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Unilateral tonsil enlargement and enlarged lymph nodes

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Hi this is my first post and hoping for some answers!

I have had large lymph nodes on my neck for around a month. I was sent for a sonogram and they reported all lymph nodes on the right side of my neck to be inflamed. The right side was fine and my spleen showed no abnormalities. Although the right side was inflamed all were oval shaped and showed no obvious abnormalities.

I then noticed about a week ago that the tonsil on my right side (the same as the lymph node enlargement) is massively enlarged and is more than half way across my throat. The left side is perfectly normal and can barely be seen.

My doctor referred me to an ENT specialist who immediately ruled out tonsillar cancer as I am 26 (I find cancer being ruled out based purely on age quite worrying). He did say he had no idea what was wrong but it was not infected as it was smooth and clear. I also have had no chills or fever that I am aware of. He said that I should have another scan on my lymph nodes in 4-6 weeks an if they increase in size we will do a tonsillectomy. I asked what if the lymph nodes decrease and the tonsil stays enlarged and he said in that instance we would do nothing. This worries me very much.

I have blood test results due in 5 days to rule out Lymphoma and infections. Fingers crossed this all comes back fine. My question is, can you have a unilateral elarged tonsil for perfectly innocent reasons? It is about an inch and a half long and more than half way across my throat. The ENT doctor raised the possibility of me always having this enlarged tonsil bit it is so large I am sure I would have noticed it before and secondly it is slightly uncomrtable to swallow which I have never had before. Do you think I should ask for a second opinion? I would preferably have a tonsillectomy now than wait another 6 weeks or do nothing at all.

I would also add, just in case it is important, that I have a deviated septum on the same side of my head and no air can pass throught this nostril at all (and hasn't for about 20 years). Could this somehow be trapping mucus or causing inflamation of a tonsil? I find it strange that all my problems (nose, tonsil, lymph node) are on one side and nothing on the other.

Any opinions greatly appreciated (especially from Medical professionals or people who have had the same issues).

Thanks,

James
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First Helper User Profile NomadicBoo
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replied December 7th, 2009
I am intrested in your post because I have had unilateral swollen tender lymph nodes on the left side of my neck. With slight discomfort when swallowing and a tight feeling in my tracheal region. I have had pain in the left side of my neck for at least a month now and recently went to my physician for a check-up. I waited 3 hours to see my doctor and ended-up being examined by an inexperienced Physician's assistant who came in the room and immediately told me he was placing me on antibiotics for strept throat. There are several things wrong with this. #1 I had no throat culture/strept test, #2 I have unilateral pain and swelling in my neck which is NOT associated with strept (normally bilateral), #3 I do not have a sore throat, only difficomfort when swallowing. This guy has no idea he could easily be sued for malpractice, a major problem with health care is the constant push for antibiotics when no diagnostic testing confirms the exact cause of a condition, thus leading to tolerance of infectious organisms like MRSA and strains of the flu that cannot be treated by normal antibiotic therapy. I am a student nurse aspiring to become a nurse practitioner. My best suggesting is to see a GI specialist. Standard practice physicians can tell you what they "think" but without supporting evidence, such as a CT scan or MRI, an accurate diagnosis is not likely. Please reply if you discover your problem.
- Thanks
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replied April 19th, 2011
While I agree with your post and the majority of what you said, I just want to point out that the flu is a viral infection, and thus can not be treated with antibiotics.
That said, you are absolutely correct about the troubling nature of your PA treating without testing. A strep test is a simple ELISA that takes only a few minutes, so there's no excuse for not doing it.
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replied December 21st, 2009
1. Your doctor should not have ruled out cancer just do to age. Unilateral tonsillar enlargement may be a sign of lymphoma at ANY age; although, it is rare in general and less common at your age. Also, the lack of abnormalities in shape or texture would make this seem less likely.
2. Yes, there are several causes that could lead to one of your tonsils being enlarged that are generally of little to no concern. Allergies, tension, infections, or even excess sinus drainage over the tonsil may cause your symptoms. It may also be possible for your tonsil/tonsils and lymph nodes to stay swollen for as much as 3 months after an infection. Also, there are genetic issues that can cause them to enlarge on their own, and there are some cases of benign tumors growing that are of no real consideration as long as they don't impede the function of the throat.
3. Regardless of the cause of the enlargement you should be able to have your tonsils removed if they are causing any of the following symptoms; sleep apnea (severe snoring with occasions where you stop breathing in your sleep), excessive difficulty swallowing, or breathing complications in general.
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replied January 11th, 2010
Hi. Thanks for the responses.

