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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does The Development Of A Lymph Node On The Back Of Left Neck And In The Arm Pit Of A Three Year Old Indicate?

My three year old has one large lymph node on the back of his left neck which has been enlarged for two years. Last week it enlarged substantially. The pediatrician was quite concerned with its size. CBC normal now we go to a pediatric surgeon to see what they think. Since Friday the lymph Node is still enlarged but not quite as large as it was Friday. The pediatrician said all his neck lymph nodes were enlarged and one under his jaw bone. He has shotty palpable lymph nodes in the Arm pit and groin areas. Does this sound cancerous?
Fri, 10 Jan 2014
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General & Family Physician,  's  Response
Thanks for query.Most lymph node enlargement in children is due to benign self-limited disease such as viral infections, and adenopathy is secondary to an increase in normal lymphocytes and macrophages in response to an antigen. Other less common mechanisms responsible for adenopathy include nodal accumulation of inflammatory cells in response to an infection in the node (lymphadenitis), neoplastic lymphocytes or macrophages (lymphoma), or metabolite-laden macrophages in storage diseases (Gaucher disease).
In young children,front of neck lymph nodes as large as 2 cm, armpit nodes as large as 1 cm, and groin nodes as large as 1.5 cm in diameter are normal, and further evaluation is usually not indicated. malignancy is usually associated with nodes larger than 3 cm in diameter.However, the presence of even shotty (< 0.5 cm) supraclavicular or epitrochlear nodes may be associated with malignancy and warrants further evaluation.as your child blood counts are normal I hope its not a serious issue.biopsy of the node will make things more clear.regards
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What Does The Development Of A Lymph Node On The Back Of Left Neck And In The Arm Pit Of A Three Year Old Indicate?

Thanks for query.Most lymph node enlargement in children is due to benign self-limited disease such as viral infections, and adenopathy is secondary to an increase in normal lymphocytes and macrophages in response to an antigen. Other less common mechanisms responsible for adenopathy include nodal accumulation of inflammatory cells in response to an infection in the node (lymphadenitis), neoplastic lymphocytes or macrophages (lymphoma), or metabolite-laden macrophages in storage diseases (Gaucher disease). In young children,front of neck lymph nodes as large as 2 cm, armpit nodes as large as 1 cm, and groin nodes as large as 1.5 cm in diameter are normal, and further evaluation is usually not indicated. malignancy is usually associated with nodes larger than 3 cm in diameter.However, the presence of even shotty ( 0.5 cm) supraclavicular or epitrochlear nodes may be associated with malignancy and warrants further evaluation.as your child blood counts are normal I hope its not a serious issue.biopsy of the node will make things more clear.regards