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Suggest treatment for enlarged lymph nodes in neck

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Posted on Sat, 16 Jan 2016
Question: CT of abd. & labs after PCP found enlarged right supracl. node. WBC high initially, ct normal, 2wks on ABX then normal WBC. Node still enlarged! Im confused?!!
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Answered by Dr. Prakash H Muddegowda (43 minutes later)
Hi,
Single enlarged lymphnode, not to worry. Lymph node takes time to reduce. Maybe upto 2-3 months. As WBC count is normal and there are no other enlarged lymph nodes and also considering your age, not to worry.
Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Prakash H Muddegowda (15 minutes later)
I attached my recent labwork and ct results. I do have multiple enlarged lymph nodes in my neck and by the crease in my left elbow according to my doctor. I guess my question is why would all the lymph node enlargement occur with normal labs and normal CT? Some are becoming so large its uncomfortable, mostly in my neck. The doctor freaked out when he first saw the enlarged right supraclavicular node; mostly because he wasnt expecting anything to actually be enlarged, so it freaked me out too! Also, they have been enlarged over 3 months. Should I just waitand see if they finally go back to normal?
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Answered by Dr. Prakash H Muddegowda (1 hour later)
Brief Answer:
Further tests necessary - FNAC or biopsy of lymph node.

Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on query and attached report, my opinion is as follows:

1. Multiple enlarged lymph nodes with normal laboratory reports is rare.
2. The initial lab report was suggestive of infection, possibly bacterial, as neutrophils is raised and it has reduced.
3. If the lymph nodes are not reducing, and with multiple lymph nodes picture, Fine needle aspiration cytology or biopsy of accessible lymph nodes like supraclavicular or axillary area needs to be done. Three months is pretty long time and with normal laboratory profile, test like FNAC or biopsy is necessary to rule out any chronic infections or possible lymphomas.

Do ask your doctor regarding the tests.

Hope it helps.
Any further queries, here to help again.

Dr. Prakash HM
Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Prakash H Muddegowda

Geriatrics Specialist

Practicing since :2004

Answered : 2138 Questions

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Suggest treatment for enlarged lymph nodes in neck

Hi, Single enlarged lymphnode, not to worry. Lymph node takes time to reduce. Maybe upto 2-3 months. As WBC count is normal and there are no other enlarged lymph nodes and also considering your age, not to worry. Thanks.