Enlarged Lymph Nodes: Causes and When to Seek Help

Lymphadenopathy

I am 18 years old, and recently, after my gastroesophageal reflux improved, I noticed a round lump between my left jaw and neck.
It has not disappeared after more than two weeks, although it has fluctuated in size, ranging within 1.5 centimeters.
During these two weeks, I experienced two episodes of oral ulcers.
I would like to ask what could be causing this.
I have read many articles that suggest being cautious if it is painless, but I do not feel any pain, just some discomfort and a dry throat.
What should I be aware of?

Liu Xiansheng, 10~19 year old female. Ask Date: 2021/07/10

Dr. Ji Zhaoyun reply Otolaryngology

Hello, based on your description, it is most likely that you are experiencing pharyngitis and oral ulcers accompanied by cervical lymphadenopathy.
Treatment typically involves the use of certain medications, and antibiotics may be prescribed if necessary.
However, if the cervical swelling continues to progress and leads to a deep neck infection, it is essential to take antibiotics and other medications.
It seems that there are multiple small lesions in the mouth, which could be ulcers.
Most ulcers heal within two weeks of treatment, but if they persist beyond two weeks, further examination is required.
If symptoms continue and worsen, it is advisable to consult an otolaryngologist, and medication should be taken as needed.
Wishing you safety and good health.
Ministry of Health and Welfare Taichung Hospital.

Reply Date: 2021/07/10

More Info

Enlarged lymph nodes can be a common concern, especially in young individuals, and they can arise from a variety of causes. In your case, the presence of a round lump in the left side of your jaw and neck area, which has fluctuated in size but remains under 1.5 cm, warrants careful consideration. The fact that you have also experienced oral ulcers and a dry throat adds another layer of complexity to your symptoms.

Lymph nodes are part of the immune system and play a crucial role in fighting infections. They can become enlarged due to several reasons, including:
1. Infections: The most common cause of swollen lymph nodes is an infection. This could be a viral infection (like a cold or flu), bacterial infection (such as strep throat), or even localized infections in the mouth or throat. The occurrence of oral ulcers may suggest a viral infection, which could also lead to lymphadenopathy (swelling of lymph nodes).

2. Inflammatory Conditions: Conditions such as autoimmune diseases (like lupus or rheumatoid arthritis) can cause lymph nodes to swell as the immune system is activated.

3. Malignancies: Although less common in younger individuals, cancers such as lymphoma or metastasis from other cancers can cause lymph node enlargement. However, these are usually accompanied by other symptoms such as unexplained weight loss, fever, or night sweats.

4. Other Causes: Certain medications, vaccinations, or even benign conditions can lead to lymph node enlargement.

Given that your lymph node has not been painful and has fluctuated in size, it is likely that it is reactive rather than malignant. However, the persistence of the lump and the occurrence of oral ulcers should not be overlooked.

When to Seek Help
You should consider seeking medical advice if:
- The lymph node continues to grow or does not decrease in size after a few weeks.

- You experience additional symptoms such as fever, night sweats, or unexplained weight loss.

- You have persistent oral ulcers that do not heal or worsen.

- You experience difficulty swallowing or breathing.

Recommended Actions
1. Consult a Healthcare Provider: It would be wise to schedule an appointment with a healthcare provider, preferably an internist or an ENT specialist. They can perform a physical examination and may recommend further tests, such as blood tests or imaging studies (like an ultrasound or CT scan), to determine the cause of the lymph node enlargement.

2. Monitor Symptoms: Keep track of any changes in the size of the lymph node, the presence of new symptoms, or any changes in your overall health.

3. Oral Care: Since you have experienced oral ulcers, maintaining good oral hygiene and possibly using topical treatments for the ulcers may help alleviate discomfort.

4. Stay Informed: Educate yourself about the potential causes of lymphadenopathy and be proactive in discussing your concerns with your healthcare provider.

In conclusion, while many cases of enlarged lymph nodes are benign and related to infections, it is essential to monitor your symptoms and seek medical advice if the condition persists or worsens. Early evaluation can help rule out serious conditions and provide peace of mind.

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