Just to keep everyone filled in, I had an appointment and blodd tests with a doctor which all came back ok. He felt it warranted further investigation and sent me to a specialist.

Appointment at specialist today, 4 blood tests and a sample for biopsy from one of the lymph nodes. I get the results in one week.

As soon as I find anything out I will post back. Cheers.
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replied January 20th, 2010
So results came back inconclusive. I am having a tonsillectomy on Tuesday (in 6 days) and then I have to wait a further week for the results.
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replied February 1st, 2010
Ok just recieved results and I have Hodgkins Lymphoma. Please, whoever is reading this and has one swollen tonsil, don't let the doctors get away with fobbing you off. I was told I had EBV, Mono, chronic infection and waited for 5 months. Now they have finally diagnosed cancer.
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replied February 27th, 2010
Same scenario! Swollen tonsil and lymph node.
I am a 34 yr. old female and I am going through the same scenario. Noticed a swollen clavicular node about 6 months ago. It was movable and kind of squishy. I told my doctor, he ordered a CT of the neck. The node showed up on the scan, but the Dr. chose not to pursue it. My blood work all came back normal. Just to ease my mind, he ordered a course of antibiotics. They did nothing. I have been VERY fatigued for the last 7-8 months. And my joints have been aching. I was sent to a rheumotologists who said I have fibromyalgia. Yet, I don't have any of the "trigger points" associated with it. So about 3 months ago I noticed that I have a hard swollen node behind my right ear....about the size of an M&M. I also noticed one on the back of my head and one on the left side (near the back) of my head. Both hard and fixed. My right tonsil is also swollen. I pointed them out to my Dr. and he is now sending me to an oncologist. He asked me if I have a history if lymphoma in my family. Does he suspect cancer?
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replied March 2nd, 2010
hey brightlite28, i'm curious how swollen your tonsil is? i've got a similar thing going on (couple palpable lymph nodes in neck and a slightly enlarged tonsil) but i just got done with like six consecutive bouts with group a strep. my right tonsil is visibly bigger than the other but its only by about half a centimeter. how far into your throat is yours jutting out?
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replied March 2nd, 2010
Hi tpain- It is probably about the size of a grape..with no swelling of the other tonsil at all. The other tonsil is flat against my throat. Unlike you though, I have not had any recent infections. Not even a sinus infection. I have also noticed a hard swollen node under my chin...but only on one side...the same side as the other swollen glands. That is what scares me the most is that is is unilateral. If it were generalized swelling or if the nodes were painful, i wouldn't be so worried. My oncologist appointment is on Friday. I will let you know what I find out. Have you been to the doctor and asked about you tonsil? Do your lymph nodes move when you push on them? Do they hurt at all?
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replied March 3rd, 2010
to answer your questions, i saw an ENT doctor because of the recurrent strep infections i had. it was a referral from my university health center. about a week before the ENT appointment i got a fever and a sore throat and the throat looked pretty strep-esque, except my right tonsil was the only one swollen. both had the white spots characteristic of throat infections though. after a week or two the swelling went down but the right tonsils still a bit bigger. ENT wanted to keep track of the tonsil and i have a follow up appointment scheduled for sometime next week.

as for my lymph nodes, theres one on both sides that is palpable. the one on the same side as the tonsil is higher up on my neck than the other, but both are on the back of my neck, sort of under the ear. they move around when i play with them and feel sort of soft and rubbery. they're not painful, though. like maybe a little tender when i touch them but otherwise they're not noticeable.
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replied March 6th, 2010
So, I went to the oncologists. She found an additional swollen lymph node under my arm. So, I am seeing the surgeon next week to have several of them excised. I will fill you in when I get the biopsy results.
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replied March 15th, 2010
I'm 14 years old, female. I have had 1 swollen tonsil on my right side since grade 6. I'm in grade 9 now. I watched it grow over a course of a couple days back in grade 6, and it hasn't changed since then.

