Enlarging Left Neck Lymph Nodes: Should You Worry About Cancer?

The lymph nodes on the left side of the neck are increasing in size and number?

Hello doctor, I have swelling in the lymph nodes on the left side of my neck.
Initially, there were two hard nodes, approximately 2 cm by 2 cm.
I went to a large hospital for examination and had a biopsy, but I will have to wait two weeks to see the results.
My blood test results were normal with no abnormalities.
However, during the waiting period, I have noticed that the swelling on the left side of my neck has increased to about eight nodes, forming a cluster that extends close to my collarbone.
Upon careful examination, I can also feel small hard lumps the size of grains of rice.
I would like to know if this description could indicate cancer.
Additionally, should I urgently see a doctor again due to the increasing number of lumps? Thank you.

Mian, 10~19 year old female. Ask Date: 2022/09/07

Dr. Ji Zhaoyun reply Otolaryngology

Hello, based on your description, "However, during the days of waiting for the report, the left side of my neck has developed about eight lymph nodes that have grown together, extending close to the collarbone." Rapidly enlarging cervical lymph nodes are often indicative of an infection and are typically treated with medication, including antibiotics if necessary.
However, if the swelling continues to progress and leads to a deep neck infection, it is essential to take antibiotics and other medications.
If the condition is still progressing, it is advisable to consult an otolaryngologist (ENT specialist) and take medication as needed.
Wishing you safety and good health.

Reply Date: 2022/09/07

More Info

When it comes to the concern of enlarging lymph nodes in the neck, especially in the context of potential malignancy, it is essential to consider several factors before jumping to conclusions. Based on your description, you initially had two hard lymph nodes measuring approximately 2 cm each, and now you have noticed an increase in the number and size of lymph nodes, with some reaching close to the clavicle. This situation understandably raises concerns about the possibility of cancer.

Firstly, it is important to recognize that lymph nodes can enlarge for various reasons, including infections, inflammatory conditions, and malignancies. The fact that you have undergone a fine needle aspiration (FNA) and that your blood tests returned normal results is a positive sign. Normal blood work, particularly markers such as complete blood count (CBC) and inflammatory markers, can help rule out some serious conditions. However, it is crucial to wait for the results of the FNA, as this will provide more definitive information regarding the nature of the lymph nodes.

In general, lymph nodes that are reactive due to infection or inflammation may feel firm or hard, but they are often mobile and tender. In contrast, malignant lymph nodes may be hard, fixed, and non-tender. The presence of multiple lymph nodes enlarging in a cluster, as you described, can sometimes indicate a systemic issue, but it does not automatically mean cancer.
The increase in the number of lymph nodes you are feeling could be due to a reactive process, especially if there has been an underlying infection or inflammatory condition. For instance, viral infections, such as Epstein-Barr virus (EBV), can cause lymphadenopathy. If the lymph nodes are indeed reactive, they may continue to enlarge temporarily as your body responds to the underlying issue.

Given that you are experiencing a rapid increase in the number of lymph nodes, it is advisable to follow up with your healthcare provider sooner rather than later. They may recommend further imaging studies, such as an ultrasound or CT scan, to assess the lymph nodes more thoroughly. If the FNA results indicate any atypical cells or if there is a significant change in the size or characteristics of the lymph nodes, a biopsy or further evaluation may be warranted.

In summary, while the enlargement of lymph nodes can be concerning, it is essential to wait for the FNA results and consult with your doctor about your symptoms. If you notice any additional symptoms such as unexplained weight loss, night sweats, or persistent fever, these should be reported to your physician immediately. Regular follow-up and communication with your healthcare provider will be key in managing your concerns and ensuring appropriate care.

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