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lymphanode is hard but it is paining some time. reoccurance?

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Dear Doctor,

Sadly I was infected with TB in lymphanode in my left collar bone in 2007 dec and then underwent treatment for six months initially and then when the swelling did not sbside and grew further i continued the treatment for another three months so in all got treated for nine months with the prescribed drugs. at the end of seven months of treatment i was operated wherein the doctor carried out open drainage of the lymphanode and repeatd the same till it healed back to normal. I was back to fittness and remained so from mid Jun 2008 till Jan 2012.

Unfortunately in end jan 2012 i developed a problem in my tooth and underwent re-filling of an old cavity, this resulted in the swelling up of my lymphanode in a similar manner as it was earlier during its initial stages, now after 15 days since the swelling has reoccured i see the lymphanode growing slowly, but unlike previous instance although the lymphanode is hard but it is paining some time. Is it reoccurance?? Pl Help.


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replied February 18th, 2012
Tuberculosis Answer A31731
Hi, and thanks for your query on eHealth forum!

A tooth infection should not cause a lymph node to swell in your collar bone area. Yes, supraclavicular lymphadenopathy (lymphnode in area between collar bone and jaw) is worrisome. Especially the ones larger than 1cm in diameter should be investigated thoroughly for cancers and granulomatous diseases. The right supraclavicular area receives drainage from the organs in chest, whereas the left supraclavicular lymph nodes drain the abdomen. The supraclavicular lymph nodes also receive lymphatic drainage from the breasts. Hence the malignancies of these regions are possible. Tuberculosis, sarcoidosis, histoplasmosis, cat scratch disease and cryptococcosis are the other possibilities.

I understand the anxiety and since you have a history of tuberculosis, this should be ruled out first. A fine needle aspiration cytology should be done. Since it has probably recurred, it would be best to excise the lymph node, send it to biopsy and re-start anti-tubercular treatment after testing for sensitivity to anti-tubercular drugs. Since a confirmed diagnosis cannot be given on net please consult your doctor to find whether TB has recurred, and best mode of treatment. Hope this helps. Take care!



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