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Lymphoma or anxiety

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Dear Doctor,

My case: Before Christmas (aprox. 15th December) I discovered two swollen lymph nodes, one on each side of my neck. Not very big, just the size of a pea, but quite hard, one can move them and have not been there before. Visited my family doctor and said it was nothing to be worried about. However, I am quite a hypochondriac and it ruined my Christmas feelings.
By avoiding to touch them, one of them disappeared, the other one still there. And, to make things worse, my tonsil on the same side suddenly swollen (approx. 30th December). As I am not specially happy with my family doctor, I proceeded directly to the Nose, Ear and Mouth Doctor (is it called like this in english? Very Happy) and he had to clean the ear on that side as it was totally closed. For the swollen tonsil, as it had no white spots visible, just gave me some pain caramels for the case that throath pain comes. "Might be a virus, don't worry, it will be over in 10 days".
Today is January the 26th and the tonsil has the same size (and the down-neck node still there, less than 1 cm). In the morning I have noticed that the veins on the back of my mouth are very red and visible. In the last week it has get worse, since I also suffer from headaches every day (especially early morning and late afternoon), I sleep very poorly, waking up almost every hour and sometimes having night sweats and bad dreams. Other medical checks:
-Blood test, everything perfect, no elevated lymphocytes or liver/kidney parameters.
-Tonsil sample for culture: nothing came out, no bacteria or similar.

I also have a sharp pain that goes from behind my ear (same side as swollen nodes) down the muscle of my neck, which is pretty painful. And also discover myself to press my teeth often during the day (are these two things and the headache maybe linked?).
It is a very stupid situation, when my "rational" brain thinks about it, is clear to me that is almost impossible that four different doctor miss a mortal disease, but you know how this goes, the problem is that the irrational brain is very powerful.
My doctor ordered today (I think he is as tired as me) to be sure, two more checks:
-Magnetic resonance of head, to look after those headaches.
-Visit to the orthopedist to look after the neck pain.

I would be very grateful if you give me your opinion about my case.

Many thanks in advance!
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replied January 30th, 2011
Lymphoma typically causes painless (and progressive) enlargement of one or more lymph nodes. On the other hand, tender, painful lymph nodes are usually caused by infection or inflammation.

Unfortunately, it is not possible to provide a specific diagnosis over the Internet to patients with concerns regarding enlarged lymph nodes. Therefore, my advice is for you to see your doctor for an examination. If you have persistently enlarged lymph nodes (and especially if they continue to enlarge), then a biopsy may become necessary to rule-out lymphoma, or other cancers involving the lymph nodes.


Robert A. Wascher, MD, FACS

Author, "A Cancer Prevention Guide for the Human Race" (2010)

A landmark, evidence-based guide to a healthy cancer-prevention lifestyle, based on cutting-edge cancer research.
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