Enlarged lymph nodes, grown on serial exams

Hi,

Last November I had an U/S done on my thyroid because of hoarseness. While doing this, they found some lymph nodes in my neck. The largest in the left submandibular region was 1.4 x 0.6cm and in the right submandibular region was 1.5 x 0.7cm. The report said the lymph nodes have a normal fatty hilum and appear reactive.

Because of this, I had a followup ultrasound again at the end of February. The results are below. I am confused on a few things:

1. In the first ultrasound they said they look clearly benign and reactive. Now in the second on the radiologist just says unclear if reactive. I'm assuming if they had loss of hilum or anything bad he would say so, but what does "unclear if reactive" really even tell me?

2. I also have a 2.4 x 0.8cm lymph node in my right armpit, but this appears benign. An FNA was done to be safe, but it was inconclusive, so I will have a scan again later this year. When I see my doctor again, do you think I should push for a biopsy or are they still too small?

3. I know submandibular is not a "scary" place to have enlarged lymph nodes, but is it possible for it to be lymphoma there. I know I likely don't have it, just was curious if it was even a possibility. I just want to know some facts, so I can be ready on what to ask when I see my specialist. Also what does followup mean, I've already waited 4 months and it has grown, not sure what they mean by followup. Thanks a lot!!!

RESULTS: Thyroid gland is normal in size and echogenicity. No focal nodule. Slightly prominent lymph nodes within the neck measuring up to 2.2cm x 2.1cm x 0.9cm in the right submandibular region and 2.3cm x 1.5cm by 0.8cm in the left. Lymph nodes have increased from prior scan during November 2010.

IMPRESSION: No evidence for suspicious thyroid nodule. Slightly prominent nodes within the neck increased from prior ultrasound. It is unclear if these are reactive. Follow-up is recommended.