Lymph Nodes and Nasopharyngeal Health Concerns

Lymph nodes and nasopharynx?

Hello, I previously inquired about lymphatic issues.
I have had a left-sided cervical lymph node that has been present for a long time (I'm not sure how long, but it should be at least over a year).
I have not gone to a major hospital for examination.
On May 22 of this year, this lymph node suddenly enlarged and became inflamed.
I first visited a small clinic where the doctor advised me to go to a hospital for further examination.
After reading many articles on Google, I wanted to avoid going to a major hospital and decided to try taking antibiotics for three days.
After three days of treatment, it indeed reduced in size.
When I returned for a follow-up, the doctor was surprised and said, "You've reduced it a lot; 0.5 to 1 cm is nothing to worry about." Finally, I was prescribed another three days of medication, and after six days, as of June 29, it had not enlarged again (but it still remains).
Currently, it does not affect me; I have no fever, no fatigue, and I have not lost weight (in fact, I have gained weight).
I have an appetite every day and sleep well.
This is what I inquired about a few days ago.

Now, I would like to ask about my recent visit to a major hospital.
I am scheduled for an ultrasound next Monday.
The doctor at the clinic showed me a nasopharyngoscopy, and my oral cavity was completely fine.
The main concern is in the nasopharyngeal area, where there is currently nasopharyngeal swelling, a deviated septum, and lymphoid tissue hyperplasia.
The doctor told me that there is currently lymphoid tissue hyperplasia, and from what I see, it does not appear to be serious.
He prescribed me antibiotics.

1.
The location of my lymph node is in the posterior neck, on the left side.

2.
What I can confirm is that taking antibiotics causes this lymph node to reduce in size (it shrinks but does not completely disappear; I can still feel it).
The size after finishing the medication is between 0.5 and 1 cm.

3.
Is lymphoid tissue hyperplasia a sign of cancer?
4.
Since it is confirmed that medication can reduce swelling, can I rule out nasopharyngeal cancer?
5.
Regarding the ultrasound next Monday, what does the doctor think about the possibility of a biopsy? If the ultrasound doctor thinks there is no issue, what is the current perspective based on my description?

Niming, 20~29 year old female. Ask Date: 2024/07/09

Dr. Ji Zhaoyun reply Otolaryngology

Since you have already visited the clinic in person, why not patiently wait for the test results?

Reply Date: 2024/07/09

More Info

Hello! Thank you for your detailed questions regarding your lymph nodes and nasopharyngeal health. It’s understandable to have concerns, especially when dealing with persistent lymphadenopathy and related symptoms. Let’s address your questions systematically.

1. Understanding Lymph Node Enlargement: Lymph nodes can enlarge for various reasons, including infections, inflammation, and, less commonly, malignancies. The fact that your lymph node has responded to antibiotics suggests that it may be reactive to an infection or inflammation rather than a malignant process. Lymph nodes that are less than 1 cm and not associated with systemic symptoms (like fever, weight loss, or night sweats) are often considered benign.

2. Lymphoid Hyperplasia: The term "lymphoid hyperplasia" refers to an increase in the number of lymphoid cells, which can occur in response to infection or inflammation. It is not inherently a sign of cancer. In fact, it is a common response of the immune system to various stimuli, including chronic infections or irritants. Your doctor’s observation of lymphoid tissue hyperplasia in the nasopharynx, combined with your lymph node response to antibiotics, suggests a benign process.

3. Cancer Concerns: The fact that your lymph node shrank significantly after antibiotic treatment and that you are asymptomatic (no fever, weight loss, etc.) makes it less likely that you have nasopharyngeal cancer. While it is essential to remain vigilant, the characteristics of your lymph node and the response to treatment are reassuring.

4. Next Steps with Ultrasound: The ultrasound will provide more information about the lymph node's characteristics. If the ultrasound shows that the lymph node is still reactive (well-defined, no irregular borders, no calcifications), it is likely benign. If there are any concerning features, your doctor may suggest a biopsy for further evaluation. However, based on your description, it seems that your healthcare provider is optimistic about your condition.

5. Follow-Up and Monitoring: After the ultrasound, your doctor will assess the findings and determine if further action is necessary. If everything looks normal, they may recommend routine follow-up to monitor the lymph node. It’s essential to keep an open line of communication with your healthcare provider and report any new symptoms or changes.

6. Lifestyle and Health Considerations: While you wait for your ultrasound, consider maintaining a healthy lifestyle. Adequate sleep, a balanced diet, and stress management can support your immune system. If you smoke, consider cessation, as smoking can irritate the respiratory tract and contribute to chronic inflammation.

In summary, while it’s natural to feel anxious about lymph node enlargement and potential cancer, the evidence you’ve provided suggests a benign process. The upcoming ultrasound will be crucial in providing clarity. Trust your healthcare team, and don’t hesitate to reach out with any further questions or concerns. Your health and peace of mind are paramount. Best wishes for your upcoming appointment!

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