Lymph Node Swelling: When to Seek Further Medical Advice

Q: Lymph Node Swelling: When to Seek Further Medical Advice

Hello： Generally, if lymph nodes have decreased in size and there is no persistent pain, it is mostly a benign change. <br>Larger lymph nodes that shrink may still persist. <br>For lymph nodes larger than 1 cm, it is recommended to visit the ENT department of a hospital for a hea

Cervical lymph nodes

Hello doctor, about a month and a half ago, I discovered a swollen lymph node near my neck, close to the jawline, measuring 1.5 cm.
There is another one about 2 cm below it (this one has likely been present for many years, but it was also more swollen at that time).
Concerned, I visited an ENT specialist who used an endoscope to check and confirmed that there was no nasopharyngeal cancer or laryngeal cancer, advising me not to worry too much.
However, it has been a month and a half, and while both lymph nodes have decreased in size, they still remain, especially the upper one, which was previously 1.5 cm and is now still about 1 cm in size.
How long does it typically take for lymph nodes to shrink? What size do they need to reach to be considered normal? Should I see a hematologist-oncologist? Thank you for your clarification.

Huang Huihui, 30~39 year old female. Ask Date: 2019/06/22

Dr. Zheng Jueyi reply Otolaryngology

Hello: Generally, if lymph nodes have decreased in size and there is no persistent pain, it is mostly a benign change.
Larger lymph nodes that shrink may still persist.
For lymph nodes larger than 1 cm, it is recommended to visit the ENT department of a hospital for a head and neck ultrasound, fine needle aspiration, or other relevant examinations.
Wishing you safety and health.
Sincerely, Dr.
Jue-Yi Cheng, Director of the ENT Department, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2019/06/22

More Info

Lymph node swelling can be a concerning symptom, and understanding when to seek further medical advice is crucial for your health. Based on your description, you have experienced swelling in the lymph nodes located near your neck, specifically close to the jawline, with one node measuring 1.5 cm and another that has been present for years but has also become more pronounced. You have already consulted an ENT specialist who performed an endoscopic examination and ruled out serious conditions such as nasopharyngeal or laryngeal cancer. However, you are still concerned about the persistent swelling of your lymph nodes, particularly since the larger node has only reduced to 1 cm after a month and a half.

Firstly, it is important to understand that lymph nodes can swell for various reasons, including infections, inflammation, or malignancies. In many cases, lymph nodes that swell due to infections (such as viral or bacterial infections) can take several weeks to months to return to their normal size after the infection has resolved. The timeline for lymph node shrinkage can vary significantly depending on the underlying cause, the individual's immune response, and other health factors.

Typically, lymph nodes that are reactive due to infection may take anywhere from a few weeks to a couple of months to shrink back to their normal size. However, if the lymph nodes remain enlarged for an extended period, such as several months, or if they continue to grow, it may warrant further investigation. Generally, lymph nodes are considered abnormal if they are larger than 1 cm in diameter, particularly in adults, and if they are hard, fixed, or associated with systemic symptoms such as fever, night sweats, or unexplained weight loss.

In your case, since the lymph nodes have decreased in size but are still present, it is advisable to continue monitoring them. If they do not return to normal size within a few months, or if you experience any new symptoms, it would be prudent to seek further evaluation. Consulting a hematologist or an oncologist may be appropriate, especially if there are concerns about potential hematological issues or if the lymph nodes exhibit characteristics that raise suspicion for malignancy.

In summary, while it is common for lymph nodes to take time to shrink after an infection, persistent enlargement beyond a few months or any concerning changes should prompt further medical evaluation. It is always better to err on the side of caution, so if you have any doubts or if your symptoms change, do not hesitate to seek further medical advice. Regular follow-ups with your healthcare provider can help ensure that any potential issues are addressed promptly.

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