Doctor- I have had several small, hard lymph nodes located on the left, lower portion of my neck and collar bone for at least 2 months. I have seen a GP who at first stated a MRI or CT may be required. However, upon my return for a follow up appointment, the doctor stated that I should not be concerned and he believes that the lymph nodes do not "feel" like anything serious, (ie. cancer), due in part to the fact they have not changed in size. Blood work and a chest x-ray were done. The doctor explained that he believes the lymph nodes on the left side of my neck are easily detectable, as opposed to the nodes on my right side of my neck, because the muscle on the right side is covering the nodes. Is it common for the nodes to differ depending on which side of the neck they are located, and would you recomend that I obtain a 2nd opinion? Thank you!
Reply: -------------------------------
Not all palpable lymph nodes require biopsy. Often small non-pathologic lymph nodes may be felt in individuals with thin necks or in certain areas of the neck where there is less musculature. Generally speaking, the index of suspicion for serious disorders associated with lymph node enlargement which warrant biopsy is raised when there are non-tender, firm to hard lymph nodes of significant size (usually > than 2cm), that have been present for more than a month and have occurred (or persisted) in the absence of an ongoing or recent (past 3-4 weeks) upper respiratory infection. In addition to these basic characteristics, there are many other factors that may enter into the decision as to whether or not a biopsy might be recommended including the exact location of the lymph node, the presence of certain risk factors such as cigarette smoking, recent unexplained weight loss, night sweats, unexplained fevers, etc. If you do not feel comfortable with the recommendation of your physician, you might consider a second opinion from an otolaryngologist.
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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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