Lymph Node Swelling in the Neck: Common Concerns and Questions

Questions about cervical lymph nodes?

Hello Dr.
Chen: When I was about 4 to 5 years old, I discovered an oval-shaped mass in the middle of my right neck that was oriented vertically.
It felt soft and movable.
Although the mass was not very large, it was clearly visible.
My mother took me to see a doctor at that time, but the physician did not specify what the mass was, only advising us to observe it and that it was fine as long as it did not continue to grow.
As I grew older, my neck became thicker, and the noticeable mass on the right side of my neck has since disappeared.
Recently, after doing some research, I believe that the mass on the right side of my neck during childhood was likely an enlarged lymph node.
I would like to ask Dr.
Chen the following questions:
Q1: Although the noticeable mass on the right side of my neck has disappeared as I grew older, I still feel that the middle of my right neck is slightly more swollen than the left when I touch the sides of my neck.
If the mass I had at 4 to 5 years old was indeed an enlarged lymph node, is it possible that this lymph node could still be enlarged and not have decreased in size or disappeared after several decades?
Q2: Are lymph nodes on both sides of a person's neck always symmetrical and of equal size? Or is it possible for the lymph nodes on the left and right sides of the neck to be asymmetrical and of different sizes? I am wondering if it is possible that the lymph node on the right side of my neck was "congenitally" larger than the lymph node on the left side.
Q3: Yesterday (April 5), I noticed that the middle of my right neck felt more swollen than the left, and when I tilted my head to the left and straightened my right neck, I could feel a slight soft movable lump in the middle of my right neck, although it was not very prominent.
The left side of my neck did not have this phenomenon.
Recently, I have experienced some cold symptoms and mouth ulcers, which may have caused the lymph nodes in my neck to swell.
However, I only felt the enlargement on the right side of my neck and not on the left.
Dr.
Chen, is it normal for a cold and mouth ulcers to cause swelling of lymph nodes only on one side (the right side)?
Thank you, Dr.
Chen.

Kris, 40~49 year old female. Ask Date: 2024/04/06

Dr. Chen Sirong reply Oncology

Kris / 42 years old / Male
Q1.
Is it possible for the lymph nodes to remain enlarged without decreasing in size or disappearing, and still be present today?
A: 1.A It is uncertain whether it is a lipoma or a lymph node.
1.B It can still be present.
Q2.
Dr.
Chen, are the lymph nodes on both sides of a person's neck always symmetrical and of equal size? Or is it possible for the lymph nodes on the left and right sides of the neck to be asymmetrical and of different sizes? I am wondering if it is possible that the lymph node on my right side is "congenitally" larger than the lymph node on the left side.

A: 2.
Every part of the body can be asymmetrical.
Q3.
Dr.
Chen, is it normal for only the lymph nodes on one (right) side to be enlarged due to my cold and lip ulcer?
A: 3.
The original lymph nodes can still be present and may enlarge when encountering an infection.
If you wish to confirm with a CT scan at your own expense, or you can have an examination by an ENT specialist covered by health insurance.
Best wishes: May spring bring warmth and peace.
Taoyuan Hospital, Dr.
Chen Si-Rong.

Reply Date: 2024/04/06

More Info

Hello! Thank you for your detailed questions regarding lymph node swelling in the neck. It’s completely understandable to have concerns about any changes in your body, especially when it comes to lymph nodes, as they can be indicative of various health issues. Let’s address your questions one by one.

Q1: Can a lymph node that was enlarged in childhood remain enlarged or not shrink over the years?
Yes, it is possible for a lymph node that was enlarged during childhood to remain palpable or slightly enlarged into adulthood. Lymph nodes can swell due to infections, inflammation, or other stimuli, and sometimes they do not return to their original size after the triggering event has resolved. In your case, if the lymph node was indeed enlarged due to a previous infection or condition, it may have become fibrotic or scarred, making it persistently noticeable. However, if it has not changed in size or characteristics over the years, it is likely benign. Regular monitoring and clinical evaluations are essential to ensure that there are no changes that warrant further investigation.

Q2: Are lymph nodes on both sides of the neck always symmetrical and of equal size?
No, lymph nodes on either side of the neck do not have to be symmetrical or of equal size. It is quite common for individuals to have slight variations in lymph node size and shape between the two sides. Some people may naturally have larger lymph nodes on one side due to genetic factors, previous infections, or other benign conditions. As long as the lymph nodes are not significantly enlarged, painful, or associated with other concerning symptoms (such as fever, weight loss, or night sweats), this asymmetry is generally not a cause for concern.

Q3: Is it normal for only one side of the neck’s lymph nodes to swell in response to an infection?
Yes, it is entirely normal for lymph nodes on one side of the neck to swell in response to localized infections or inflammation. For example, if you have a sore throat or an oral ulcer, the lymph nodes on the same side may react more strongly than those on the opposite side. This is because lymph nodes filter lymph fluid from specific regions of the body, and they can become reactive to infections or inflammation in their drainage areas. If you are experiencing symptoms like a cold or oral ulcers, it is reasonable for the lymph nodes on the affected side to be more prominent or tender.

Additional Considerations:
1. Monitoring Changes: It’s important to keep an eye on any changes in the size or characteristics of the lymph nodes. If you notice significant growth, persistent pain, or any new symptoms, it would be wise to consult a healthcare professional for further evaluation.

2. Self-Examination: While self-examination can be helpful, it’s crucial not to obsess over the lymph nodes, as this can lead to increased anxiety. If you find yourself frequently checking them, consider discussing your concerns with a healthcare provider who can provide reassurance and guidance.

3. Follow-Up: Regular check-ups with your doctor can help ensure that any changes in your lymph nodes are monitored appropriately. If you have a history of lymph node enlargement, it may be beneficial to have periodic evaluations.

In conclusion, while it’s natural to have concerns about lymph nodes, many variations in size and response are normal. If you have any ongoing worries or if your symptoms change, don’t hesitate to reach out to a healthcare professional for personalized advice. Your health and peace of mind are paramount. Thank you for your questions, and I hope this information helps clarify your concerns!

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