Lymph Node Concerns: Insights on Swelling and Inflammation

I have another question regarding lymphatic issues?

Hello Dr.
Chen, in February I had a mouth ulcer and swelling and pain in my left parotid lymph nodes.
I also accidentally found a lymph node near the left side of my neck, close to the clavicle.
Later, my mouth healed, and the left parotid lymph node pain subsided, but the lymph node near the clavicle is still present, about the size of a peanut, approximately one centimeter, and it is movable.
I underwent a CT scan at the end of April, and the results were as follows:
Imaging findings: CT of Neck: The pre- and post-contrast enhanced axial images were obtained.
The bone window of the images was also reviewed.
Large lymph nodes (>1 cm) are noted in bilateral level IIa.
Mild enlargement of the bilateral tonsils is noted.
The density of the bilateral lenses is decreased.
The neck anatomical spaces are essentially clear and preserved.
The trachea is patent without foreign body.
The bony structure is intact.

Impression:
1) Suspect lymphadenopathy in bilateral level IIa.

2) Mild enlargement of the bilateral tonsils.

- Differential Diagnosis: adenitis, tonsillitis.

- Suggest clinical correlation.
At that time, the doctor said I was fine and not to worry.
Over the past few months, I have been observing it, and the size has remained about the same, with no feeling of enlargement.
However, in the past two days, I have felt more heat in my body, developed another mouth ulcer, and the left parotid lymph node is slightly swollen and painful again.
I feel that the lymph node near the clavicle has increased in size, about 1.2-1.5 centimeters.
I keep pressing on it, and I am becoming increasingly anxious and panicked.
I would like to ask you the following questions:
1.
Do you think the lymph node near the clavicle is normal?
2.
With a mouth ulcer and swelling and pain in the left parotid lymph node, and considering the distance to the lymph node in the neck, could inflammation or infection affect that lymph node's swelling?
3.
Can lymph nodes persist without resolving?
4.
I have been overly concerned about the lymph nodes; can you provide me with some advice to help alleviate my anxiety?

Xiao Ke, 30~39 year old female. Ask Date: 2018/08/15

Dr. Chen Sirong reply Oncology

1.
If you keep pressing it, it will only make you more anxious and panicked.
A: It's advisable not to keep pressing it, as it may irritate the area.
If you check it once a day to monitor its size, that would be fine!
2.
Do you think the lymph nodes near the clavicle are normal? A: In terms of location, it is normal to have lymph nodes there.
Whether there are cancer cells inside is uncertain; it’s likely that the inflammation is causing them to enlarge, which sounds more like lymphadenopathy due to inflammation.
3.
I have mouth ulcers, and my left submandibular lymph nodes are swollen and painful, with some distance from the left neck.
If it’s an inflammatory infection, can it also affect the lymph nodes in that area? A: Yes, inflammation of the head and neck organs can cause swelling of the cervical lymph nodes.
It’s important to understand that lymphatic vessels are spread throughout the body, similar to blood vessels, but they are less noticeable.
They transport lymph fluid and filter out foreign invaders in the lymph nodes, which is why they enlarge during inflammation.
4.
Will the lymph nodes always remain swollen and not go down? A: Yes, they can remain enlarged.
5.
I have been overly concerned about my lymph nodes.
Can you give me some advice to help ease my anxiety? A:
1.
Understand that lymphatic vessels are spread throughout the body, similar to blood vessels, but they are less noticeable.
They transport lymph fluid and filter out foreign invaders in the lymph nodes, which is why they enlarge during inflammation.
2.
Life and death are determined by fate; wealth and status are in the hands of a higher power.
In Christianity, it is said to entrust everything to the Lord and go with the flow.
3.
Accept that you have this constitution and also accept your worries about illness.

Taoyuan Hospital, Dr.
Chen Sih-Rong.

Reply Date: 2018/08/15

More Info

Understanding lymph node concerns can be quite challenging, especially when experiencing symptoms that lead to anxiety and fear. Based on your description, let’s address your questions and provide some insights into lymphadenopathy and its implications.

1. Is the lymph node near the clavicle normal?
The lymph node you described near your clavicle, measuring around 1-1.5 cm, is considered enlarged since lymph nodes larger than 1 cm are typically classified as abnormal. However, it is important to note that lymph nodes can enlarge for various benign reasons, such as infections or inflammation. Given that you have had recent oral ulcers and left parotid lymphadenopathy, it is plausible that the lymph node near your clavicle is reacting to an infection or inflammation in the surrounding areas.
2. Can inflammation or infection in the mouth affect distant lymph nodes?
Yes, lymph nodes can become reactive to infections or inflammation even if they are not directly adjacent to the site of infection. The lymphatic system is interconnected, and lymph nodes filter lymph fluid from various regions of the body. Therefore, an infection in the mouth can lead to swelling in lymph nodes located in the neck and even those further away, such as near the clavicle. This is a normal immune response as your body fights off the infection.

3. Will lymph nodes always remain enlarged?
Lymph nodes can remain enlarged for a variable period, depending on the underlying cause. In cases of infection, lymph nodes may remain swollen for weeks or even months after the infection has resolved. If the lymph node remains stable in size and is not associated with other concerning symptoms (such as fever, night sweats, or unexplained weight loss), it is often safe to monitor it. However, if you notice any significant changes, such as rapid enlargement or new symptoms, it is advisable to consult your healthcare provider.

4. How to manage anxiety regarding lymph nodes?
It is completely understandable to feel anxious about your health, especially when dealing with symptoms that are unfamiliar or concerning. Here are some strategies to help manage your anxiety:
- Educate Yourself: Understanding the normal functions of lymph nodes and the common reasons for their enlargement can help alleviate fears. Remember that many people have benign lymph node enlargements due to infections.

- Limit Self-Examination: Constantly checking the lymph node can increase anxiety. Try to limit how often you examine it and focus on other activities.

- Talk to Your Doctor: If your anxiety persists, consider discussing it with your healthcare provider. They can provide reassurance and may suggest a follow-up plan to monitor the lymph node.

- Mindfulness and Relaxation Techniques: Practices such as meditation, deep breathing exercises, or yoga can help reduce anxiety and improve your overall well-being.

- Seek Support: Sharing your concerns with friends, family, or a mental health professional can provide emotional support and help you cope with your fears.

In summary, while the enlarged lymph node near your clavicle is concerning, it is likely a reactive process due to your recent oral issues. Continuous monitoring and communication with your healthcare provider are key. Remember that many lymph nodes can remain enlarged for a while without indicating a serious problem. Focus on your overall health and well-being, and try to manage anxiety through education and support.

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