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Suggest treatment for enlarged lymph node, pain while swallowing and yawning

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Posted on Mon, 25 May 2015
Question: I am a 53 yo female with a diagnosis of polymyalgia rheumatic since October 2014. Previous CRP level of 24. Latest CRP normal after a couple of rounds of low dose prednisone. I have an enlarged lymph node of the left side of my neck for the past week associated with painful swallowing and pain when yawning. CBC and Chem 12 were normal. No relief with OTC medications such as Acetaminophen and Aleve. Family history of Thyroid cancer in younger sibling. No sudden weight loss or excessive night sweating. Was seen by an urgent care PA who prescribed Tylenol and Aleve. I am an RN so of course I jump to Lymphoma or cancer. How long should I wait to seek treatment. Pain upon swallowing is becoming much worse over the past 5 days. No fever.
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Answered by Dr. Naval Mendiratta (41 minutes later)
Brief Answer:
Cause of lymph node

Detailed Answer:
Good evening

Thank you for writing on health care magic

Well, it s a bit unusual for PMR to start at the age of 52. It is usually seen but we normally suspect it in individuals around 70. Secondly , ESR is a more specific test for PMR monitoring than CRP. Can you check if that was done?

About the lymph node, it may be a submandibular gland enlargement or tonsilitis since you are having difficulty in swallowing. A Lymph node on the outside of the neck normally doesnt cause difficulty in swallowing unless it is due to either of these 2 glands enlargement. Considering you are on Prednisolone, you may not get fever even if it is due to some infection as steroids do suppress the inflammatory release. So , I would advise you to complete the course and wait for 2 weeks. If it is still persisting, you will need to get an FNAC done.

Also, keep a watch on the size of the node and if any new nodes come up. Either of them is an indication that we should intervene early.

It is too early to say lymphoma or cancer for now. But lets wait for a few more days before we plan for a FNAC

Hope the information was useful

Do let me know for more queries

REgards
Dr Naval
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Naval Mendiratta

Rheumatologist

Practicing since :2007

Answered : 754 Questions

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Suggest treatment for enlarged lymph node, pain while swallowing and yawning

Brief Answer: Cause of lymph node Detailed Answer: Good evening Thank you for writing on health care magic Well, it s a bit unusual for PMR to start at the age of 52. It is usually seen but we normally suspect it in individuals around 70. Secondly , ESR is a more specific test for PMR monitoring than CRP. Can you check if that was done? About the lymph node, it may be a submandibular gland enlargement or tonsilitis since you are having difficulty in swallowing. A Lymph node on the outside of the neck normally doesnt cause difficulty in swallowing unless it is due to either of these 2 glands enlargement. Considering you are on Prednisolone, you may not get fever even if it is due to some infection as steroids do suppress the inflammatory release. So , I would advise you to complete the course and wait for 2 weeks. If it is still persisting, you will need to get an FNAC done. Also, keep a watch on the size of the node and if any new nodes come up. Either of them is an indication that we should intervene early. It is too early to say lymphoma or cancer for now. But lets wait for a few more days before we plan for a FNAC Hope the information was useful Do let me know for more queries REgards Dr Naval