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Forum Name: Lymphoma

Question: Lymphadenopathy or normal size?


 Medstud - Fri Jul 06, 2007 6:12 pm

Hi all,

I am a 19 years old student (male), non-smoker and non-drinker.
no history of lymphoma in my family, leukemia in one extended member and breast cancer in another. That's about it.

Being the worried 1at year medical student that I am, I choose to study structures on myself etc. I recently ( april 13th came down with a viral infection that was thought to be some sort of allergies since my phlegm was clear. I noticed that I have palpable lymph nodes on both sides of my neck, on my left side I have a string of lymph nodes running down ( size 3-4mm, and mobile and soft). On the right side I have 2 lymph nodes also posterior cervical family, and one jugular lymph node at the base of my neck. ( all of them are <1 cm , soft and mobile). Then i developed a 2nd viral infection ( doctor thought it was viral I still think it was bacterial, nonetheless..it was stronger, sore throat and dry cough at night, with dark yellow phlegm ) that one cleared up, and I decided to probe my supracalvicular nodes (BIG MISTAKE!!) initially if i am performing a normal physical they are not palpable, however when i strain my neck hard enough and move all my muscles above the clavicle ( and take the most awkward position possible) I can feel one on the left side <1 cm softer than all my other nodes combined and extremely mobile ( which is why I questioned if it was indeed a supraclavicular node, might be a lipoma or cyst due to my bag strap)

Now I am very well informed about the supraclavicular nodes, so it freaks me out that I can feel them. I have alot of viral infections throughout the year and i have been like that all my life, and also at the age of 13 had a major infection in one of my leg wounds ( 10 stitches and wound contamination) , so i am assuming that i am generally one of the people that can feel most of their lymph nodes. Of course I can feel my inguinal lymph nodes.

my questions are:

1) Can healthy individuals have palpable supraclavicular lymph nodes after an infection? because I think my infection cleared up at the end of may, but i can still feel most of them ( cervical ones seem smaller but not much of difference) my left supraclavicular seems softer and more mobile.

2) should I have my supraclavicular node checked on?, i recently had an X-ray before i noticed it. may 4th and the X-ray was clear. However i am just paranoid that it might be something serious that managed to metastasize in a month.

The summary:

1) they are all <1cm, soft and mobile ( the groin ones are slightly firmer but this possibly due to my leg infection that I had years back)

2) I am known to have large lymph nodes, when i was a child I had a viral infection and caused 2 lymph nodes to enlarge and they deflated to about 1.5cm in both sides of my jaw and it has been 8 years now with the same size and consistency.

Any other symptoms, I don't have night sweats or weight lose or body fever, however I do feel hot ( possibly attributed to dehydration) I recently literally 4 weeks ago had a blood test ( CBC count, liver and kidney function, TSH, randomized glucose and iron levels) everything turned out perfectly normal.

One thing I might add is that due to the heat, i developed a rash-like-pustule looking dots on my chest and clavicular area, so that might be a reason why.

Anyways, sorry for the long rant..I just need to know if its okay or not.
Thanks in advanced =).
 Dr. Tamer Fouad - Sat Jul 07, 2007 2:15 pm

User avatar Hi,

You may want to check on our cervical lymph node page. Click here!
This page has a section about supraclavicular lymph node enlargement.

Following infection, lymph nodes occasionally remain permanently enlarged, though they should be non-tender, small (less the 1 cm), have a rubbery consistency and none of the characteristics described for malignancy or for infection. These are also known as 'Shotty Lymph nodes'.

Nodes are generally considered to be normal if they are up to 1 cm in diameter.

Another point to take into consideration: In the primary care settings, patients 40 years of age and older with unexplained lymphadenopathy have about a 4 percent risk of cancer versus a 0.4 percent risk in patients younger than age 40.

However, I strongly recommend being evaluated by your physician. This information does not constitute an assessment of your condition.

Best regards,
 Medstud - Sat Jul 07, 2007 10:38 pm

Hi Dr. Tamer,

Thanks for the fast reply, I did consult my doctor regarding feeling hot, she ran all tests and didn't find anything abnormal. All doctors feel my neck and never find any nodes, so going for another visit to tell them about lymph nodes that are only felt by me will only warrant a referral to a psychiatrist for being an obsessive hypochondriac.

I do of course know the omen behind virchow's node, however due to the structure/mobility/ and feel of this lymph node I am not 100% worried. its <1cm, soft and mobile ( could it still be cancerous even with those properties?)

Also are nodes that are <1cm in supraclavicular area normal in general ? will viral infections make these node swell like other nodes?

is there anything that is worrisome in my situation?

cheers!
dave
 Medstud - Wed Jul 11, 2007 8:56 pm

Any doctor out there?
 debmatt - Thu Jul 12, 2007 11:22 am

MedStud,

In your studies, is it "normal" to be able to feel small squishy lymph nodes on the sides of the neck. Small I mean less than or equal to 1 cm.

