Persistent Lymph Nodes: When to Seek Medical Attention

Lymph node issues?

Hello Doctor: I have a question.
Last year, I had a neck issue and consulted an ENT specialist who said it was lymph nodes.
I took antibiotics, but after six months, they have not decreased in size; there are about 1.5 cm lymph nodes on both sides.
Recently, I noticed one or two lymph nodes under my jaw, one measuring 1.5 cm and the other 1 cm.
Why haven't they decreased in size, and why are new ones appearing in other areas? Should I go to the hospital? Which department should I see?

Xiao V, 20~29 year old female. Ask Date: 2017/06/08

Dr. Chen Sirong reply Oncology

Hello, I'm 24 years old female.

1.
Can you please explain why the lymph nodes haven't decreased in size and have instead increased in other areas?
A: 1.1 Benign lymph nodes can enlarge due to repeated infections and irritation.
Many people experience this phenomenon, and once they enlarge, they may not shrink back down.
1.2 Malignant lymph nodes can spread to other areas.
Based on your description, the likelihood of it being benign is higher, although we cannot completely rule out the possibility of malignancy.
2.
Should I go to the hospital for further evaluation?
A: Since we cannot completely rule out the possibility of malignancy, it is advisable to see a doctor if you experience any of the following: 2.1 New lymph nodes appearing, 2.2 Existing lymph nodes enlarging, 2.3 Changes in color, or 2.4 Hardening of the lymph nodes.
3.
Which department should I consult?
A: Based on the location, I recommend seeing an Ear, Nose, and Throat (ENT) specialist.

Thank you for your inquiry.

Taoyuan Hospital, Dr.
Chen Sih-Rong.

Reply Date: 2017/06/08

More Info

When it comes to persistent lymph nodes, especially those that do not resolve after antibiotic treatment, it is essential to approach the situation with caution and seek appropriate medical attention. In your case, you have noted that you have lymph nodes in your neck that have not decreased in size over the past six months, and you have also developed new lymph nodes under your jaw. This situation warrants further evaluation.

Firstly, it is important to understand that lymph nodes can become enlarged for various reasons, including infections, inflammatory conditions, and malignancies. Infections, such as viral or bacterial infections, can lead to reactive lymphadenopathy, where the lymph nodes swell in response to the infection. However, if the lymph nodes persistently remain enlarged despite treatment, this could indicate that the underlying cause has not been resolved or that there may be another issue at play.

The size of the lymph nodes you mentioned—1.5 cm and 1 cm—can be concerning, particularly if they are increasing in number or size. Generally, lymph nodes larger than 1 cm in diameter are considered abnormal, and further investigation is warranted. The fact that you have developed additional lymph nodes in different areas (submandibular region) also raises the need for a thorough evaluation.

Given your symptoms and the persistence of the lymph nodes, I recommend that you seek medical attention. The appropriate specialist to consult would be an Ear, Nose, and Throat (ENT) physician, as they are well-equipped to evaluate lymphadenopathy in the head and neck region. They may perform a physical examination and may recommend imaging studies, such as an ultrasound or CT scan, to assess the lymph nodes further. In some cases, a biopsy may be necessary to determine the nature of the lymph nodes, especially if there is a suspicion of malignancy.

In summary, persistent lymph nodes that do not resolve after antibiotic treatment, especially when new lymph nodes appear, should not be ignored. It is crucial to consult an ENT specialist who can provide a comprehensive evaluation and guide you through the necessary diagnostic steps. Early intervention can be key in addressing any underlying issues effectively.

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