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What causes lymph node enlargement?

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Answered by

Oncologist, Surgical
Practicing since : 1986
Answered : 59 Questions
General Persistent Lymphadenopathy. Hi there, I am an 18 year old fit and healthy male I am 6"2 and relatively slim. i have had a small 1cm soft rubbery,movable bump(probably lymph node) on my trapezius muscle for at least a few years with no apparent growth so i never really worried about that one. Two months ago I noticed a small bump under my chin and found two very small lymph nodes next to each other largest was about 1 cm, after persistence of about 3 weeks I saw my GP who after a brief 2 min examination ordered a round of antibiotics because he though they were due to the acne on my face. A week passed while taking the antibiotics I think that one of the lymph nodes decreased slightly(2-3mm)on the fourth day in but not again after that. After some research I felt my armpits and other regions of my neck and found another sausage shaped,rubbery,highly movable, lymph node in my left armpit which again was about 1cm in length. So I went and saw my GP and he ordered a blood test which came back fine. A week later I found another 2 easily movable, smooth, and rubbery 1cm lymph nodes in my posterior cervical region on the left side of my neck. This was concerning because from what Ive gathered on the internet lower neck lymph nodes swell usually due to malignancies. So I freaked out and asked my doc for a referral to a surgeon for biopsy. Yesterday was my appointment with the surgeon, he felt the lymph nodes in my neck and armpits and decided he wasnt concerned and that we should wait 3 months to see if they grow before doing a biopsy. However I forgot to tell him about the lymph node on my trapezius muscle and I dont think he felt the largest lymph node in my lower right underarm(2cm, easily movable, and rubbery) so now I am left wondering if he would have been surprised by these lymph nodes and instead done a biopsy. Now the thing is I havent been having any other symptoms and my blood tests have been fine thus far. Most of the nodes are all 1cm or smaller, painless, rubbery, and highly movable and I have no idea how long some of them have been there because Ive never looked for them, I only found them when I searched thoroughly through every inch of these parts. another thing is that my left shoulder has been sore on and off, so I am wondering if that 1cm node on my trapezius(thats been there for at least a year) could have been causing the pain and if so is actually something serious, and if it is due to the fact that my brain is so close if it is lymphoma it could spread to my brain as well. I know I sound a little hypochondriac but this is the first time in my life I've been this worried and anxious about something. I hear about so many misdiagnosis on the web with regards to lymphoma and they really freak me out so I cant help but wonder if I fall into the category or whether I should just trust my doctor and surgeon. On one hand they(doctor and surgeon) know what theyre doing, and none of my lymph nodes are that big or have been growing, blood tests are fine, no symptoms, nor do I know how long alot of these have been around etc. On the other I am worried that this could be an indolant lymphoma that could spread to my brain due to the fact that one lymph node is so close, plus the nodes themselves are painless and rubbery(another sign of lymphoma), an indolant lymphoma would also explain my lack of symptoms as well. Should I get a third opinion from another doctor or am I just worrying unnecessarily? also, i have also noticed that a chain of 3 lymph nodes all around 1cm or smaller are palpable from my lower left posterior cervical region down to just above my supraclavicular area. i have done research and it says these are usually malignant so now I am very worried. They are all small,painless, rubbery, and movable. Today upon further deep palpatation of my lower armpit near my ribcage i noticed a 3cm,hard, skinny but very elongated node alongside the larger 2cm node, it is very movable and was hard to find because it was so deep in my lower armpit. Also my sister had a bad case of salmonella poisoning two months ago, could this be part of the reason my lymph nodes are swollen? Or is it normal to feel nodes like this if you feel around enough?
Posted Sat, 25 Jan 2014 in Cancer
Answered by Dr. K. Harish 5 hours later
Brief Answer: You may need a node biopsy Detailed Answer: You need to trust your surgeon since he feels that the swellings are not significant and can wait. There are many causes for lymph node enlargements one of them being lymphoma. Since you complain of a swelling around rib cage, it is possible (an outside chance) that many of these swellings could be lipomas. (such swelling in neck and arm pit are unlikely to be lipomas and are usually lymph node swellings). Since a surgeon has examined you and asked you to wait for a biopsy, I presume the enlargements felt must be lymph nodes only. Generally, salmonella poisoning of a relative would not cause swelling like these. Multiple nodal enlargements like these could be due to various reasons like infections (tuberculosis etc), non infectious (like sarcoidosis etc) and lymphomas. If the nodal enlargements persist, you may require a biopsy for diagnosis. Your surgeon would be the best to time the same.
