Lymph nodes - Enlarged

I have had enlarged groin lymph nodes for over a year.  They were painless but were not getting any smaller.  A few weeks ago a general surgeon excised one superficial groin node.  The result came back as a reactive lymph node.  Is it normal to have a lymph node considered "reactive" for that length of time?  I now have a huge lump, about 3 inches by 2 inches just below the incision site.  It is not painful but is hard and not mobile.  When I questioned the surgeon he said he "interrupted" the femoral chain and it could take 3 to 4 months for this to resolve.  This sounds a little odd to me.  It almost seems like another lymph node has enlarged.  I did not know if this was due to the surgery.  My PCP thinks it might be a hematoma - I have applied heat and still have had no luck with the size diminishing.  Is it possible that there could be something going on in my lymph system and the one that was excised was normal but others may not be?  Do I really wait 3 or 4 months to see if this resolves?

[Fernando Roque, MD]

Hi.  A "reactive" node is a lymph node which gets enlarged as a result of an inflammation or infection in a nearby area.  If that inflammation/infection has not resolved, or is chronic or recurrent, then it is possible for the node to remain enlarged for over a year.  If you have doubts about the pathology result, you can bring the biopsy specimen and slides to another pathologist for a second opinion.  It is always possible that something was missed out during the initial examination of the biopsy slides.

The hard lump just below the incision site that appeared after the surgery may be  hematoma, as your primary physician has suggested. If it is, it may take 3 weeks or more to heal. Another possibility is that some lymphatic vessels ("the femoral chain") were damaged during the surgery. If this is the case, lymphatic fluid may accumulate below the incision site and cause the lump.  I'm not sure though, if it's going to take 3-4 months for this kind of situation to resolve.