Persistent Lymph Nodes: Concerns and Insights

Lymph nodes inside the right lower jaw?

Hello Doctor, in early December, I noticed a swollen lymph node on the inside of my right jaw that was painful.
I went to an ENT clinic for an examination, and the doctor diagnosed it as lymphadenitis and prescribed medication for three days.
After taking the medication for one day, the swelling decreased significantly, but I stopped taking the medication after the second day.
The lymph node has remained about the same size since then; sometimes it feels soft, and other times it feels hard.
I often check my neck and am very concerned about that lymph node next to my jaw, which is not visible externally and can only be felt by touch.
I stopped taking the medication, and later when I visited the hospital, an ENT resident examined me and said they couldn't feel anything abnormal.
The doctor, after examining me, said it was nothing to worry about and that the "lump" felt more like my artery.
However, I can still feel it myself.
There were no further tests or need for a biopsy, and I was advised to relax and not be overly anxious, as swollen lymph nodes are mostly normal.

Over the following month, the lymph node has maintained a similar size.
During this time, I did not take any medication.
Although the doctor said they couldn't feel anything, I could still feel that lump and often checked for it.
From early December to mid-February, the lymph node has not noticeably increased in size, but it hasn't disappeared either.
It doesn't hurt and is still there, but I wonder if it might be psychological.
Sometimes it feels hard, and sometimes it feels soft.
I frequently check that lymph node, and because I was so concerned, I went back to the ENT clinic for another examination and advice.
The doctor examined it and also said it didn't seem malignant, being less than one centimeter, and there was no need for a biopsy.
After I checked it myself, I felt that it might be smaller today, possibly because I have been on a five-day course of medication for a bladder infection.
I am wondering if the antibiotics or anti-inflammatory components in the bladder infection medication could have caused the lymph node to shrink a bit.
Is this what is referred to as fibrosis? Why do some lymph nodes disappear while others persist? I am really very concerned and often check it for no reason, and my own nervousness is causing me a lot of stress.
I frequently observe the lymph nodes in my body for any abnormalities, and the presence of that one lymph node has become a source of anxiety for me.
Thank you, Doctor.

chuang, 20~29 year old female. Ask Date: 2017/02/14

Dr. Chen Sirong reply Oncology

Chuang / 23 years old / Female
Hello,
1.
After self-examination, I feel that today's lymph node is smaller.

A: Malignant lymph nodes typically do not fluctuate in size; they tend to grow continuously.
2.
Could it be that the medication for my bladder infection contains antibiotics or anti-inflammatory components that have reduced my lymph node size?
A: Anti-inflammatory medications can cause lymph nodes to shrink, and it is not cancer.
3.
Is this what is referred to as fibrosis?
A: Some people say that.
4.
Why do some lymph nodes disappear while others remain?
A: It depends on individual constitution and recurrent infections.
5.
I am really very concerned and often check my lymph nodes for abnormalities, which is causing me a lot of stress due to my own anxiety...
The presence of that one lymph node has become a source of worry for me...
A: You should realize that this is not helpful; it’s important to accept it as part of your body.
If it grows significantly, then seek medical attention at Taoyuan Hospital, Dr.
Chen Si-Rong.

Reply Date: 2017/02/14

More Info

Understanding persistent lymph nodes can be a source of anxiety for many individuals, especially when they are accompanied by discomfort or changes in size. Your experience with the lymph node in your neck is not uncommon, and it's important to approach this situation with a balanced perspective.

Firstly, lymph nodes are an integral part of the immune system, acting as filters for harmful substances and playing a crucial role in the body's defense mechanisms. When lymph nodes become enlarged, it can often be due to various benign causes, such as infections, inflammation, or even stress. In your case, the initial diagnosis of lymphadenitis (inflammation of the lymph node) suggests that your body was responding to an infection, which is a normal immune response.

The fact that your lymph node decreased in size after starting medication is a positive sign, indicating that the inflammation was likely resolving. However, it's not unusual for lymph nodes to remain palpable even after they have decreased in size. The variability in how lymph nodes feel—sometimes soft and sometimes firm—can be attributed to changes in the surrounding tissue or the lymph node itself as it undergoes healing.

Your concern about the lymph node persisting in size and your tendency to frequently check it are understandable. Many people experience heightened anxiety about their health, especially when they feel a lump or swelling that wasn't there before. It's essential to remember that not all lymph nodes that remain palpable are indicative of a serious condition. In fact, many individuals have lymph nodes that can be felt but are entirely benign.

Regarding your question about whether the medication for your bladder infection could have influenced the size of the lymph node, it's plausible. Antibiotics and anti-inflammatory medications can help reduce inflammation throughout the body, including in lymph nodes. However, this does not necessarily mean that the lymph node has undergone fibrosis or permanent changes; rather, it may simply be a reflection of the ongoing immune response.

The phenomenon of some lymph nodes disappearing while others remain can be attributed to individual differences in immune responses, the nature of the initial stimulus (infection, inflammation, etc.), and even genetic factors. Some lymph nodes may react more vigorously to infections, leading to more significant enlargement, while others may not respond as dramatically.

It's also worth noting that the medical professionals you consulted have reassured you that the lymph node does not appear malignant, which is an important factor in alleviating your concerns. The absence of pain, significant enlargement, and the lack of other concerning symptoms are all reassuring signs.

If your anxiety about the lymph node continues to affect your quality of life, consider discussing this with your healthcare provider. They may recommend further imaging studies or a follow-up examination to provide additional reassurance. Cognitive-behavioral strategies or mindfulness techniques can also be beneficial in managing health-related anxiety.

In summary, while it's natural to be concerned about persistent lymph nodes, the information you have received from your healthcare providers suggests that your lymph node is likely benign. Regular monitoring and open communication with your healthcare team can help you manage your concerns effectively. Remember, your health is a journey, and it's okay to seek support along the way.

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