Lymph Nodes: When to Worry About Swelling

Is it lymphatic?

Hello, Dr.
Hu.
Here's the situation: About two weeks ago, I had a cold, and then I experienced swelling and pain below my jaw.
The doctor said it was lymphadenitis, and after taking medication for a week, the swelling subsided.
However, at that time, I noticed a lump near my left clavicle and deep in my neck (I believe it's near the subclavius muscle), about the size of a peanut, which is movable.
I can feel it more clearly when I raise my shoulder.
Sometimes it feels harder, and other times it feels softer.
I have seen two doctors, and both told me it was a lymph node and not a concern, and they did not prescribe any medication.
I would like to ask the following questions: 1.
Is that size (about the size of a peanut) considered normal? 2.
I have noticed it for almost two months, and its size seems to remain about the same (I feel it fluctuates between larger and smaller).
Do you think further examination is necessary? I had a health check-up in mid-November last year, and my blood tests and chest X-ray were normal.
3.
I feel that constantly pressing on it makes it feel larger, harder, and more painful.
Could I have caused inflammation by manipulating it? Thank you!

Xiao Ming, 30~39 year old female. Ask Date: 2018/04/03

Dr. Hu Ziren reply Oncology

It sounds like it is advisable not to constantly pinch or stimulate it; just observe it instead.

Reply Date: 2018/04/03

More Info

When it comes to understanding lymph nodes and when to worry about swelling, it’s important to consider several factors, including the size, consistency, and duration of the swelling, as well as any accompanying symptoms. Based on your description, it seems that you have a lymph node located near your collarbone that has been present for about two months, and you have already consulted two doctors who have reassured you that it is likely benign.

1. Size and Normalcy: A lymph node that is approximately the size of a peanut (around 1 cm) can be considered within the range of normal, especially if it is mobile and not fixed to surrounding tissues. Lymph nodes can vary in size due to various factors, including infections, inflammation, or even benign conditions. In many cases, lymph nodes can become enlarged in response to infections, and they may remain palpable even after the infection has resolved.
2. Duration and Need for Further Investigation: Since you mentioned that the lymph node has not changed significantly in size over the past two months and that you had normal blood tests and chest X-rays last November, it may not be necessary to pursue further imaging or invasive procedures at this time. However, if you notice any changes in size, consistency, or if you develop new symptoms such as fever, night sweats, unexplained weight loss, or persistent pain, it would be prudent to seek further evaluation.
3. Impact of Manipulation: Constantly pressing or manipulating the lymph node can indeed cause irritation and may lead to localized inflammation, making it feel larger or more tender. It’s advisable to avoid excessive palpation of the lymph node, as this can lead to discomfort and may not provide any additional information about its nature.
In summary, based on your current situation, it appears that the lymph node is likely benign, especially given the reassurance from your healthcare providers and the absence of concerning symptoms. However, it’s essential to monitor the lymph node for any changes and to maintain open communication with your healthcare providers. If you have any concerns or if the lymph node changes in any way, do not hesitate to reach out for further evaluation.
Additionally, if you find yourself feeling anxious about the lymph node or your health in general, consider discussing these feelings with a mental health professional. Anxiety can sometimes exacerbate physical symptoms, and addressing it may help you feel more at ease. Remember, it’s always better to err on the side of caution, so if you have any doubts, don’t hesitate to seek a second opinion or further testing.

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