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Have movable lymph node around collar bone. X-ray normal. Should I investigate further?

Jan 2013
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Internal Medicine Specialist
Practicing since : 2003
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I have a movable lymph node around my collar bone. Had a ultra sound and chest X-ray with no abnormalities found. It measures 1.1cm. Should I investigate any further . Bloods normal and no symtoms but it does move around my collarbone.
Posted Tue, 26 Mar 2013 in Medicines and Side Effects
Answered by Dr. Mayank Bhargava 3 hours later
Welcome to XXXXXXX forum.

Let me know the associated symptoms along with enlarged lymph nodes.
Do you have difficulty in swallowing/ fever/ throat discomfort/ running nose?
What is the consistency of lymph node? whether hard or soft.
Is this lymph node is painful or painless?
Do you have active pain in joints due to RA?

With the available described symptoms, there appears to be possibility of localized persistent infection (affecting upper respiratory tract) or rheumatoid arthritis induced lymph node enlargement.

With simultaneous history of dry mouth, there could also be possibility of Sjogren's syndrome and Still's disease.
Sjogren's syndrome is characterized by gland inflammation that causes dryness of the eyes, mouth, skin, and other areas and at times the lymph nodes become very large.
Still's disease is common in children and very rarely occurs in adult and it is characterized by swelling, joint pains, fever and rash with enlargement of lymph nodes.
As you have mentioned recent onset flare up, enlargement of lymph nodes could be due to active rheumatoid arthritis.

You should consult with your treating doctor/ XXXXXXX medicine specialist and should go for thorough check up.
You have already undergone a chain of blood investigation with normal reports.
You should go for excision biopsy of suspected lymph nodes.
Excision biopsy with pathological examination rules out the cause of enlarged lymph node.

There may be possibility of other pathology such as fibroma or lipoma as lump is highly movable.
Meanwhile, you should continue your medication as advised by your treating doctor.
Let me know the results of excision biopsy.

Hope that helps.
Let me know if I can address any more concerns.
Take care,
Dr. Mayank Bhargava

Above answer was peer-reviewed by
Follow-up: Have movable lymph node around collar bone. X-ray normal. Should I investigate further? 9 hours later
The lump is soft to rubbery and painless. I had active pain in the joints up until a couple of weeks ago although shoulder is still quite stiff. I do have Sjögren's syndrome and I have had that burning sensation in my mouth and horrible bad taste in mouth for quite some time .
Answered by Dr. Mayank Bhargava 5 hours later
There appears to enlargement of lymph nodes due to active Rheumatoid arthritis and Sjogren's syndrome.
Still you should go for excision biopsy of lymph nodes.
You should take plenty of water at small interval to maintain hydration of mouth.
You can also use chewing gums.
You should use air humidifiers for maintaining moisture in air, this will keep you throat and oral cavity wet.
Best regards,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
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