Parotid and cervical region
Hello, Doctor: I am 32 years old, with no smoking, drinking, or betel nut habits, but I do stay up late, with sleep duration ranging from 5 to 7 hours, and I take a 1-hour nap at noon.
My significant medical history includes: 1.
Childhood cryptorchidism, for which I had surgery; a recent ultrasound follow-up showed normal results.
2.
Internal hemorrhoids: I underwent endoscopic ligation surgery, and my condition improved postoperatively; however, if my stools are hard, it can still cause anal fissures, and wiping with toilet paper may result in slight blood traces.
I had a colonoscopy last year, which was normal, and a small polyp was removed and tested normal.
3.
Mild deviation of the left nasal septum, with long-term hypertrophy and redness of the nasal turbinates; I have experienced nasal congestion on the left side since childhood, with fluctuations in severity.
Sometimes, dryness or a cold can cause slight bleeding from the nasal mucosa, but it stops easily.
It is approximately 1 cm in size, with varying consistency—sometimes soft, sometimes hard—and it occasionally enlarges or shrinks.
I would like to know if there is a possibility of it worsening.
Additionally, there are two more lymph nodes in the middle of my left neck, approximately 1 cm and 0.5-1 cm in size, respectively.
I can't recall exactly how long they have been there, but it has been at least two years or more.
Their consistency also varies, and their size changes similarly to the lymph node below my ear.
During or after a cold, they can become slightly enlarged and hard, with mild tenderness upon pressure, but this is inconsistent.
I have consulted three or four ENT specialists and have undergone nasopharyngoscopy and otoscopy.
The doctors stated that there were no abnormalities and advised that the size of the lymph nodes fluctuates due to my body condition and that they have not been persistently enlarging, suggesting they are likely normal reactive lymph nodes that should be monitored without the need for special testing.
In recent years, I have also had blood tests, which showed the following results: WBC: 5500-6500 µL, RBC: 5.5 x 10^6, Hgb: 15.8 g/dL, Hct: 46%, MCV: 84 fL, MCH: 28.9 pg, Platelet: 240-255 x 10^3/µL, Neutrophil: 51-55%, Lymphocyte: 36-41%, Monocyte: 5.2-6%, Eosinophil: 1-1.5%, Basophil: 0.3-0.9%.
Other results showed slightly elevated cholesterol close to 200, TG around 120, total bilirubin 0.7-1.2 mg/dL, direct bilirubin 0.3-0.5 mg/dL, and GOT, sGPT around 20 U/L.
I would like to ask the doctor: 1.
Based on my description, should I continue to monitor the enlarged lymph nodes in my neck? Should I get an ultrasound or any tests? 2.
What can an ultrasound determine regarding the lymph nodes? 3.
Based on the blood report, are there any particular abnormalities that need to be followed up on?
Yilü de ren, 30~39 year old female. Ask Date: 2013/01/24
Dr. Fan Sheng reply Oncology
Concerned individual: Your blood test results are completely normal.
The cervical lymph nodes have been present for a long time and are very small, so there should be no major issues.
Please do not worry.
Reply Date: 2013/01/24
More Info
When it comes to lymph node changes in the neck, particularly in your case, there are several important factors to consider regarding their evaluation and management. Based on your description, you have been experiencing fluctuating sizes and consistencies of lymph nodes in your neck, particularly on the left side, which have been present for a long time. You have also consulted multiple ENT specialists who have reassured you that these changes are likely benign and related to your body's immune response.
1. Observation and Follow-Up: Given that the lymph nodes have been stable in size and have not shown any significant changes over time, the recommendation to continue observation is reasonable. Lymph nodes can enlarge in response to infections or inflammation, and they may return to their normal size once the underlying cause resolves. Since you have experienced these changes during periods of illness (like colds), this further supports the idea that they are reactive rather than malignant. Regular follow-up with your healthcare provider, perhaps every 3-6 months, can help monitor any changes.
2. Ultrasound Evaluation: An ultrasound can provide valuable information about the characteristics of the lymph nodes. It can help determine their size, shape, and whether there are any concerning features such as irregular borders, increased vascularity, or the presence of cystic components. In your case, the ultrasound findings would likely show whether the lymph nodes are consistent with benign reactive changes or if there are features that warrant further investigation, such as a biopsy.
3. Blood Test Analysis: Your blood test results appear to be within normal limits, with no significant abnormalities that would raise immediate concern. The white blood cell count, hemoglobin, and platelet levels are all within the normal range, which suggests that there is no acute infection or hematological disorder at play. The slight elevation in cholesterol is common and may not be directly related to your lymph node concerns. However, if you notice any persistent symptoms such as unexplained weight loss, night sweats, or persistent fever, it would be prudent to discuss these with your doctor, as they could indicate a need for further evaluation.
In conclusion, based on your history and the evaluations you've undergone, it seems that the lymph nodes you have described are likely benign and reactive in nature. Continuous observation, along with periodic ultrasound evaluations, should suffice unless there are significant changes in size, consistency, or associated symptoms. Always keep an open line of communication with your healthcare provider, and do not hesitate to seek further evaluation if you have any new concerns or if your symptoms change. Your proactive approach to your health is commendable, and staying informed will help you manage your well-being effectively.
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