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What causes enlarged lymph nodes around neck?

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Posted on Wed, 24 Dec 2014
Question: Ok, this could get long. Please go back and read my previous history. I will try to pick up where I left off. I was sent to big city med center by my small town doctor to see why my lymph nodes on my left chest and neck area were enlarged and tender. I had also run a fever daily for about 6 weeks and felt like I had the flu most of the time. I went to the med center about the middle of october. They gave me a ct scan, and told me i had lymphoma in the lymph nodes on my left underarm area and set up surgery to remove them. The surgeon removed 2 enlarged nodes and the biopsy showed no lymphoma or cancer. The med center then had me do another ct scan, a pet scan and bone marrow biopsy looking for cancer. The results were all benign. No cancer which made me happy. However they had no answers as to why my lymph nodes are still swelling on my neck and and now I noticed another one on my left chest under the nipple area. They sent me to a hematologist who had no answers and now they want me to go to a rheumatologist. Should I do this and what do you think it could be. The swelled lymph nodes are all confined to the left chest, neck area. I am not feeling as bad as I did as the fevers have eased to almost nothing, but am exhausted and aching and tender in the swelled area. The two diagonses from my local doctor and the med center are the same. It is benign follicual hyperplasia of the lymph nodes. Something is causing this and my feeling is that there is something underneath my left shoulder blade that is rubbing or pinching and setting all this off. I have had pain there for some time. It is all easily relieved by aspirin, ibuprofen or tylenol, but I hate live on pills every 3 hours. The early mri and the two ct scans showed nothing but enlarged lymph nodes. Please help. Take your time as I know this is complicated. I will be gone most of the day but will answer any questions when I get home. thanks. XXXXXXX
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Answered by Dr. T Chandrakant (49 minutes later)
Brief Answer:
No cancer - this is idiopathic

Detailed Answer:
Hi XXXXXXX
Nice to see you again after Wed 3 Sept 2014.
Read the previous thread to.

Very happy to know that Biopsy showed no Lymphoma or Cancer; CT scan, PET scan and bone marrow biopsy were all benign. I can understand the plight of not getting a proper answer why the nodes still swelling on your neck.

The probable cause can be simply a reactive hyperplasia to some non-specific reaction, many times this can be due to eosinophilic infiltration as I have seen in my practice. Again the problem is o find out WHY ?? That is why this is called ''iodiopathic''. (Report: It is benign follicular hyperplasia of the lymph nodes.))

But to repeat, we have to be very happy that there is no cancer.

Now- about a the one on the left chest under the nipple area. There is no lymph node situated in this area or under the left shoulder blade. It may be a structure such as muscle mass infiltrated with inflammatory exhudate or so and can be picked up well with MRI if you tell the radiologist what your problem is.

Taking a Consultation of a Rheumatologist and / or Hematologist may give us a clue. I request you to take at least one opinion. This may help.

You may request for the following medicines while discussing with your treating Doctor/s:::
-Once a day anti-inflammatory with pain killer property like - Diclofenac SR (Sustained Release), as these need to be taken once a day, relieving your trouble of taking repeated tablets throughout the day.
-Doxycyclin - again once a day antibiotic and can be taken for a long time.
-Deflazacort- a newer steroid with minimum side effects. This is the strong anti-inflammatory as well as potent anti-allergic and works well in benign follicular hyperplasia ( it is up to your Doctor's view). This can be given over 3 weeks in tapering dosage and supplementary Calcium with Vitamin D is better taken with it.
All these medicines will help you for the under-shoulder blade problem.
-Multivitamins and probiotic to maintain good health as you had 6 weeks fever and must have really reduced your health and well-being.
-Try to find out the allergens/ factors in atmosphere, in foods , beverages and so on. avoid them to avoid recurrence; I know it is difficult but worth trying to find.
-Please try to relax as the major illness is ruled out, I am so relived to know you do not have lymphoma. Anxiety and stress does reduce the body's resistance power to enhance non-specific problems like you are suffering from.
-It is better to take an opinion of an Orthopedic Surgeon about the shoulder blade problem.

I hope this answer helps you once again and to get a relief from your symptoms, tensions and worry.

I shall be happy to assist you more if you need one, please feel free to ask / discuss .

Wishing you a healthy life.




Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. T Chandrakant

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Practicing since :1984

Answered : 18112 Questions

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What causes enlarged lymph nodes around neck?

Brief Answer: No cancer - this is idiopathic Detailed Answer: Hi XXXXXXX Nice to see you again after Wed 3 Sept 2014. Read the previous thread to. Very happy to know that Biopsy showed no Lymphoma or Cancer; CT scan, PET scan and bone marrow biopsy were all benign. I can understand the plight of not getting a proper answer why the nodes still swelling on your neck. The probable cause can be simply a reactive hyperplasia to some non-specific reaction, many times this can be due to eosinophilic infiltration as I have seen in my practice. Again the problem is o find out WHY ?? That is why this is called ''iodiopathic''. (Report: It is benign follicular hyperplasia of the lymph nodes.)) But to repeat, we have to be very happy that there is no cancer. Now- about a the one on the left chest under the nipple area. There is no lymph node situated in this area or under the left shoulder blade. It may be a structure such as muscle mass infiltrated with inflammatory exhudate or so and can be picked up well with MRI if you tell the radiologist what your problem is. Taking a Consultation of a Rheumatologist and / or Hematologist may give us a clue. I request you to take at least one opinion. This may help. You may request for the following medicines while discussing with your treating Doctor/s::: -Once a day anti-inflammatory with pain killer property like - Diclofenac SR (Sustained Release), as these need to be taken once a day, relieving your trouble of taking repeated tablets throughout the day. -Doxycyclin - again once a day antibiotic and can be taken for a long time. -Deflazacort- a newer steroid with minimum side effects. This is the strong anti-inflammatory as well as potent anti-allergic and works well in benign follicular hyperplasia ( it is up to your Doctor's view). This can be given over 3 weeks in tapering dosage and supplementary Calcium with Vitamin D is better taken with it. All these medicines will help you for the under-shoulder blade problem. -Multivitamins and probiotic to maintain good health as you had 6 weeks fever and must have really reduced your health and well-being. -Try to find out the allergens/ factors in atmosphere, in foods , beverages and so on. avoid them to avoid recurrence; I know it is difficult but worth trying to find. -Please try to relax as the major illness is ruled out, I am so relived to know you do not have lymphoma. Anxiety and stress does reduce the body's resistance power to enhance non-specific problems like you are suffering from. -It is better to take an opinion of an Orthopedic Surgeon about the shoulder blade problem. I hope this answer helps you once again and to get a relief from your symptoms, tensions and worry. I shall be happy to assist you more if you need one, please feel free to ask / discuss . Wishing you a healthy life.