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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Hello, Im a overall healthy 21 year old male. Ive

Answered by
Dr. Mahboob Ur Rahman

General & Family Physician

Practicing since :2012

Answered : 2267 Questions

Posted on Thu, 7 Feb 2019 in Medicines and Side Effects
Question: Hello,
Im a overall healthy 21 year old male. Ive been experiencing swollen lymph nodes for a year now and I’m getting concerned. I was diagnosed with mono about 11months ago and brushed them off because of that diagnoses. I recovered fairly quickly and felt completely normal excluding the lymph nodes. I had and ultra sound showing the biggest one being 1.2cm with normal morphology. They are located in my neck and groin and there are about 11 that I can tell in total. They haven’t grown and are soft/firm (depending on the lymph node) and they are all movable. My blood work 5months who was all normal with no sign of infection. I suppose my question would be is, should I go back yet again to get evaluated and what could possibly be going on? Thank you for your time.
Answered by Dr. Mahboob Ur Rahman 1 hour later
Brief Answer:
Better to be evaluated

Detailed Answer:
Hi and Welcome to Ask a Doctor service. I have read your question and here is my advice.
I understand it's better to be evaluated for the enlarged lymph glands.
There are numerous causes for enlarged lymph glands, and most of the times these are minor infections and hence settle with treatment in some times.
However lymph glands that persist beyond few weeks, need proper evaluation, and a galnd that is more then 1cm is considered abnormal and need evaluation.
Causes include infection, auto immune diseases or uncommonly cancers. Many times enlarge glands may be for no reason however that's only that first we rule out the causes.
In your case, where your blood tests are normal, cancer is unlikely ( though still possible), but infections needs to be ruled out. A number of infection like Infectious mono, hIV, syphilis, TB, toxoplasmosis and many more can causes enlarged lymph glands. So it's important to be checked for all these including HIV which may cause persistent enlarged glands.
Some autoimmune causes like sarcoidosis may also cause it.
So I understand it's better to be evaluated in details for enlarged glands that persist for more then few weeks. If these tests do not find the cause, removing a gland for biopsy would be the best option to settle the issue.
Hope I have answered your question. Please feel free if you have any further queries or concerns.
Kind regards Dr Mahboob ur Rahman.
Above answer was peer-reviewed by : Dr. Yogesh D
Follow up: Dr. Mahboob Ur Rahman 14 minutes later
Thank you for your response and your time. I was diagnosed with mono. But that was nearly 11 months ago right when this problem started to arise. I went to a specialist who thought biopsy was unnecessary but that doesn’t give me closure for I don’t have an answer for certain. Is it normal for lymph nodes to remain swollen for this duration of time after mononucleosis?
Answered by Dr. Mahboob Ur Rahman 43 minutes later
Brief Answer:
Generally resolve in few weeks.

Detailed Answer:
Hi, thanks for writing back to us.
Generally symptoms, including enlarged nodes, settle in few week and does not persist more then few weeks. . Though it's possible that it may persist, but that is extremely rare, and in such cases we always need to rule out other causes first, before putting it to mono. The reason is that a number of diseases can present like mono and infectious mononucleosis can cause a few complications sometimes . So the general rule is that if glands remain swlooen after four weeks of an inf, we need to work for it.
It's good that you feel healthy,so it may not be any thing serious, but just to be very safe, we need to Chek for other possible causes.
Biopsy is not an emergency, and we can wait for it in such cases( where you feel well and blood work is good) . But the routine blood work, and work up for other infections should be done first. If things don't settle, of course biopsy would be an answer but we can wait for it in your case.
Hope you find it helpful, please don't hesitate to ask me if you have anything else to know.

Above answer was peer-reviewed by : Dr. Nagamani Ng

The User accepted the expert's answer

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