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Swollen gland in submandibular region

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I am 39 years old. What are the likely causes of a swollen gland or lymph node in the submandibular region of the neck present for over ten years? The swollen lump is roughly 2cm squared, a little lumpy, very firm, palpable, is pretty stationary in position and is tender when pressed on. My past medical procedures include removal of tonsils and adnoids at age 12 due to chronic inner ear infection and tonsilitis, and wisdon teeth removed at age 19. The lump will swell slightly when I am fighting an infection but never recedes back to a nomal size. So over the years it has increased slightly in size after tough boughts of sickness.

The same area on the other side of my neck is slightly swollen and hard, kind of lumpy but roughly 1.25 cm squared and has also been present for a long time; 10+ years. Is cancer a likely outcome based on my medical history, leanth of time symptoms have been present and lack of any other symptoms? Your thoughts and answers are greatly appreciated.

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replied July 18th, 2009
Lymphoma Answer A6959
It is, of course, not possible (or prudent) to try and make a diagnosis over the Internet. As a general response, however, I can say that there are many lymph nodes located in the neck, just beneath the skin. When an infection occurs, these lymph nodes may become enlarged and tender. After the infection resolves, these acute reactive changes in the lymph nodes usually slowly recede over a period of a few weeks, In some cases, the lymph nodes may remain mildly enlarged and firm for a much longer period of time, however. Also, in patients who have chronic low-level infections (especially in the head, oral cavity, or neck areas), the cervical lymph nodes may remain chronically enlarged and/or tender.

Obviously, chronically enlarged lymph nodes, anywhere in the body, raise the concern of a possible cancer (either a primary cancer of the lymph nodes themselves, which is called lymphoma, or the spread of cancer to the lymph nodes from some other site). In most such cases, however, the lymph nodes will continue to significantly enlarge if such cancers are not treated.

While your history is more suggestive of a benign reactive process involving your cervical lymph nodes, as I am unable to examine you, you should see your personal physician for further evalaution. If he/she has concerns about these enlarged lymph nodes, then you should be referred to an ENT physician or a General Surgeon for further evaluation.

Sincerely/ Robert A. Wascher, MD, FACS

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