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What Causes Enlarged And Tender Right Supraclavicular Lymph Node?
Question: Hello, I noted an enlarged and tender right supraclavicular lymph node today. This is new. I have not had a cold recently. I have had a very bad flare up of facial acne lately with pustules. Given that the right SN drains from thorax and esophagus, should I get a CXR? I have an appointment tonight with my PCP. Perhaps I should try antibiotics for acne and maybe the node will clear up? I have an appointment with the dermatoligist on 8/4/15. Thank you.
Brief Answer:
You'd better be examined by your doctor first
Detailed Answer:
Hello,
I'd prefer to avoid jumping into conclusions without clinical examination data. Your doctor may be able to distinguish between a lymph node and a sebaceous cyst for example. Examination of other lymph node regions and the spleen and liver is also essential to get the complete picture. If many lymph node regions are enlarged then the differential diagnosis can become broader.
Other significant aspects of the approach to an enlarged lymph node include the symptoms. A painful or tender node is usually linked to inflammatory conditions (infections, etc). The size plays a role. A small node can be ignored most of the times although the right supraclavicular fossa raises suspicions for serious diseases and is more difficult to ignore. A rock-hard node is suspicious of malignancy.
Regardless of the above, in patients like you, I always ask for at least a chest X-ray and depending on the patient a chest computed tomography, which is much more sensitive than the X-ray. If nothing can be identified with clinical examination and radiological assessment of the chest then the esophagus could be checked.
I don't believe that your skin lesions have anything to do with the supraclavicular region.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
You'd better be examined by your doctor first
Detailed Answer:
Hello,
I'd prefer to avoid jumping into conclusions without clinical examination data. Your doctor may be able to distinguish between a lymph node and a sebaceous cyst for example. Examination of other lymph node regions and the spleen and liver is also essential to get the complete picture. If many lymph node regions are enlarged then the differential diagnosis can become broader.
Other significant aspects of the approach to an enlarged lymph node include the symptoms. A painful or tender node is usually linked to inflammatory conditions (infections, etc). The size plays a role. A small node can be ignored most of the times although the right supraclavicular fossa raises suspicions for serious diseases and is more difficult to ignore. A rock-hard node is suspicious of malignancy.
Regardless of the above, in patients like you, I always ask for at least a chest X-ray and depending on the patient a chest computed tomography, which is much more sensitive than the X-ray. If nothing can be identified with clinical examination and radiological assessment of the chest then the esophagus could be checked.
I don't believe that your skin lesions have anything to do with the supraclavicular region.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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