Lymphadenopathy: When to Seek Medical Attention

Q: Lymphadenopathy: When to Seek Medical Attention

Dear Shi： You indicated that your gender is male, but the doctor mentioned it could just be mastitis. <br>You also have a history of lupus erythematosus, which is more common in females, making it a bit unusual. <br>The reason for the swollen lymph nodes could be due to lupus its

Lymphadenopathy..?

Three years ago, I experienced pain in my right armpit, but my family said it was nothing serious, so I didn't pay much attention to it.
About six months ago, I noticed a lump in my right armpit (one larger lump with some smaller ones around it), which gradually increased in size (over 1 cm).
Then it shrank again.
I consulted a doctor, who said that if it had shrunk, it wasn't a major concern and might just be a case of mastitis.
However, I've noticed that this lump sometimes enlarges and sometimes shrinks, and recently it has grown larger again (3-4 cm), and now there is also a lump in my left armpit.
Additionally, when I raise my right arm, there is a noticeable bulge in my armpit.
Could this be cancer? Which specialty should I consult for treatment? I also have lupus erythematosus; could this be related?

shih, 10~19 year old female. Ask Date: 2004/03/20

Dr. Fan Sheng reply Oncology

Dear Shi: You indicated that your gender is male, but the doctor mentioned it could just be mastitis.
You also have a history of lupus erythematosus, which is more common in females, making it a bit unusual.
The reason for the swollen lymph nodes could be due to lupus itself, lymphoma, AIDS, or other infections.
Do you have a cat at home? It would be advisable to consult an infectious disease specialist first.
Wishing you a speedy recovery.

Reply Date: 2004/03/20

More Info

Lymphadenopathy, or swollen lymph nodes, can be a concerning symptom, especially when it is persistent or changing in size. In your case, the history of pain in the right axilla (armpit) and the presence of a lump that has fluctuated in size over time warrants careful consideration.
Lymph nodes can swell for a variety of reasons, including infections, inflammatory conditions, and malignancies. Given your history of systemic lupus erythematosus (SLE), an autoimmune condition, it is important to recognize that autoimmune diseases can also lead to lymphadenopathy due to immune system activation. In SLE, the immune system may mistakenly attack healthy tissues, leading to inflammation and swelling of lymph nodes.

The fact that you have noticed a significant increase in the size of the lymph nodes, particularly with the right axilla swelling to 3-4 cm and the appearance of a lump in the left axilla, is concerning. While the doctor you consulted may have suggested that the changes in size could be related to benign conditions such as breast inflammation, the persistent and fluctuating nature of the swelling, especially with the recent increase in size, should not be ignored.

When to seek medical attention for lymphadenopathy can depend on several factors:
1. Duration: If the lymphadenopathy persists for more than two weeks without improvement.

2. Size: Lymph nodes larger than 1 cm in diameter, especially if they are hard, fixed, or growing.

3. Associated Symptoms: If you experience systemic symptoms such as unexplained weight loss, night sweats, fever, or fatigue, it is crucial to seek further evaluation.

4. Location: Swollen lymph nodes in unusual locations (e.g., supraclavicular area) or multiple regions can be more concerning.

Given your situation, it would be advisable to consult with a healthcare provider who specializes in hematology or oncology, as they can provide a thorough evaluation of your lymphadenopathy. They may recommend imaging studies, such as an ultrasound or CT scan, and possibly a biopsy to determine the nature of the lymph nodes.
In addition, since you have a history of SLE, it is essential to keep your rheumatologist informed about these developments. They can help assess whether your autoimmune condition may be contributing to the lymphadenopathy and adjust your treatment plan accordingly.

In conclusion, while not all lymphadenopathy is indicative of cancer, the characteristics of your swollen lymph nodes, combined with your medical history, suggest that further evaluation is warranted. It is better to err on the side of caution and seek a thorough assessment to rule out any serious underlying conditions.

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