Dear Doctor, I am a forty year old female. During 1995 I had numerous sinus infections & headaches. Was put on antiotics throughout the year. Had allergy testing done and everything came up negative. Saw and ear, nose and throat who suggested septoplasy. Prior to surgery noticed a muscle which seemed to go out of place in my neck. After surgery I still had this prolem and was told I had a swollen lymph node which was 2 centimeters. Was given anti-inflamatory which helped reduce node. Had CAT scan and it determined that I did have swollen nodes. Doctor didn't think they would e cancerous. Surgery was done in Aug of '96. I still have feel something when I swallow. Nodes don't seem swollen yet they are still very evident to me. Also have noticed a slight pain in my ack etween shoulder lades. Could their e a connection. Plan on see my doctor this week. What are your thoughts??
Reply: ---------------
The most important initial issue in the evaluation and subsequent management of any lump in the neck is accurate clinical diagnosis. The most common cause of a new lump in the neck in both children and adults is inflammatory swelling of a lymph node, a manifestation of the human body's defense mechanism. Typically such inflammatory lymph node swelling occurs with obvious upper respiratory infections and the node or nodes are tender to touch. With resolution of the infection, the enlarged lymph nodes diminish in size and usually become non-palpable. Individuals who are prone to frequent upper respiratory infections may develop more chronic lymph node swelling because of the frequency of infection. In this case, the lymph nodes may be non-tender and may persist for months. In these cases the lymph node enlargement is predictable and explained easily by the overall clinical picture.
Non-tender lymph node enlargement, particularly in adults, when not easily explained on the basis of frequent or chronic upper respiratory infection, warrants consideration of biopsy. Furthermore certain other clinical characteristics may provide strong support for consideration of biopsy such as a long history of cigarette smoking, weight loss, heavy sweating during sleep, very large lymph node swelling (>3 or more centimeters), etc.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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