Lymph Node in Neck

43-year old male in overall good health.  I visited my PCP this week complaining of fatigue that has lasted about 3-4 months (no known infection, no fever, no night sweats, etc.) and he discovered a small lump in my neck that he thought could be either a carotid body tumor or a swollen lymph node.  He ordered a carotid ultrasound and a CT soft tissue.  The ultrasound examined the lump and defined it as 1.3cm wide x 7mm deep and determined it was likely a lymph node.  The CT found "all lymph nodes and cervical spaces are more numerous than typically seen but none meet the criteria for enlargement."  It determined it was likely just "mild benign reactive lymph node prominence".  That's all great news but here's my question: my PCP had no comment on the findings and so I'm wondering if that's the end of it?  I have a history of cancer in my family (both mother and father) so should I just keep an eye on it?  If so, for how long and what would I be looking for as warning signs that should send me back to the doctor?  Thanks for any advice.

[Kevin Pho, MD]

Continued observation of the lymph nodes should be done.  Any infection or inflammation can lead to enlargement of the lymph nodes.  If this is the case, appropriate antibiotic therapy can be done.  

If the lymph nodes continue to be enlarged or are more prominent, a referral to an ENT can be considered for possible biopsy.

I would also consider a blood test to evaluate the blood count - possible lymphomas can present this way.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[mybrg]

Forgot to mention that the PCP ordered a CBC (came back "normal" but I didn't get the #'s) and a B12 test (came back borderline low at 270).  Since I've had problems in the past keeping my B12 level up he prescribed monthly injections, which I've just started.

[potatofanatic]

I woke up Saturday morning and got in the shower, I noticed a lump on the back of my neck while washing my hair. The lump had a appeared over night, and is tender to the touch. I am having a hard time distinguishing between it being a knot in my muscles or it being a swollen lymph node. My neck on the right side is very tight and sore. How do I tell the difference and should I go to the doctor??

[skeetelmore65]

A related discussion, have a knot under my ear area and under chin was started.