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Dr. Andrew Rynne

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What causes swollen lymph node below jaw?

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Dr. Hariom Sharma

ENT Specialist

Practicing since :2006

Answered : 1113 Questions

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Posted on Tue, 5 Aug 2014 in Ear, Nose and Throat Problems
Question: I have a swollen lymph node below my jaw (submandibular) and it has been that way for months. It is not visible but it is about the size of a kidney bean and it is like that only on one side. On my other side of the jaw it feels like there's 2-3 pea sized lymph nodes in the same area. I also have some itchyness in those areas intermittenly. If I turn my head away from the lymph node it doesn't move much, but if I turn toward the swollen lymph node it moves readily.

I have some intermittent ear aching on both sides and I noticed when I was running earlier that it feels like something in my head is jumping up and down when I run and it can hurt at times. I'm not sure if this is related or not, but it is a recent development.

In my mouth, there appears to be a swollen tonsil on one side with a bit of a whitish/beige spot underneath the tissue visible. That swollen tonsil is on the opposite side of the swollen lymph node. My gums don't appear to be infected and I haven't had a fever/cough etc for about 3 months.

My concerns are (in order of emotional disturbance):
1.) Lymphoma
2.) Strep infection and Abscess
3.) ???

I'd love a professional opinion on what may be going on (preferrably an ENT specialist) and would like to put these worries to rest. I have an ENT appointment on Monday but I cannot wait because this is constantly distracting me.

http://imgur.com/a/zgGkb#0
This is 6 months worth pictures of the tonsils in the back of my mouth.

Other symptoms:
1.) intermittent sharp chest pain on left side - doctor's could not find anything up with it.
2.) Some intermittent leg pain (around knees above and below.... feels like veiny pain)
3.) Sleep disturbance in the past couple of weeks.... no sweating really or if there is sweating it's also 80 in my apartment.
4.) No fever since April... My temperature is usually around 97 actually
5.) Blood work shows nothing abnormal other than low(ish) platelets (141).
6.) Intermittent bubbly urine and constipation (diet isn't really changing though).

My habits.)
I sit on the computer all day. I get about 30 minutes of exercise a day on average of moderate intensity (some days more, some days less). I'm 24 years old with no history of illness other than anxiety and cavities in my teeth. I'm a white male and always been a bit underweight. I am 5'10 1/2'' and weigh 130 lbs.
Blood pressure is usually around 110/70 and resting heart rate is 50-60 bpm.
I live in XXXXXXX in a highish stress environment for the last 1 year and have developed health anxiety after some crappy experiences (started sleeping with some women and contracted HSV-1 (HSV-1 and 2, HIV, HPV, Hepatitis were all tested with only HSV-1 positive). Also got robbed shortly after. Developed a chest pain shortly after that that has remained until this day.
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Answered by Dr. Hariom Sharma 1 hour later
Brief Answer:
Pharyngotonsillitis

Detailed Answer:
Hi Sir,

I have gone through your query, medical history and image; it suggest that you may be suffering from the pharyngotonsillitis probably due to HSV 1 infection. Lymph node enlargement may be due to this infection.

The features and the pictures are not consistent with bacterial (streptococcal infection). Lymphoma doesn't present this way. You can discuss about ultrasound of the neck and FNAC of the cervical Lymph node swelling if you still suspect lymphoma.

The condition can be managed according to physical examination findings of the examining doctor. It isn't as alarming as you think. So don't be worried.

Hope this helped. Let me know if you need clarifications.

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