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What Can Cause A Swollen Lymph Node In The Side Of The Neck?
Question: I have a swollen lymph node on the side of my neck, around 1cm. Around 2 months ago I got bloods taken which came back fine and an ultrasound that said while enlarged, it didn't look suspicious. However, the node is still there, firm and enlarged. My GP says to get another ultrasound and we'll take it from there. Should I be worried?
Brief Answer:
The previous normal results are good
Detailed Answer:
Hi,
The main concern with enlarged lymph nodes would be the possibility of cancer such as leukemia or lymphoma but this would show up on blood tests and ultrasound.
Enlarged nodes can also occur with spread of cancer, infection in a nearby area or infection of the node, trauma to the lymph node, medication reactions, skin infections, allergies.
Your doctor would have likely done a complete blood count and ESR - the white cell count of the complete blood count would have been very elevated in infection, lymphoma and leukemia, it would also show changes in the spread of cancer.
The ESR looks for inflammation in the body. It would go up in cancer or infection. If it is normal then these are not likely to be present.
The ultrasound would have looked at the structure of the lymph nodes and would have been able to tell if it looks suspicious, the fact that it was normal was good.
The normal blood tests and imaging are good and mean that the increase is not likely due to a dangerous cause.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Michelle Gibson James, General & Family Physician
The previous normal results are good
Detailed Answer:
Hi,
The main concern with enlarged lymph nodes would be the possibility of cancer such as leukemia or lymphoma but this would show up on blood tests and ultrasound.
Enlarged nodes can also occur with spread of cancer, infection in a nearby area or infection of the node, trauma to the lymph node, medication reactions, skin infections, allergies.
Your doctor would have likely done a complete blood count and ESR - the white cell count of the complete blood count would have been very elevated in infection, lymphoma and leukemia, it would also show changes in the spread of cancer.
The ESR looks for inflammation in the body. It would go up in cancer or infection. If it is normal then these are not likely to be present.
The ultrasound would have looked at the structure of the lymph nodes and would have been able to tell if it looks suspicious, the fact that it was normal was good.
The normal blood tests and imaging are good and mean that the increase is not likely due to a dangerous cause.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Michelle Gibson James, General & Family Physician
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you - that has really put my mind at ease. If my next ultrasound is also normal, do you think it's worth requesting a needle-biopsy? Or would I have enough conclusive evidence to forget about it and move on?
My doctor's main concern is the length of time that it has been enlarged without any other symptoms (cold, infection etc.). May this node be swollen indefinitely and never go back down?
My doctor's main concern is the length of time that it has been enlarged without any other symptoms (cold, infection etc.). May this node be swollen indefinitely and never go back down?
Brief Answer:
If normal, a good sign
Detailed Answer:
Hi,
You can consider repeating both the blood tests and the imaging either repeat ultrasound or CT. If both of these are normal then the enlargement is not likely due to a serious condition because it should at least be reflected in the blood tests in the majority of persons.
I do agree that the length of time is unusual if you both want to cover your bases, your doctor can speak to one of his hematologist colleagues for a second opinion.
The hematologist would determine if any further is needed based on the info your doctor gives him.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Michelle Gibson James, General & Family Physician
If normal, a good sign
Detailed Answer:
Hi,
You can consider repeating both the blood tests and the imaging either repeat ultrasound or CT. If both of these are normal then the enlargement is not likely due to a serious condition because it should at least be reflected in the blood tests in the majority of persons.
I do agree that the length of time is unusual if you both want to cover your bases, your doctor can speak to one of his hematologist colleagues for a second opinion.
The hematologist would determine if any further is needed based on the info your doctor gives him.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Michelle Gibson James, General & Family Physician
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. You mentioned that the enlarged node may be due to reaction to medication...I have MS and I'm on immunomodulating drugs (Dimethyl Fumarate, product name: Tecfidera) - do you think the node may be swelling up because of this? I was also worried that the medication may be reducing my blood count, thus "masking" any elevations in my white blood cells caused by lymphoma...I feel like I'm going crazy! Very worried still, what do you think?
Brief Answer:
Not a known side effect
Detailed Answer:
Hi,
The immune suppressant can affect/alter the response of your immune system but the ultrasound was also normal.
Enlarged lymph nodes are not a known side effect of this medication.
It is a side effect that can be seen with some antibiotics, some anti-seizure meds (phenytoin, carbamazepine), some BP or heart meds (atenolol, hydralazine, quinidine).
I can understand your concern, though the ultrasound and blood tests were previously normal, I think that unless you have a biopsy showing definitely that the node is normal, you may remain concerned/worried.
With the new info on the immune suppressant meds that may affect your count, you may want to conclusively, definitely make sure everything is okay, I believe it is.
I also believe in being as thorough as the situation warrants, best to do what is needed than to wonder.
Hope I have answered your query.
Regards,
Dr. Michelle Gibson James, General & Family Physician
Not a known side effect
Detailed Answer:
Hi,
The immune suppressant can affect/alter the response of your immune system but the ultrasound was also normal.
Enlarged lymph nodes are not a known side effect of this medication.
It is a side effect that can be seen with some antibiotics, some anti-seizure meds (phenytoin, carbamazepine), some BP or heart meds (atenolol, hydralazine, quinidine).
I can understand your concern, though the ultrasound and blood tests were previously normal, I think that unless you have a biopsy showing definitely that the node is normal, you may remain concerned/worried.
With the new info on the immune suppressant meds that may affect your count, you may want to conclusively, definitely make sure everything is okay, I believe it is.
I also believe in being as thorough as the situation warrants, best to do what is needed than to wonder.
Hope I have answered your query.
Regards,
Dr. Michelle Gibson James, General & Family Physician
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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