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Enlarged Lymph node, left side of neck. Additional details below

Hello, I am looking for some more general information regarding my current symptoms, and maybe some suggestions as far as what questions to ask my doctor so we can expedite the diagnosis process here in a month or so. I am a 23 year old male, in believed to be good health as I have never really had any major health issues in the past. Non-smoker, active lifestyle etc. Around the December 7th 2012 timeframe I noticed a lump on the lower left side of my neck while showering. After two and a half weeks or so I made an apointment with a doctor, suspecting that it was a swollen Lymph node. He got me in immediately, and concluded that it was a Lymph node. The Lymph node is about the size of a quarter, very hard, non-movable, and with no pain. It might of gotten slightly larger since I first noticed it, but it's hard to tell really. My doctor told me to come back in six weeks if the Lymph node hasn't decreased in size. At that time he will do a Sonogram to determine the size of it and look for inconsistancies in the shape (I think). I haven't been sick for quite some time, but I have had three or four instances of a slight rash accross the upper portion of my body (chest, abdomen) that has been accompanied by slight to moderate itching sensation accross my body since I first noticed the enlarged Lymph node. (The itching isn't always accompanied with the rash, seems more random than anything) I haven't switched detergents, or changed anything that I can think of that would cause a slight allergic reaction. I have researched these symtoms online, and it really seems like it could be just about anything. Anything from an infection, to Lymphoma (I know that Lymphoma is fairly rare). It has been two weeks since I last talked with my doctor, so I have four more weeks to go until I see him again assuming that the Lymph node doesnt decrease in size. I beleive the lymph node is on the Posterior Cervical Lymph node chain, at the base of the neck. But I could be wrong.

I would like to know what questions you would ask the doctor, and what information is really worth mentioning to him. Also who here has had similar or same symptoms? And what was the diagnosis? What other test might I expect, or should I request? I realize anything at this point is just speculation, I'm just curious.

Any help and suggestions will be greatly appreciated!
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First Helper Skyler89
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replied January 10th, 2013
Hello Skyler89,
It have the EXACT same enlarged lymph node at this moment. It is hard, the size of a quarter, and doesn't move much. Sometimes, it just seems to go in deeper. Anywho, I've had this enlarged lymph node for atleast 1.5 years!
I am 18, male, hispanic. I also haven't had any symptoms whatsoever.

My advice would be to not overthink the situation, trust me, it will take a mental and physical toll on you. Although Lymphoma is scary, it is very curable. Even in its late stages, the prognosis is atleast 85%, even if the cancer has spread. Stay positive! Chances are that everything will be okay.
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replied January 24th, 2013
Yeah I'm not terribly worried about it, I'm more curious than anything. It is still enlarged, and it might of increased in size but it is still hard to say. I should be able to see the doctor here in two or three weeks so we shall see what he says. By that point I think that I will try to push for a biopsy if he doesn't already recommend it. Or at least try to get scheduled to see an ENT. Anyone else have some insight on what I should do? I have read that by this point and time they will usually do blood work and chest x-ray? My doctor hasn't mentioned that, but he did say that he will do a sonogram if it hasn't decreased in size. Should I request a chest x-ray and blood work if he doesn't already do it? What exactly are they looking for when they do those things?

Thanks!
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replied February 2nd, 2013
go to the doctor
Hi. My brother is 23 as well. he noticed a lymph none up to his left collar bone which was rubbery in consistency and with no pain whatsoever. Other than that he had no other symptoms. He went to the doctor, his blood tests were good, and he got a CT scan. the CT scan revealed a tumor in his chest of about 11 cm in diameter. After biopsy, we found out it is Hodgkin lymphoma. He started chemotherapy in september 2012 and finished this monday. His CT scan now looks way way better -tumor reduced at a diameter of 3 cm. He's having a PET scan soon. So go to a doctor, ask for a toracic and abdominal CT scan - with contrast. Btw, i'm a medical school graduate.
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replied February 5th, 2013
Hello Windex, thank you for your input on this. I have an appointment with my doctor on Tues Feb 12th so we shall see what he thinks. I'd imagine that by this point he would start running tests on me to figure out the cause of this. Like I said before, he said that he would do a sonogram on my neck so I'm going to hold him to his word. I suppose then they can more accurately determine the size of the Lypmh Node then. Any idea what size is considered questionable? And what exactly is it that they look for?

