Persistent Lymph Node Enlargement: When to Seek Further Evaluation

Q: Persistent Lymph Node Enlargement: When to Seek Further Evaluation

Patient： 22 years old, male Q1： I would like to ask the doctor, does this count as benign lymphadenopathy? A： Based on the current situation, it is. Q2： Is there a possibility that lymphadenitis won't resolve? A： Yes, it can happen! Q3： Do I need more detailed exam

Lymphadenopathy has persisted for a long time?

Hello doctor, I am 22 years old.
Around August of last year, I noticed a slightly protruding lump in the middle of the right side of my neck (it feels soft to the touch), approximately 1 cm or a little more.
The day before I felt it, I had a mild fever (37 degrees Celsius) and experienced some stiffness in my neck.
I first visited an ENT specialist who diagnosed it as a bacterial infection, and said it would resolve with medication.
However, after finishing the prescribed medication, the lump did not go away.
Concerned, I went to a second ENT specialist who conducted more thorough examinations, including checking my ears and performing a nasopharyngoscopy, but found nothing abnormal.
He also prescribed medication, but again, the lump did not disappear.
After another visit, the doctor mentioned that it might not go away and that it should be fine, advising me to just keep an eye on it.
Now, it has been 1 year and 3 months.
I have not experienced any other symptoms, and upon self-examination, the lump still feels soft and has not increased in size or hardened.
Q1: Could this be considered benign lymphadenopathy?
Q2: Is it possible for lymphadenitis to persist without resolution?
Q3: Do I need more advanced testing, or is it sufficient to just monitor it for now?
Thank you, doctor.

Xiao Yi, 20~29 year old female. Ask Date: 2017/10/31

Dr. Chen Sirong reply Oncology

Patient: 22 years old, male
Q1: I would like to ask the doctor, does this count as benign lymphadenopathy?
A: Based on the current situation, it is.
Q2: Is there a possibility that lymphadenitis won't resolve?
A: Yes, it can happen!
Q3: Do I need more detailed examinations or is it okay to just observe for now?
A: Based on what you mentioned: it has been 1 year and 3 months.
My body has shown no abnormalities, and I have been monitoring it myself.
It still feels soft and hasn't increased in size or become hard.
I agree with what your doctor said: it is possible that it may not resolve, but it should be fine.
Just keep an eye on it.
Wishing you peace and joy,
Taoyuan Hospital,
Chen Si-Rong

Reply Date: 2017/10/31

More Info

When it comes to persistent lymph node enlargement, especially in a young individual like yourself, it’s essential to approach the situation with a combination of clinical insight and appropriate follow-up. Based on your description, let’s address your questions systematically.

Q1: Is this considered a benign lymph node enlargement?
Given that you have had this lymph node for over a year and it has remained soft, stable in size, and without any associated symptoms (like fever, weight loss, or night sweats), it is likely that this lymph node is benign. Reactive lymph nodes can occur due to various reasons, including past infections, and they may not always resolve completely. In many cases, lymph nodes can remain palpable even after the inciting cause has resolved. The fact that you have consulted multiple specialists and undergone examinations without any alarming findings is reassuring. However, benign does not mean that it should be ignored indefinitely.

Q2: Can lymph node inflammation persist without resolution?
Yes, lymph nodes can remain enlarged for an extended period even after the initial cause of inflammation has resolved. This is often seen in cases of reactive hyperplasia, where the lymph node responds to an infection or inflammation but does not return to its original size. In some individuals, particularly younger ones, lymph nodes may remain palpable for months or even years without indicating any serious underlying pathology.
Q3: Do I need more advanced testing, or can I just observe?
In your case, since the lymph node has remained stable and you have no concerning symptoms, it may be reasonable to continue with observation. However, it is crucial to maintain regular follow-ups with your healthcare provider. If there are any changes in the characteristics of the lymph node (such as increased size, hardness, or associated symptoms), further evaluation may be warranted.
Advanced imaging, such as an ultrasound or CT scan, can provide more information about the lymph node's characteristics and help rule out any potential malignancy if there are concerns. In some cases, a biopsy may be recommended if there is suspicion of a more serious condition.
In summary, while your lymph node appears to be benign based on your description and the lack of alarming symptoms, it is essential to keep an open line of communication with your healthcare provider. Regular monitoring and a proactive approach to any changes will help ensure that any potential issues are addressed promptly. If you have any new symptoms or concerns, do not hesitate to seek further evaluation.

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