Suggest Treatment For Enlarged Lymph Nodes And Sore Throat

Posted on Sat, 10 Jun 2017

Question: Hi,

I have been having enlarged lymph nodes for a few months now.

1. Started about 2-3 months with a single semi tender node in the right inguinal area. This node waxes and wanes according to weather and time of day. About 1 cm in size

2. I have some other tender and matted nodes around the node mentioned in 1. All appear between 1-2cm. These nodes are slightly painful to touch

3. On the left inguinal side, I have a single tender node about 2cm.

4. After a month since the above, I discovered enlarged nodes on my neck and under my jaw. The ones on the jaw and vertical portion of the neck are smaller ( less than 1cm) and tender and sometimes slightly painful touch

5. I also have enlarged Virchow's nodes on the left side, which is about 1-1.5 cm each. This node waxes and wanes as well. The node is tender and sometimes slightly painful to touch

6. All nodes that I have discovered are movable.

7. Apart from sore throat when I first discovered the nodes, I haven't had any symptoms

8. I have had a course of amoxicillin, no significant reduction in size of the nodes

Should I be immediately concerned? Also, should I be particularly concerned about the Virchow's node, or the node in the inguinal area that's not as tender as the rest? Additionally, is the lack of any symptoms concerning?

Thank you very much

Answered by Dr. Deepak Sundriyal (1 hour later)

Brief Answer:
You'll require evaluation only if the size is big

Detailed Answer:
Hello dear. I have gone through the details.

So, you have all nodes less than 2cm, hence there is a little reason to believe them disease related unless they increase in size, or associated with fever, weight loss or night sweats.

There is only one other condition in which such picture can arise, i.e. HIV infection. But if you didn't have unprotected intercourse/any other risky exposure, then again no need to worry.

Relax. Just observe them.

Feel free to ask further.
Thanks and regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Deepak Sundriyal (3 hours later)

Thank you very much. Here I have mentioned the diameter/width of the nodes. I think there are one or two nodes which has length of around 2-2.5cm .

Regarding the Virchow's node, I have read that even a minor increase in size is sometimes concerning. Is that the case?

I haven't had any risky exposure. I was just wondering about the symptoms since the increase in the node sizes doesn't seem to have any underlying causes that I can trace.

Thank you very much for the help

Answered by Dr. Deepak Sundriyal (4 hours later)

Brief Answer:
Hello dear. Just wait and watch

Detailed Answer:
Hello dear. Even if a node us 2.5 cm, just watch ut fr increase in size. Meanwhile you can have a serum LDH test done which is an independent marker for lymphoma. If the node increase in size then a biopsy is required. It is difficult to palpate a 1 cm virchows node. Only an expert physician can do that and it should be strictly a virchows node. Even in that case it can be tuberculous also and again a biopsy will tell the diagnosis.
Thanks and regards
Feel free to ask further

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Deepak Sundriyal (45 minutes later)

Thank you very much. One final thing, if the nodes are relatively soft/tender apart from that one inguinal node which is semi tender, this means there is not much cause for concern, regardless of the size?

Answered by Dr. Deepak Sundriyal (3 minutes later)

Brief Answer:
No, it is not true

Detailed Answer:
Hello. Hardness or softness or pain is not a reliable marker for diseased nodes.
Thanks and regards

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Deepak Sundriyal (21 hours later)

Thank you. I have also just noticed a 1cm length 0.5cm width node behind my left year. Additional point I had forgotten to mention earlier, I am someone who is prone to acne on my face and body frequently. Does this particularly affect anything?

Answered by Dr. Deepak Sundriyal (2 minutes later)

Brief Answer:
Hello. Yes, so this can also cause enlarged nodes

Detailed Answer:
Hello. So acne infections sometimes can cause nodes on head and behind ear. But not on other part of body. Still relax and just observe.
Thanks and regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Deepak Sundriyal (2 days later)

Hi,

Just wanted to follow up on one thing. I am now feeling what feels like multiple clumps of tissues/ muscles of different shapes and sizes ( none too big) on the upper part of my chest, especially near the clavicles. They are soft and fairly movable and seem to be primarily attached to the skin and not the chest wall. I am not sure if I am feeling existing muscles or veins

Another reason I think these are attached to the skin is because there is once such lump in the area between the two clavicles thats very movable. Could these be fatty lumps under the skin?

Upon further examination some of it appears to be some kind of fatty lumps (probably) which are slightly painful to touch and others appear to be normal veins/vessels which are probably slightly enlarged.

Just another point to add, this could also be the case around the other lymph nodes, but I am probably feeling this only around the upper chest because I am thin in that area.

Answered by Dr. Deepak Sundriyal (19 hours later)

Brief Answer:
Hello dear. A clinical examination is. Must

Detailed Answer:
Hello dear.
So if you are feeling multiple clumps, then you require clinical examination by a doctor. Of course you could not palpate muscles, and vessels dont feel like clumps. Most likely cause will be lipoma as you said.
Thanks and regards

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

Follow up: Dr. Deepak Sundriyal (59 minutes later)

Thank you, the reason I thought these might be vessels are because there are vessel like structures that continue from the area of these clumps. Also, no changes on the skin surface can be seen

Answered by Dr. Deepak Sundriyal (12 minutes later)

Brief Answer:
Hello. It might be vessels.

Detailed Answer:
Hello. Yes, they might be vessels, you can send a pic for more information.
Thanks and regards

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

Follow up: Dr. Deepak Sundriyal (29 minutes later)

Thank you, I am unable to take a pic now but the skin is not raised nor are any vessels visible. I feel these clumps only when I palpate. Some of them are painful

Answered by Dr. Deepak Sundriyal (3 minutes later)

Brief Answer:
Hello. Just keep relaxed

Detailed Answer:
hello. No need to worry. You will be fine.
Thanks

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Above answer was peer-reviewed by : Dr. Prasad