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Is Enlarged Lymph Nodes Along Trachea In Chest X Ray Caused Due To Bronchitis?

Posted on Thu, 16 Jan 2014

Question: Hi, I had bronchitis that was treated with antibiotics (therapy completed about 17 days ago) still have dry cough (6 weeks of cough) with some clear phlegm and SOB at times. Today I found enlarged lymph nodes on the Left side oy my neck. Did the ultrasound that confirmed lymphadenopathy. Also did CXR and that showed enlarged lymph nodes along trachea but not hilar.Will se pulmologist soon. Could this be just related to bronchitis or something more serious. Thank you

Answered by Dr. Luchuo Engelbert Bain (49 minutes later)

Brief Answer: No worries as yet. Need monitoring. Detailed Answer: Hi and thanks for the query, It should not in any case cause any panic. Any acute inflammatory process, like an infection as in your case, can cause lymph node enlargement. However, it is important to know if you were experiencing other respiratory signs and symptoms before this specific incident. It is most probable that the lymph node enlargement be simply due to the infection. The most important aspect in your care at this point in time is monitoring. It is advised in my humble opinion, that the ultrasound, or CT scan be carried out after a couple of weeks to track the evolution of the lymph nodes. Under normal circumstances, the sizes should decrease. Should they persist, or increase in size, an in depth evaluation might be required. I really do not think you have to bother much at this point in time. I appreciate the fact that you got an appointment with a pulmonologist. No need to panic for real for now. Please, do feel free asking further questions in case of need. The most important aspect in your care now remains clinical and radiologic (ultrasound/ct scan) monitoring. Thanks and kind regards as I wish you the best of health. Dr Bain

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Luchuo Engelbert Bain (29 minutes later)

Thank you very much. Feel much better now. Before developing cough, about 6 weeks ago no other respiratory problems.My concern was that I did receive antibiotics for acute bronchitis and was thinking that 2 weeks after finishing antibiotic th lymph nodes should not be swollen anymore and was actualy scared that more than just one was swollen. Hopefully everything is going to be well. Thank you again, all the best. Hi Dr.Bain, hoping wou will se this message. I did Blood work today, my ESR is 56, CRP 68, WBC 9.62, HGB 112,LYMPH 1.29, MONO 0.59, EO 0.52, IG 0.05. Had my app with pulmologist, she is suggesting CT thorax, possible bronchoscopy and biopsy of lymph nodes. I am apsolutely terrified. I knew that lymph nodes can signs of maligncy but hearing today just broke me into pieces. Any advice from you? Thank you from the bottom of my heart. Also they are thinking Sarcoidosis as I did have some skin rash before. Does the largest neck node fit into that idea? My understanding that with sarcoidosis lympnode are located in the chest only. My neck node is moveabale. Thak you

Answered by Dr. Luchuo Engelbert Bain (2 days later)

Brief Answer: No worries for now. Detailed Answer: Hi and thanks for the query, I agree with the fact that lymph nodes normally had to decrease in size, but not disappearing immediately or so fast. They do need some time to do so. I am afraid it is difficult to start thinking of sarcoidosis in a context with an evident cause of lymph node enlargement. Despite a history of a rash, I do humbly think it is more logical to stay calm, and only start working on the hypothesis of sarcoidosis if the lymph nodes fail to reduce with time. It might be prudent to do a control X ray and Ct scan in a month's time in case you are too worried, and to be pretty sure. Thanks and kind regards as I wish you the best of health. DR Bain

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Luchuo Engelbert Bain (28 hours later)

Unfortunately, today's CT-chest showed massive mediastinal lymphadenopathy and I was told that this is likely Lymphoma.

Answered by Dr. Luchuo Engelbert Bain (1 hour later)

Brief Answer: Immediate evaluation of mass and management Detailed Answer: Hi and thanks for the query, It might be necessary at this point to get an aggressive evaluation to ascertain the exact nature of the mediastinal mass. It could of course be a lymphoma. Other causes like sarcoidosis should also be borne in mind. Bronchoscopy, biopsy under special conditions could be important for histologic analysis to ascertain the exact nature of the tumor. The opinion of a cardiothoracic surgeon for any probable biopsy and your internist/cancerologist would be most appropriate. Early management of course would yield better results. Thanks and kind regards as I wish you the best of health. Dr Bain

Above answer was peer-reviewed by : Dr. Raju A.T