Lymphadenopathy: When to Seek Further Medical Evaluation

Lymphadenopathy

The lymph nodes on the left side of my neck have been swollen for three months now.
They were painful during the first month, but the pain has since subsided, although there is still a small area of swelling in my neck.
Starting in the second month, I experienced swelling and pain in my ear, and after examination, it was diagnosed as eustachian tube inflammation, with no issues found with the eardrum.
After taking antibiotics for two weeks, I began to feel pain above my clavicle, and the lymph nodes in my left armpit are also swollen and painful, along with numbness in my left hand.
Should I get a CT scan, or should I return to the ENT specialist? The doctor previously advised waiting for it to resolve on its own, but the issues seem to have increased since then.

Bai Xiaojie, 20~29 year old female. Ask Date: 2019/03/15

Dr. Hu Ziren reply Oncology

It is recommended to first consult a general surgeon or an obstetrician-gynecologist.

Reply Date: 2019/03/15

More Info

Lymphadenopathy, or swollen lymph nodes, can be a sign of various underlying conditions, ranging from benign infections to more serious diseases like lymphoma or metastatic cancer. Given your symptoms and the duration of the lymphadenopathy, it is crucial to seek further medical evaluation to determine the underlying cause and appropriate treatment.

In your case, the left neck lymph node has been swollen for three months, initially painful but now painless. The development of additional symptoms, such as ear pain, pain above the clavicle, and swelling in the left axillary region, raises concern. The fact that you also experience numbness in your left hand could indicate nerve involvement or other systemic issues that need to be addressed.

The initial recommendation from your doctor to wait for the lymph node to resolve on its own may have been appropriate at first, especially if there were no alarming signs. However, the persistence of the lymphadenopathy, coupled with the new symptoms, suggests that further investigation is warranted. A CT scan can provide detailed imaging of the lymph nodes and surrounding structures, helping to identify any abnormalities that may not be palpable during a physical examination.

Additionally, the presence of pain in the axillary region and numbness in your hand could indicate that the lymphadenopathy is affecting nearby nerves or that there is another underlying condition that needs to be evaluated. It is essential to communicate these new symptoms to your healthcare provider, as they may influence the urgency and type of imaging or further tests required.

Returning to your ENT specialist may be beneficial, especially if they have been managing your ear-related symptoms. However, given the complexity of your situation, it may also be prudent to consult with a primary care physician or a specialist in hematology or oncology. They can provide a comprehensive evaluation, including a review of your symptoms, physical examination, and any necessary imaging or laboratory tests.

In summary, based on the duration of your symptoms, the progression of your condition, and the emergence of new symptoms, it is advisable to pursue further medical evaluation. A CT scan can help clarify the nature of the lymphadenopathy and guide your healthcare team in determining the next steps for diagnosis and treatment. Do not hesitate to advocate for your health and seek a thorough evaluation to ensure that any serious conditions are ruled out or addressed promptly.

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