Also has your brother ever been exposed to any chemicals such as Benzene etc? From what I have read Lyphoma can be linked to Benzene exposure, which I have been exposed to almost on a daily basis (Jet fuel) for the past three or four years. So it will be interesting to find out what comes from this. Thank you for your help, and I hope that your brother continues to win his fight against Lymphoma.

Thanks
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replied February 12th, 2013
Well I just got back from seeing the doctor today and he has went ahead and put in a referral to have a ultrasound done. So I am pretty pleased with that. He feels that the Lymph node has increased in size, but he doesn't feel that it is in an area that is generally of concern, though he did say that there is always the possibility of it being Lymphoma, just unlikely. So we will see what the results are from that, I'd imagine I should have the ultrasound done in a few weeks at the latest.
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replied March 1st, 2013
Skyler, did you have the ultrasound done yet? Were you able to gain any insight? I have a very similar situation. Lump in same locale, noticed mine in November. First ultrasound said it was an enlarged lymph node, doctors office scheduled a second ultrasound for six weeks later. Just got results from the second ultrasound. Lymph node did not change in size and became more vascular. Doctor would like to research something further and will contact me next week. While I understand what vascular in general means, I don't have a clue what it means in this case. Good luck with everything.
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replied March 5th, 2013
Hello Michmom, I had my Ultrasound on 20Feb and just received my results yesterday. According to the radiologist that reviewed my Ultrasound results, I have a 1.5cm, partially calcified mass in my neck. It appears to be a lymph node, but apparently he isn't one hundred percent positive on it. I am now being referred to an ENT (ear, neck, and throat specialist) so we shall see what he/she thinks of it. He didn't say anything about the vascularity of it, though I thought that I heard the ultrasound tech state that she couldn't get any color out of the doppler sonogram, so to my limited knowledge that would indicate no blood flow through it. Now is that a good thing or a bad thing? I honestly have no idea. Unfortunately when it comes to lymph nodes you really just need to do a biopsy to determine if it is cancerous or not.

Here is an interesting paragraph about vascularity in a lymph node.

Doppler evaluation of metastatic nodes

Vascular distribution
Evaluation of the vascular pattern of cervical lymph nodes has been reported to be highly reliable, with a repeatability of 85%[46]. On power Doppler ultrasound, approximately 90% of normal lymph nodes with a maximum transverse diameter greater than 5mm will show hilar vascularity[43]. Normal and reactive nodes usually show hilar vascularity, or appear apparently avascular[47-50]. However, peripheral or mixed vascularity (the presence of both hilar and peripheral vascularity) are common in metastatic nodes[47-49],[51],[52]. Therefore, the presence of peripheral vessels in lymph nodes is a useful indicator of malignancy (Fig. 5). The peripheral vascularity in metastatic nodes is believed to be related to tumour infiltration of the lymph nodes in which the tumour cells produce tumour angiogenetic factor (TAF), which causes angiogenesis and recruitment of peripheral vessels[47-49],[51]. Mixed vascularity is seen in malignant nodes because angiogenesis occurs and peripheral vessels are induced, but the pre-existing hilar vessels are preserved until they are destroyed by the tumour cells at a later stage[48].

