Enlarged Lymph Nodes: Causes and Concerns in ENT Health

Lymphadenopathy

A month ago, I experienced swollen lymph nodes in the anterior neck, hoarseness, and bilateral mucous membrane cysts in the lower lip area, which led to a CT scan.
FINDINGS: Thyroid: no pathology.
Nasopharynx, oropharynx, hypopharynx, larynx, oral cavity: no pathology.
Submandibular and parotid glands: no pathology.
Orbits, paranasal sinuses, skull base, mastoid air cells: no pathology.
Temporomandibular joints: no pathology.
Vascular structures: no pathology.
Lymph nodes: no pathology.
Other findings: no pathology.
IMPRESSIONS: * No CT evidence of sialolithiasis or sialadenitis.
However, the day after the CT scan, I noticed a lymph node in the posterior neck that was not easily palpable at first, but now, after a month, it feels larger and is easily palpable.
Can I ask if this indicates that there might be another issue with my body?

Xiao Hui, 30~39 year old female. Ask Date: 2024/07/28

Dr. Ji Zhaoyun reply Otolaryngology

According to the CT report you provided, no significant issues were found, including diseases of the salivary glands (such as sialolithiasis or sialadenitis) and abnormalities in other related structures.
However, you mentioned that the day after the CT scan, you noticed lymph nodes in the posterior neck, and a month later, they felt enlarged and more palpable.
Lymphadenopathy can be caused by various factors, including: 1.
Infection: Viral or bacterial infections can lead to lymph node enlargement, particularly upper respiratory infections.
2.
Inflammation: Inflammation in other parts of the body may also cause lymph node enlargement.
3.
Immune response: Certain immune system reactions can result in lymphadenopathy.
4.
Other diseases: In some cases, lymph node enlargement may be associated with more serious health issues, such as lymphoma or other tumors.
It is advisable to consult a physician in person if the symptoms persist, especially if the lymph nodes continue to enlarge or are accompanied by other symptoms (such as fever, weight loss, night sweats, etc.).
The doctor may recommend further evaluations, such as ultrasound-guided aspiration, blood tests, or surgical biopsy for pathological examination, to determine the cause of the enlargement.

Reply Date: 2024/07/28

More Info

Enlarged lymph nodes can be a source of concern, especially when accompanied by symptoms such as hoarseness and the presence of salivary gland cysts. Your recent CT findings indicate that there were no abnormalities detected in the thyroid, nasopharynx, oropharynx, hypopharynx, larynx, oral cavity, submandibular and parotid glands, or any other structures examined. The report specifically noted that there was no evidence of sialolithiasis (salivary stones) or sialadenitis (inflammation of the salivary glands), which is reassuring.

However, the emergence of a new, palpable lymph node in the posterior neck that has increased in size over the past month warrants further evaluation. Lymph nodes can enlarge for various reasons, including infections, inflammatory conditions, or malignancies. In your case, the following considerations are important:
1. Infection: Enlarged lymph nodes are often a response to infection. This could be a viral infection, such as a common cold or flu, or a bacterial infection. Given your symptoms of hoarseness, it is possible that there is an underlying infection that has not yet been fully diagnosed.

2. Inflammation: Conditions such as autoimmune diseases can also lead to lymphadenopathy (enlarged lymph nodes). If you have a history of autoimmune conditions, this could be a contributing factor.

3. Malignancy: While many cases of lymphadenopathy are benign, persistent enlargement, especially if the lymph nodes are hard, fixed, or associated with systemic symptoms (like weight loss, fever, or night sweats), raises concern for malignancy.
4. Follow-up: Since you have noticed a change in the lymph node's size and palpability, it is advisable to follow up with your healthcare provider. They may recommend further imaging studies, such as an ultrasound, or a biopsy to determine the nature of the lymph node.

5. ENT Specialist Consultation: Given your symptoms and the findings, it would be prudent to consult an Ear, Nose, and Throat (ENT) specialist. They can perform a thorough examination and may recommend additional tests or procedures to assess the lymph node and any associated symptoms.

6. Monitoring: If the lymph node is not causing significant symptoms and there are no alarming features, your doctor may suggest a period of observation. However, if there are any changes or new symptoms arise, further investigation would be warranted.

In summary, while your CT scan did not reveal any immediate concerns, the new development of an enlarged lymph node in the posterior neck should be evaluated further. It is essential to communicate your concerns to your healthcare provider, who can guide you through the appropriate next steps based on your clinical presentation and history. Regular monitoring and follow-up are key to ensuring that any potential issues are addressed promptly.

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