I also have LOTS of swollen lymph nodes in my neck. They're all moveable and rubbery. They aren't noticeable to the eye. I noticed them about a year ago.

Otherwise, I'm healthy and have no other symptoms.

Reading this scares me.. should I be worried? ;|
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replied March 18th, 2010
Lindaa- Have you told your parents? I think that is the first step if you haven't already. Ask them to take you to the doctor to be checked out. Chances are, it is nothing, but it is better to be safe. I hope it all turns out well for you.

As for me, I had surgery on Monday. The surgeon intended to remove a large swollen node from my armpit but found that several other nodes were stuck to it. So he removed multiple nodes. That kid of scares me. Still no results, but I will know within a few days. The waiting is killing me!
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replied May 20th, 2010
Wow..
NomadicBoo wrote:
Ok just recieved results and I have Hodgkins Lymphoma. Please, whoever is reading this and has one swollen tonsil, don't let the doctors get away with fobbing you off. I was told I had EBV, Mono, chronic infection and waited for 5 months. Now they have finally diagnosed cancer.

Thank you for coming back to update. Hopefully you are doing well and all is ok! Take care of yourself and thank you for telling us your results. PRaying for you!
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replied September 6th, 2010
NomadicBoo wrote:
Ok just recieved results and I have Hodgkins Lymphoma. Please, whoever is reading this and has one swollen tonsil, don't let the doctors get away with fobbing you off. I was told I had EBV, Mono, chronic infection and waited for 5 months. Now they have finally diagnosed cancer.


Thank-you for keeping everyone updated about your situation, especially as you had such difficult news to deal with. I see your last post was quite a while ago now and I just wanted to say that I hope you're OK and that you're on the road to recovery.x
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replied December 1st, 2012
Hi all ive been having some ent problem now for the past year, its been such a horrific rollercoaster im at my wits end.. It started feeling like i always had a lump in my throat, docs suspected acid reflux and put me on nexium 40mg daily, that didnt work so i had an endoscopy which showed no inflammation of the esophugus etc, my symptoms got worse so docs put it down to stress and said i had a globus sensation.. after a few months of this my tonsil started really paining me and my right ear throbbed i also had neck pain and was stiff. went to ent casualty where i met an extremely rude doctor, he used a scope and said there was nothing wrong with me, 2 months later swollen lymph nodes came up on my neck and i got a bit freaked, i had a follow up wit ent and the second doctor said my tonsil was way too big that i needed a biopsy done.. on november 9th i went for another scope no biopsy and it showed my adenoids were severely swollen, along with my tonsil and my right ear is blocked with fluid.. i am going for a ct scan dis monday coming and im terrified of this being hodgkins lymphoma or tonsil lymphoma or thyroid cancer? anyone got similar symptoms? im 25 years old and i really have never felt as scared or disturbed by a sickness in all my life..
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replied December 1st, 2012
Hi all ive been having some ent problem now for the past year, its been such a horrific rollercoaster im at my wits end.. It started feeling like i always had a lump in my throat, docs suspected acid reflux and put me on nexium 40mg daily, that didnt work so i had an endoscopy which showed no inflammation of the esophugus etc, my symptoms got worse so docs put it down to stress and said i had a globus sensation.. after a few months of this my tonsil started really paining me and my right ear throbbed i also had neck pain and was stiff. went to ent casualty where i met an extremely rude doctor, he used a scope and said there was nothing wrong with me, 2 months later swollen lymph nodes came up on my neck and i got a bit freaked, i had a follow up wit ent and the second doctor said my tonsil was way too big that i needed a biopsy done.. on november 9th i went for another scope no biopsy and it showed my adenoids were severely swollen, along with my tonsil and my right ear is blocked with fluid.. i am going for a ct scan dis monday coming and im terrified of this being hodgkins lymphoma or tonsil lymphoma or thyroid cancer? anyone got similar symptoms? im 25 years old and i really have never felt as scared or disturbed by a sickness in all my life..
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