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Noticed hard immobile lymph node under jaw. What is the problem?

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Practicing since : 2001
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My active, healthy ten year old son has a two inch hard, immovable painless swollen lymph node under his right jaw for four weeks. Its not decreasing in size. No fever and not responding to antibiotics. Some coughing at night. What causes symptoms like this, other than lymphoma? The lack of pain and fever concerns me. His blood work at first dr appointment revealed only a slightly elevated white blood cell count.
Posted Fri, 2 Nov 2012 in Lymphoma
Answered by Dr. Rakhi Tayal 3 hours later
Thanks for posting your query.
A hard immobile lymph node in a ten year old with no infections is worrisome.
Lymph nodes are part of the immune system that helps in fighting against infections. They are like police man of our body, it pops out whenever there is ongoing infection in the vicinity and become inflamed or enlarged. The conditions may range from trivial infections such as a throat infection, to life-threatening such as cancers.
Even viral infections which doesn't have specific antibiotics can cause such a swelling.
Few autoimmune diseases like Hashimoto's Thyroiditis can cause swelling of the neck.
Even after the infection has subsided, there may be a reactive lymphadenopathy which may take even upto 12 weeks to subside.
For this, a FNAB (fine needle aspiration biopsy) of the lymph nodes and swollen glands is the best test. FNAB is aspiration of the material of the glands which is done by a fine gauge needle (22 or 25 gauge) and a syringe. This will confirm the diagnosis as swollen neck glands are often caused by an infection, allergic reactions, cancer or metabolic diseases.
Hope this answers your query. I will be glad to answer the follow up queries that you have.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Rakhi Tayal.
Above answer was peer-reviewed by
Follow-up: Noticed hard immobile lymph node under jaw. What is the problem? 7 hours later
Should I request a biopsy at his next follow up?
Answered by Dr. Rakhi Tayal 9 hours later
Thanks for writing again.
An FNAC - fine needle aspiration cytology will help in proper diagnosis. You can ask for it.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Above answer was peer-reviewed by
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