul 8 hours later
Brief Answer: Biopsy would be useful Detailed Answer: Hi, I understand your anxiety. Your GP felt it might be a lipoma or some other lump.Sometimes it is difficult to differentiate the exact cause of the lump only by examination. Lipomas are most often asymptomatic. When they arise from fatty tissue between the skin and deep fascia, typical features include a soft, fluctuant feel; lobulation; and free mobility of overlying skin. A characteristic "slippage sign" may be elicited by gently sliding the fingers off the edge of the tumor. The overlying skin is typically normal. Lipomas are unlikely to be hard. Lump due to any malignant deposits are usually firm to hard, immobile and fixed to underlying structures. Without examining her, it would be very difficult for me to point out the exact cause of the lump. The most common site from where metastatis can occur are, Lung, Breast and gut. I think the most useful investigation would be FNAC( Fine Needle Aspiration Cytology) or Biopsy from the lump and I think your ENT specialist will recommend it to you alongwith basic investigations . Hope It Helps. Dr. Kavita Paul
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