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Follow-up: What causes lymph node enlargement? 25 minutes later
So is it common to find small yet palpable/movable lymph nodes in the posterior cervical and supraclavicular regions in a thin individual like myself? I have heard it is always a sign of malignancy. The lymph node under my chin seems to have decreased slightly but not enough to be easily noticeable. A lot of these lymph nodes are sausage shaped or oval and I am told that these are usually benign is that accurate? My blood tests have came back fine, because I have so many swollen nodes if it was lymphoma wouldn't there be some indicator in my blood test? Since I have discovered the nodes there does not appear to be any increase or decrease in size, except for the one under my chin which decreased slightly a month ago but not since.
Answered by Dr. K. Harish 1 hour later
Brief Answer: If persistent you may require a biopsy Detailed Answer: Usually lymph nodes should not be felt. But in some individuals and in some situations like bare foot walking (nodes in groin) etc., nodes can be enlarged. Persistently palpable nodes which cannot be otherwise explained needs to be evaluated (by biopsy). They could still be benign. However, biopsy may still be desirable to prove or disprove any pathology. Blood tests may not indicate lymphoma. There would be rapid increase in size of nodes only in aggressive varieties of lymphoma.
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Follow-up: What causes lymph node enlargement? 1 hour later
OK doctor now I am very concerned, In the deep area of my armpits and after a lot of feeling around in those areas I have encountered yet another few movable hard masses. The one in my right arm pit is about 3cm by 4cm and has a very odd shape and is very movable. On the left I have found one that is also hard and movable and about 3 or 4 cm with smaller ones nearby. I am now very very concerned, these nodes feel quite odd. Especially since you stated that it is not normal to find these lumps and bumps. What could cause this? if the lymphoma is this widespread wouldn't it have shown indicators in my blood tests by now?
Answered by Dr. K. Harish 9 minutes later
Brief Answer: You may need biopsy Detailed Answer: If you have large nodal mass (presuming they are nodes), you need to undergo biopsy. I have already stated some causes. However, biopsy alone will yield a definitive diagnosis while all other causes we state would only be possibilities. Blood tests DO NOT in most cases indicate lymphoma and I have already stated this. I hope I have answered your queries and if it is a nodal mass matching your description of large size you need to undergo a biopsy for diagnosis.
Above answer was peer-reviewed by
Follow-up: What causes lymph node enlargement? 4 minutes later
Ok but if it was lymphoma and it had spread throughout my neck and armpits etc. Wouldn't I have some type of other symptoms or at least indicator of the illness? Whether through symptoms or lymphocytosis in blood etc.?
Answered by Dr. K. Harish 4 hours later
Brief Answer: Do not presume disease Detailed Answer: Lymphoma is a disease of lymph nodes (there are about 800 in the body) or more precisely lymphoreticular system. Cancers of solid organs like stomach, breast etc spread from site of origin to other areas like liver, lungs etc. However, lymphomas DO NOT spread from one node to other. They manifest in one or multiple nodes and multiple nodal basins. This is not called spread. Some patients may have fever while others do not. Hence lymphomas could be symptomatic or asymptomatic.
Above answer was peer-reviewed by
Follow-up: What causes lymph node enlargement? 3 hours later
If you were my doctor and i presented you with this information 1. surgeon has dismissed me for 3 months after exam 2. Widespread persistent lymphadenopathy with no other symptoms 3. Normal blood testsĀ  4. All nodes are movable and don't appear to be growing largerĀ  5. Largest nodes are in armpit and are hard to find generally(not found in exam by surgeon) over 3cm, most other nodes are 1 cm or less What would your suspicion level of lymphoma be considering all this info?
Answered by Dr. K. Harish 15 hours later
Brief Answer: Please undergo biopsy Detailed Answer: You appear to be very anxious. Biopsy alone will provide the diagnosis. Debating on possibilities will not give a diagnosis
Above answer was peer-reviewed by
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