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Dr. Andrew Rynne

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What causes enlargement of the cervical lymph nodes?

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Dr. Sumit Bhatti

ENT Specialist

Practicing since :1991

Answered : 2564 Questions

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Posted on Tue, 21 Mar 2017 in Ear, Nose and Throat Problems
Question: I have a question if a cervical lymph node measuring .3 by .6 by 1.1 cm is considered enlarged. I'm also curious as to what these measurements correspond to - length, width and what? Depth? This is in what I think is an occipitical lobe.
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Answered by Dr. Sumit Bhatti 55 minutes later
Brief Answer:
Thickness/ height.

Detailed Answer:
Hi,

Thank you for your query.

1. A .3 X .6 X 1.1 cm cervical lymph node is considered enlarged. Any cervical lymph node more than 0.8 to 1 cm in greatest dimension is considered abnormal and needs investigation.

2. By convention these are the length, width and thickness of the node.

I hope that I have answered your query if you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Sumit Bhatti 1 hour later
Thank you for the answer. This is what the radiologist report said:

There is an unchanged subcutaneous hypoechoic nodule with a linear
fatty hilum, consistent with a benign lymph node. This measures 0.3 x
0.6 x 1.1 cm, previously 0.3 x 0.7 x 1.0 cm, unchanged. Remaining
cervical lymph nodes are normal in size.

I have a few questions.
1. The radiologist says this is unchanged even though the measurements did change. Is there deviation to be expected among techs?

2. I had this imaged because two years ago I had a severely atypical mole removed near the area (the mole was under my ear on my neck). I had two different pathologists look at it and they said it had some features that put it in the borderline category for melanoma but that it was still benign. They both agreed that the atypical cells were limited to the epidermis and I had the mole fully excised three weeks later. Given that, should I be concerned about this node? I didn't ever notice it was swollen until after a haircut last October when my neck was cut in the area and very red and rashed. Since then, it seems to swell more whenever I have even the slightest XXXXXXX on my neck. It definitely feels more pronounced at certain times than others.

3. If this node is reacting to cuts on my neck, is it normal for this to be the sole node that reacts? I suppose others could be reacting but I don't realize since I'm not having them imaged.

4. If I was your patient, what would you recommend as follow-up?

Thank you.
doctor
Answered by Dr. Sumit Bhatti 20 hours later
Brief Answer:
Details as discussed below:

Detailed Answer:
Hi,

Thank you for writing back.

1. A slight variation between reports is expected.

2. This lymph node has remained similar in size over two years. This is a good sign.

3. Lymph nodes react to local inflammation or infections in their area of lymphatic drainage. This is normal. Abnormal lymph nodes will not settle down in between episodes of enlargement (persistent increase in size is not normal).

4. I recommend a six monthly follow up. A colour doppler study should show a normal hilar pattern of blood flow (as a against an abnormal peripheral). If this node appears spherical or circular instead of the normal oval shape, get a USG guided FNAC (Fine Needle Aspiration Cytology) done.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Prasad
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