Hello, Im a overall healthy 21 year old male. Ive
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.
Better to be evaluated
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.
Generally resolve in few weeks.
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.