Deb
 Medstud - Thu Jul 12, 2007 1:56 pm

It is very normal to have nodes on your neck that are < = 1cm. Especially in the anterior cervical chain.The fact that they are soft is in favour of benign condition. side of the neck is a very general term ( iam assuming you're either talking about the posterior or jugular chains)

cheers!
 debmatt - Thu Jul 12, 2007 3:53 pm

Yes, it is the chain you described. I can feel one on each side of my neck but it is small and squishy. I have always been scared I may have lymphoma but have not had any other symptoms. I definetely have a great energy level. I guess I should not worry anymore.
Thanks for your input it helps put me at ease.

Cheers to you!
 Medstud - Sun Aug 19, 2007 8:51 am

I have a question for the doctors,

when it comes to supraclavicular lymph nodes, why is it that they are not palpable? They are clearly present in your body just like all nodes, So why is it that you shouldn't feel them?

with regards to my update, there is no change in my cervical nodes. My left supraclvicular lymph node is thinner and softer.
 Dr. Tamer Fouad - Sun Aug 19, 2007 9:26 pm

User avatar Hello Medstud,

Normally you shouldn't feel any nodes, supraclavicular lymph nodes included. If they are palpable then they are either pathological lymph node or have been pathological at one stage. An example of the latter would be the shotty lymph nodes mentioned previously.
 Medstud - Tue Aug 21, 2007 2:31 pm

From your experience doctor would you consider a pea/BB-sized supraclavicular lymph node to be shotty ( soft, pretty mobile) ? Especially that I noticed it after an upper viral infection?
 debmatt - Tue Aug 21, 2007 3:55 pm

Also,

What about small moveable node on the side of your neck. In the jugular chain?

Deb
 Dr. Tamer Fouad - Tue Aug 21, 2007 4:49 pm

User avatar Shotty lymph nodes can appear anywhere. They are usually less than one centimeter in diameter and appear after an infection as you have said.

Please note that I cannot comment on your lymph nodes since I have not examined either of you and I am depending on your description which may or may not differ their actual condition. As always you are advsied to see a doctor in person to evaluate your condion.
 Medstud - Wed Oct 31, 2007 6:55 pm

Hey all,

I thought I would update: I did blood work and the results are
TEST NAME NORMAL ABNORMAL REFERENCE UNITS Comment

SGPT (ALT)
ALT 21 4-43 U/L F

PHOSPHATASE ALKALINE
ALK PHOS 76 30-110 U/L F

COMPLETE BLOOD COUNT
HEMOGLOBIN 157 135-180 G/L F
HEMATOCRIT 0.460 0.37-0.54 L/L F
WBC COUNT 8.4 4.0-11.0 X10 9/L F
RBC COUNT 4.95 4.50-6.50 X10 12/L F
MCV 92.9 80-97 FL F
MCH 31.7 27.0-32.0 PG F
MCHC 342 320-360 G/L F
RDW 13.3 11.0-14.5 % F
PLATELET COUNT 281 150-400 X10 9/L F
ABSOLUTE: NEUTROS 5.6 2.0-7.5 X10 9/L F
(A) LYMPH 2.1 1.1-3.3 X10 9/L F
(A) MONO 0.5 0.0-0.8 X10 9/L F
(A) EOS 0.2 0.0-0.5 X10 9/L F
(A) BASO 0.1 0.0-0.2 X10 9/L F

This was for the lymph node I have in my left supraclvicular area, around 1 cm ( bean shaped), and very soft and very mobile it roles towards my trapezius muscle at times. So what would be the next step? I have no other symptoms, and my other nodes in my body are the same size, this one however is much softer ( feels like a sac of fluid) so I think it might be cystic, and extremely mobile ( does this make it sound like its anotehr case of reactive hyperplasia ? )

thanks.
 debmatt - Thu Nov 01, 2007 10:59 am

Medstud,

Since I am not in the medical industry can you tell me what about your blood work was abnormal. Has this bean shaped node grown?

Debbie
 Medstud - Thu Nov 01, 2007 6:26 pm

Nothing is abnormal, my white blood count is avearge, and my RBC count is also normal. Lymphocytes and neutrophils are within a good range and no indication of any infection.

My node has not grown since june. It has become softer however.
 Medstud - Fri Nov 02, 2007 7:00 pm

I would love if any doctor can give me advice on my current status, as you can see from the CBC everything is normal, liver functions ( and previous kidney and TSH are normal) and my WBC count is average, and everything is just in order. The node is extremely slippery/smooth surface and soft to touch ( half a kidney bean, 1cm) very mobile and truly feels different than my other nodes ( it feels like it does not have a solid core, more like liquid filled) found above the collar bone, very edge near ( usually hides in my trapezious muscle )

Dr. Chan or Dr. Tamer any suggestions?

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