Question: Dear Doctor,
18 months ago I developed feeling of general restriction and tightness in my throat accompanied with wheezing from the throat area exacerbated with exercise.
Other symptoms include load noises when swallowing water and a little uncomfortable when swallowing food although not restricted or sore.
8 months later I noticed a Lymph node on right side of neck under ear. I had this checked under ultra sound and whilst borderline in size (just under 2cm) no other suspicious features so no further action was taken.
6 months later I developed some intermitted pain in my neck on the same right hand side near the lymph node. The pain feels muscular in nature and is intermittent and on right hand side of neck also.
6 Months more I had a follow up ultrasound and there was no change with the Lymph node but the mass in my throat feels like it is getting slight bigger on the right side and the narrowing of the airway slightly more pronounced.
When I palpate the area around and behind my XXXXXXX apple it feels unusually large on the right size and a little tender. To describe, it feels like I have swallowed a round sweet that has got stuck on the right hand side of the XXXXXXX apple (the same side as the pain and the lymph node).
Their is a definite restriction in air intake when I am exercising at high velocity and this is unusual.
There is a definite wheezing sound that is coming from a narrowing of the neck in that area.
I can feel this mass pushing on my wind pipe when I lay on a pillow that causes snoring and restriction in breath so I have to move my head so my neck is not in contact with my pillow.

I would like to ask,

1: Could the restriction in breathing be caused by an enlarged thyroid or nodule on the Thyroid?
2: Should an ultrasound of the neck with focus on Lymph nodes pick up any abnormality with the Thyroid too or do they concentrate on the area of primary concern the Lymph node.
3; Is it possibly that the lymph node is reacting to some abnormality with my thyroid.
4: Could the lymph node be reacting to a benign condition with the Thyroid.
5: Is a blood test sufficient to detect Thyroid problems.
6: What would you recommend I do next given that I have had 2 ultrasounds to look at the Lymph node.

Other things to note,

I have had blood tests for other things recently that have shown raised liver enzymes (suspected due to heavy alcohol intake) but other than that my bloods are normal.
I have NO night sweats, unexplained weight loss or change in bowel habits.
I have had no noticeable change in my voice.
I have no symptoms of acid reflux.

Thank-you for your advice, I really appreciate it.,

Dr Ajish,

Many thanks for your clear and concise answers to my questions. I very much appreciate your help. If I may ask one last question. I would like to avoid having a FNAC on my Lymph node. I would prefer if possible not to phave a CT unless their is a strong clinical reason. In your oppiinion do you think that an MRI and / or UltraSound would be good enough as an initial investigation to show things clearly to either avoid or support a FNAC / CT or would you suggest that a FNAC and CT should be my next steps given my symptoms and history. Thank-you again for your advice.

Hi Dr Ajish,

Many thanks for your quick answer, I very much appreciate it. I'm not affraid of the needle its more that I don't want to puncture my Lymphatic system unless absolutely neccsary to avoid any lymphatic obstruction that might occur when it heals. I do understand that both are required for a more conclusive answer however, if possible will an MRI be sufficient with a FNAC and to avoid the CT or is a CT neccesary also?.

Thanks again,