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Enlarged lymph nodes, throat infection, lumps on neck, breasts. History of bulimia. Treatment?

my daughter 14yrs has several enlarged lymph nodes around neck, which could be due to a current throat infection. She also has had several very hard pea shaped lumps around back of neck and collarbone for some time and has told me she has noticed marble sized lumps in her breast and has large soft long nodes above breast just below armpits, both sides. She has bulimia and has been feeling very tired and weak probably as a result of this for some time.
Asked On : Fri, 9 Nov 2012
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General & Family Physician 's  Response
Dear Concerned.,
Thanks for writing to us.
The current throat infection would give rise to a single group of lymphnode inflammation in the neck called Jugulodigastric group on both sides of neck.As they are several pea shaped jugulodigastric nodes indicating involvement of gram positive pyogenic group of organisms(probably streptococcal).
An ENT Surgeon's consultation /routine investigations of urinalysis/blood smear picture/hemogram/and a course of antibiotics/anti inflammatories would be sufficient for the sore throat part.
Now coming to breast lumps. Kindly ask her to self examine the marble sized lumps with the tip of her fingers by touching and pressing(this is called palpation) (A)If she is able to palpate by both the tip of her fingers and with the palm of her hand aginst chest wall , then it indicates Fibroadenoma(Also called mouse in the breast) which is an indication for Surgical removal.It is also benign or innocent growth.(B)If Clinically she feels it only with the finger tips and it disappears when palpated or pressed with the palm of her hands against her chest wall. Then it indicates Fibroadenosis which is a minor inflammation associated with harmonal fluctuation in young girls.This also resolves with a course of anti inflammatory medication and properly fitting garments.
In both the cases be reassured that there is nothing to panic as there would be no malignancy.
Kindly give a nutritiously balanced diet to your daughter.

If you are still worried kindly investigate after a consultation with Gen Surgeon with mammogram/and lymph node and lesional biopsy.

Get well soon,
Best Regards,
Dr Lt Cdr ASN Bhushan.

Answered: Sat, 10 Nov 2012
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