Unilateral Tonsil and Lymph Node Swelling: What You Need to Know

Q: Unilateral Tonsil and Lymph Node Swelling: What You Need to Know

Hello： It is recommended to return for a follow-up visit to review the ultrasound and sampling reports, with further management to be determined by the attending physician. <br>Wishing you safety and health. <br>Sincerely, Dr. <br>Cheng Jue-Yi, Director of the Department of Otola

Unilateral tonsillar enlargement with lymphadenopathy greater than 2 centimeters?

Hello Doctor, about a month ago, I noticed swelling on the right side of my neck near my ear.
I went to see a doctor who mentioned that my tonsils were red.
After taking the prescribed medication, I felt much better, and the swelling decreased a bit.
However, I did not return for a follow-up, and the swelling is still there, but it is not painful! Recently, I noticed that the same area has swollen again, and there are two lumps; one of them feels a bit hard and is over 2 centimeters in size! I have some pain when swallowing on the affected side of my tonsil, but there are no ulcers.
I also have a low-grade fever and feel cold.
I went to a regional hospital for an ultrasound and had a biopsy taken; the report has not come back yet, but the doctor mentioned that the ultrasound suggests enlarged lymph nodes, which may indicate a viral infection.
However, I have been on antibiotics for several days without any improvement, and I am a bit worried that it might be cancer.
I do not smoke or drink.
Could you please provide your assessment? Thank you.

Yesus, 20~29 year old female. Ask Date: 2017/10/20

Dr. Zheng Jueyi reply Otolaryngology

Hello: It is recommended to return for a follow-up visit to review the ultrasound and sampling reports, with further management to be determined by the attending physician.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2017/10/20

More Info

Unilateral tonsil and lymph node swelling can be concerning, especially when accompanied by symptoms such as pain, fever, and the presence of hard lymph nodes. In your case, the swelling of the right tonsil and the lymph nodes in the neck, particularly the one measuring over 2 cm, warrants careful evaluation.

The tonsils are part of the lymphatic system and play a role in immune function. When they become inflamed, it is often due to infections, which can be viral or bacterial in nature. Common causes of unilateral tonsil swelling include viral infections like infectious mononucleosis (often caused by Epstein-Barr virus), bacterial infections such as streptococcal pharyngitis, or even less common causes like peritonsillar abscesses.

The presence of hard lymph nodes, especially those that are larger than 1 cm, can be a sign of a more serious condition, including malignancy. However, it is essential to remember that lymph nodes can also become enlarged due to benign causes, such as infections or inflammatory processes. The fact that you have been experiencing low-grade fever and chills could suggest an ongoing infection, which might explain the persistent swelling despite antibiotic treatment.

Given that you have already undergone an ultrasound and a biopsy, it is crucial to wait for the results of these tests to provide a clearer picture of what is happening. The ultrasound can help determine the characteristics of the lymph nodes, and the biopsy will provide histological information that can confirm or rule out malignancy.

In the meantime, here are some important points to consider:
1. Monitoring Symptoms: Keep track of any changes in your symptoms. If you experience increased pain, difficulty swallowing, or any new symptoms, it is essential to seek medical attention promptly.

2. Follow-Up Care: Since you have already seen a physician and undergone imaging, it is vital to follow up with them once the biopsy results are available. They will be able to interpret the findings in the context of your clinical symptoms and history.

3. Understanding the Results: If the biopsy shows benign changes, it may indicate that the swelling is due to an infection or reactive lymphadenopathy. If malignancy is suspected, further evaluation and treatment options will be discussed.

4. Lifestyle Factors: Your non-smoking and non-drinking status is a positive factor in your overall health. Maintaining a healthy lifestyle can support your immune system during this time.

5. Anxiety and Concerns: It is natural to feel anxious about the possibility of cancer, especially with the presence of hard lymph nodes. However, many conditions can cause similar symptoms, and it is essential to wait for a definitive diagnosis before jumping to conclusions.

In summary, unilateral tonsil and lymph node swelling can arise from various causes, and while there is a possibility of malignancy, many benign conditions can also lead to similar presentations. It is crucial to await the results of your ultrasound and biopsy, maintain open communication with your healthcare provider, and continue monitoring your symptoms. If you have any further concerns or if your symptoms worsen, do not hesitate to seek medical advice.

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