Lymph Nodes: Symptoms and Concerns in Oncology

Cervical lymph nodes

Last March, I discovered a swollen lymph node in my neck.
Since then, I have noticed an increase in the number of swollen lymph nodes in my neck.
I have been continuously monitoring this condition.
Initially, an ultrasound was performed, followed by a neck CT scan, and the doctors have determined that the lymph nodes are benign, with all of them appearing to be less than one centimeter in size, although their quantity has increased.
Recently, over the past two weeks, I have come down with a cold for an unknown reason.
I initially had a fever that reached 39 degrees Celsius, but after taking antipyretics, it decreased.
However, I have noticed that I wake up with slightly damp clothes, feeling as if I have been sweating, even though my body is dry.
I have been experiencing low-grade fevers in the afternoons and a slight cough, although it has improved compared to the initial onset.
I would like to ask the doctor: 1.
If the initially swollen lymph node was lymphoma, is it possible for symptoms such as fever and night sweats to appear only now? 2.
Can lymphoma present with lymph nodes that are less than one centimeter in size?

Mr. Wang, 20~29 year old female. Ask Date: 2024/01/25

Dr. Chen Sirong reply Oncology

Mr.
Wang / 20 years old / Male
1.
Is it possible for a lymphoma that initially presented as a swollen lymph node to now show symptoms of fever and night sweats?
A: It is possible, but only a possibility.
However, if the lymphoma is present, the swollen lymph node would continue to grow.
If it has not increased in size, it is less likely to be lymphoma.
2.
Can lymphoma be smaller than one centimeter?
A: Of course, it starts from a single malignant transformed cell becoming cancerous, which cannot be seen or felt, at sizes of 0.5 cm, 1 cm.
It gradually grows to 2 cm.
However, if it is malignant, it typically will not remain under 1 cm indefinitely.
Wishing you a Happy New Year, Taoyuan Hospital, Chen Si-Rong.

Reply Date: 2024/01/25

More Info

Understanding lymph nodes and their implications in oncology is crucial for patients experiencing symptoms such as swelling or fever. Your situation, involving the discovery of swollen lymph nodes in the neck, raises several important questions regarding the nature of these lymph nodes and the potential for underlying malignancies, such as lymphoma.

1. Could the initial swollen lymph node be lymphoma, with symptoms appearing later?
Yes, it is possible for lymphoma to present with symptoms such as fever and night sweats after an initial period of being asymptomatic. Lymphoma, particularly in its early stages, can sometimes be indolent (slow-growing) and may not produce noticeable symptoms until it progresses. The symptoms you are experiencing, including fever and night sweats, are often referred to as "B symptoms" in lymphoma. These symptoms can indicate systemic involvement of the disease, but they are not exclusive to lymphoma and can occur in various infections or inflammatory conditions. It is essential to consult your healthcare provider to evaluate these symptoms in the context of your medical history and current findings.

2. Can lymphoma present with lymph nodes smaller than one centimeter?
Yes, lymphoma can indeed present with lymph nodes that are smaller than one centimeter. In fact, lymph nodes can vary significantly in size, and not all lymphomas present with enlarged nodes. Some lymphomas may manifest with lymphadenopathy (swelling of lymph nodes) that is subtle and may not exceed one centimeter. The size of lymph nodes is not the sole determinant of malignancy; rather, the characteristics of the lymph nodes (such as their shape, consistency, and whether they are tender or fixed) and associated symptoms are also critical factors in assessing their nature.

Given your recent symptoms of fever, night sweats, and cough, it is advisable to follow up with your healthcare provider. They may recommend further imaging studies, blood tests, or even a biopsy of the lymph nodes to rule out or confirm any malignancy. It is also important to consider other potential causes of your symptoms, such as infections or autoimmune conditions, which can also lead to lymphadenopathy and systemic symptoms.

In summary, while the presence of swollen lymph nodes, especially those that are increasing in number, can be concerning, it is essential to approach the situation with a comprehensive evaluation. Your healthcare provider will be able to guide you through the necessary diagnostic steps to determine the underlying cause of your symptoms and provide appropriate management. Regular monitoring and open communication with your medical team are key components in addressing your concerns and ensuring your health is prioritized.

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