Enlarged Lymph Nodes: Symptoms and When to Seek Help

Cervical lymph nodes

Hello Doctor, I am currently studying in the UK.
About three months ago, I noticed a movable lymph node about 1 cm in size on the right side of my neck.
Over time, it has increased in size, reaching approximately 2.8 cm by the end of May.
However, a few days later, it slightly decreased to around 2.3 cm.
I felt relieved when it shrank, but unfortunately, it started to grow again and is now about 3 cm.
During this time, I also noticed a lymph node about 1 cm in size under my right ear, which is almost immovable, and it has recently started to cause some pain.
Additionally, I have a history of migraines, and recently the frequency and intensity of my headaches have increased significantly.
I have already seen a doctor within the local healthcare system, who ordered blood tests and diagnosed me with severe anemia, prescribing iron supplements.
After my repeated requests, they also performed an ultrasound.
However, due to the high demand in the local healthcare system, I have been waiting for about three weeks and still have not been able to schedule a follow-up appointment.
I would like to ask you two questions: first, should I consider returning home for an earlier consultation? Second, does my current condition present typical symptoms of lymphoma? Thank you for your time and assistance.

Lin Xiansheng, 20~29 year old female. Ask Date: 2024/07/02

Dr. Yan Jingheng reply Oncology

Enlarged lymph nodes in the neck are not necessarily indicative of lymphoma; a pathological biopsy is required for confirmation.
They could also be benign tumors, and lymphoma may be associated with head and neck cancers.
Additionally, since your lymph nodes have been enlarged for several months, it is advisable to return to Taiwan for an evaluation by an otolaryngologist.

Reply Date: 2024/07/02

More Info

Enlarged lymph nodes can be a source of concern, especially when they change in size or are accompanied by other symptoms. In your case, you have noticed a lymph node in your right neck that has increased in size from approximately 1 cm to around 3 cm over a few months, along with another lymph node near your ear that is about 1 cm and has become painful. Additionally, you have experienced an increase in headaches and have been diagnosed with severe anemia.

Firstly, it is important to understand that lymph nodes can enlarge for various reasons. Common causes include infections (viral or bacterial), inflammatory conditions, and malignancies such as lymphoma or metastatic cancer. The fact that your lymph node has fluctuated in size may suggest a reactive process, often seen with infections or inflammation. However, persistent enlargement, especially if accompanied by pain, systemic symptoms (like fever, night sweats, or unexplained weight loss), or significant changes in your health status, warrants further evaluation.

Given your symptoms, including the increase in headaches and the recent diagnosis of severe anemia, it is advisable to seek medical attention sooner rather than later. Anemia can be a sign of underlying health issues, and the combination of symptoms you are experiencing could indicate a more complex situation that requires thorough investigation.
Regarding your concern about whether your symptoms are typical of lymphoma, it is important to note that while swollen lymph nodes can be a symptom of lymphoma, they can also be due to benign causes. The presence of pain in a lymph node is often associated with infections rather than malignancy, but this is not a definitive rule. The fluctuating size of the lymph nodes and the presence of anemia should be discussed with a healthcare provider who can perform a comprehensive evaluation, including blood tests, imaging studies, and possibly a biopsy if indicated.

In summary, I recommend that you consider returning to your healthcare provider or seeking a second opinion if you feel that your symptoms are worsening or not being adequately addressed. It is crucial to have a thorough evaluation to rule out serious conditions and to ensure that any necessary treatment is initiated promptly. Your health and peace of mind are paramount, and timely medical intervention can make a significant difference in outcomes.

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