Self-Exam Finding?

I have seen via this site and many others (WebMD, Mayo Clinic, etc.) that self exams are a good idea for things like testicular cancer, periodic lymph node exams, etc.

I had a tonsil (right one) enlarge in April and when I went to my GP, she noted it looked to be due to my seasonal allergies, which have been aweful this year with fairly significnt post nasal drip which has caused me to have pressure in my ears that requires me to pop my ears on a regular basis.  The swelling went down within a day and I had no other symptoms - no sore throat, fever, tenderness of the tonsils, etc.

Move forward to July. I was able to "extract" something like a tonsil stone, but the consistency of the stone was not hard like others I've fished out of the tonsil crevices - it was more like playdough and looked kind of like puss.  When this occurred, I had no pain, no sore throat, no fever, etc. Just allergies.  Actually, I haven't been sick in quite some time.  The stuff that came out was also not as "smelly" as the tonsil stones I've had in the past.

During these past couple months, I've been overly aware of my neck and I'm often palpating to see if I can find any other "issues" or changes to any of my anatomy - especially looking for swollen nodes and/or lumps. Probably a month or two ago I noticed two lumps on either side of my neck (i.e. not right in the center on my neck; both are off-center using my adam's apple as "center") - they are above my thyroid and below the jaw line in a line that appears to be almost directly below the tonsils.  They do not hurt, do not appear to be growing, and they move when I swallow.  The are not near my jaw line where I assume my lymph nodes are at - these two lumps are deeper, toward my neck, and I have to push (in and slightly up) into my skin with my index finger and thumb to feel them at the same time.  They are probably 1 cm or less in size and they move fairly freely when I palpate with my hand.

My questions:

1.  Could these lumps be my tonsils (or the bottom of them)?
2.  If they are not my tonsils, what could they be? Submandibular or other glands?
3.  If these were lymph nodes and were considered 'enlarged', should I expect to be having other symptoms (i.e. fever, sore throats, etc.)?  I had blood work done in late April (CBC, comp metabolic panel and TSH) and all results were well within normal ranges.

I know with seeing me you can't tell for sure, but just curious, given the background I've provided, what things I should be considering here.  I do plan to see my GP in 2 weeks time, but wasn't sure if I should move my appt up or not.  Cheers.

[Kevin Pho, MD]

To answer your questions:
1) Tonsillar swelling is possible.  I cannot be exactly sure what it is without a physical examination.

2) A cyst, mass, calcification or other glands are all possible.  A referral to an oral surgeon or ENT physician can provide a more detailed evaluation.

3) Normally enlarged tonsillar nodes would be indicative of infection.  Testing for mono as well as strep can be considered.  

If the symptoms continue, referrals to the aforementioned specialists can be considered.

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_