Hopefully this helps, I will send an update whenever I hear from the ENT. Best of luck!
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replied March 27th, 2013
Well I'm not sure if anyone still utilizes this forum anymore but I figured I might as well give an update to my situation. I had my appointment with an ENT yesterday, he felt around on my neck and said it was at 2.5cm now, up from 1.5cm three weeks ago. He did an Endoscopy and didn't see anything in my nose or throat. He put in a referral for a FNAC so I should be getting a call about that here soon. Who here has experienced this type of biopsy? He assured me that it has a 98% sucess rate when it comes to finding anything cancerous in the lymph node. (I'm sure that depends on the skill of the person doing it, but apparently the place that I'm going to is pretty good)So we shall see!
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replied May 14th, 2013
Another update just incase anyone has similar symptoms. I had the biopsy about a month ago, and according to the doctor that was doing it, it appears to be bone. He was thinking maybe somewhere off of my spine. I talked to my ENT a couple weeks after that and he really didn't feel that it could be bone, so he ordered a CT scan with contrast. After some insurance screwups, I had the scan a little over a week ago and I'm now waiting on the results. I'll have another update here in a few weeks.
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replied May 17th, 2013
I have the exact same situation, with a about a 2cm node in that same spot.
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replied May 17th, 2013
To go into detail from my last post:

I am a 27 year old male, athletic, no history of health problems.

In Feb 2013 I had a large painfull cyst on the left side of my neck. I had tried to pop it with a needle (twice). It became pretty red and that side of my neck was a bit inflammed.

During this time I noticed that a posterior cervical node had enlarged directly below where I had stabbed the cyst (maybe 1-2cm below it). Maybe it had been there prior to the cyst but I am 95 percent sure it wasn't. I went to the DR, who gave me antibiotics. Two weeks later no change in the node, although the cyst had shrunk considerably to what it is today (not visible noticable, but I can still feel it). I had also noticed an enlarged node right where my chin and neck meet, on the same side. The dr felt it was connected to the cyst, but ordered an ultrasound to put me at ease.

The ultrasound report came back showing the two nodes that were enlarged that I already knew were there, an additional smaller node (1.2cm in between). The report indicated they appeared benign. The largest was the one where my chin and neck meet (2.2cm), and the posterior cervical node below where the cyst was measured about 1.8cm.

I was then told to just get another ultrasound in 6 months.

Being as I had other symptoms, fullness feeling under my chin on that side, feeling like it was strained, and sometimes low grade pain, I decided to see an ENT. Upon her evaluation, she prescribed more antibiotics and a 6 day course of steroids. Two weeks later, no change. She then ordered a needle biopsy of the largest node by my chin, and that came back indicating a reactive node. She then sent me on my way and said to come back in 4 months for a checkup, because I felt fine otherwise.

The sensation under my chin and enlarged nodes kept bothering me and was a source of constant anxiety that I went to see her again. She examined me and told me again to come back in 4 months or so. I also have been having an odd sensation belwo my tongue on the same side and a slightly enlarged salivary gland below the tongue. She said it could be an obstruction and told me to suck on sour stuff. She said if I wanted she could remove the posterior cervical node very easily if it was bothering me. I went out of her office not having scheduled it.

Having used chewing tababco for 4 years (I quit a few months ago), I was still anxious. A few days ago I saw an oral surgeon who did a very thorough inspection of my mouth and took a few x rays. He did not see anything wrong with my mouth and said there is nothing to operate on.

So here I stand now. I have decided to go ahead and get the node removed, as I view this as the final step. If it comes back normal, I will no longer worry about this crap that has been ruining my life for the past 3 months. I have spent 2,500 dollars in medical bills, which is my deductable on my insurance plan, so why not go ahead and get the biopsy now? The problem is I have to wait a week to hear back from the ENT scheduling people, then God knows how long before I can get the actual procedure done.

Up to this point I still feel fine. I feel like the node has been getting larger (posterior cervical one), but maybe it's from me touching it all the time? I am an avid weight lifter and go to the gym 5-6 times a week, and have been making continual progress as usual in terms of strength. I do know that in many cases of lymphoma there are no other symptoms besides swollen glands. I do grind my teeth like crazy and have been told by many dentists I need a mouth guard for when I sleep, I wonder if this could have anything to do with the odd sensations below my chin.

Please update with your progress.
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replied March 31st, 2014
Did either of you ever get a diagnosis? I am about to loose my mind, I have the same issue and have been to the ENT twice but he is telling me I need to go see a neurologist in a month. I have had a lot of sleepless nights since this started and I don't know how many more I can take.
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