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enlarged lymph nodes
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by CCgurl, Apr 01, 2002
Hi Doctor.  I am 19 yrs of age, and about a month ago, I became extremely sick.  It felt like flu symptoms at first, but then the symptoms persisted for almost 2 weeks.  I had chills, body aches, a fever, sore throat, and very bad coughing.  The doctor told me that I might've caught some sort of virus because flu symptoms don't usually last for that long.  In between those two weeks of feeling ill, I woke up one morning and noticed that my
left underarm (armpit) area was extremely tender and sore.  I
thought nothing of it at first, but 3 days later, the soreness was still there.  When I finally started feeling on it, I noticed a lump there, or a lymph node if u will.  It was still extremely tender to the touch, so I began to worry.  By this time, my "flu-like" symptoms were going away, but the lump and the soreness was still there.  When I finally went back to the doctor, he suspected that it was mononucleosis, and did a monospot test on me.  The test result turned out to be negative, so he prescribed something called Zithromax for me, and told me that if the lump was still there in two weeks, go back and see him.  It's been about 3 weeks now and the pain and tenderness has completely disappeared, but the lump is still there.  I don't have insurance and was waiting a while before I had to visit the doctor again, but now I am gettin myself more and more worried.  I'm thinking the worse, cancer possibly?  So my questions for you are, can the lymph node be due to the virus or infection I had?  What will the next step be if I do go back to the doctor?  Could this possibly be something serious? Cancer?
Also, the lymph node in my neck is also enlarged too.
I would appreciate any insight you could give me on the stressful matter.
Answer:
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by Forum-M.D.-DT, Apr 01, 2002
Thanks for visiting the Family Practice Forum.
What you are describing sounds to me like a viral infection, quite possibly mono (the tests are not 100% accurate), with resultant getneralized lymphadenopathy. It sounds like this lymph node under your arm got more inflamed than others and may have had a secondary bacterial infection associated with it (hence the prescription for the antibiotic - Zithromax).
The good news is that "cancer" of the lymph nodes is rarely painful and would not improve with antibiotics.

I, however, understand your concern. If the lymph node enlargement persists, your doctor may consider doing a "biopsy" of the gland itself. It is not uncommon for lymph nodes to remain enlarged for a period of time after an infection is present. Lymph nodes help to clear the body of infection, this is why they get larger when there is an infection.

Characteristics of lymph node swelling that are more concerning are:
1. Hard (like a stone)
2. Fixed (meaning they appear to adhere strongly to the tissue around them).
3. Non-tender.

What you describe to me does not SOUND like cancer, but, any persistent lymph node swelling ... should be biopsied if it does not continue to improve after the infection clears.

I hope this helps

Dean M. Tomasello, M.D.
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Member Comments (13)
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by CCgurl, Apr 01, 2002
Thank you doctor for your quick response.  One more question, how long does it usually take for a lymph node caused by an infection to disappear, since I was sick for a long period of time.  And when should I go back to the doctor to get, perhaps a biopsy?

Thank you again.
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by treponema, Apr 19, 2002
Acute symptoms like yours could suggest an Acute Retroviral Syndrome. I dont want to scare you but if you had unprotected sex or exchanged IV needles with someone of unknown (or positive) serostatus in the 2-4 weeks before the onset of your symptoms i suggest HIV antibody testing at 3 months post exposure. Consult your healthcare provider about this issue.
Take care.
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by treponema, Apr 19, 2002
Acute symptoms like yours could suggest an Acute Retroviral Syndrome. I dont want to scare you but if you had unprotected sex or exchanged IV needles with someone of unknown (or positive) serostatus in the 2-4 weeks before the onset of your symptoms i suggest HIV antibody testing at 3 months post exposure. Consult your healthcare provider about this issue.
Take care.
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by CCgurl, Apr 30, 2002
Thanks treponema for responding, but I highly doubt that it is what you're describing because I have been with my bf for a while now, a little over a yr, and it's just been us two.  And also about a year ago, I had an HIV test, and std test done, all negative.  So right now, no worries in that department.
As for the lymph node, it's still there!!!  I'm still waiting to go back to the doctor but I think I am soon.  

Well anyways, thank you for your info and anyone else that could give me some insight, please feel free to.

Thanks.
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by kid louise, Jun 01, 2002
I was recently diagnosed with a kidney infection. The Dr. put me on Bactrim DS for a week without results. He now has me on Levaquin,I've been on this for four days now and I'm still having pain. I also have some swelling in my groin area?
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by llraz, Jun 03, 2002
I am also interested in CCgurl's question regarding how long a lymph node could be enlarged after an infection.  I have a hard, non-tender marble size lump that my doctor thinks is an enlarged pre-auricular lymph node possibly from a breakout of acne, or possibly due to an infection in the lymph node itself.  I am on tetracycline now and acne is getting better, but the lump is not changing.  I have seen in several articles that these enlargements may persist "for a period of time", but does that mean several days, a week, several weeks, several months?

Does anyone have any information on this?
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by grannymac17, Jul 08, 2002
I'm a 50 year old female post kidney stone and complications arising from treatment (chf, lyte imbalance, anemia).  However, even after those were resolved, I started spiking temps of 99.5 to 102. Hosp. from 6/16 through 7/3 - fevers persisted with or without antibiotics.  Many tests run to determine infection process including indum scan (results pending).  CT scan of chest showed an enlarged mdiastinal node plus possibly others (fluid in lungs may have masked other enlarged nodes).  History of breast cancer with 33 rads and 4 a/c treatments.  My doc proposed lymphoma, but two onco's aren't concerned.  Symptoms now include debilitating, and I mean debilitating weakness./fatigue and spiking fevers - when I spike fever, I feel quite ill, like I got hit by a mack truck.  Present meds are tamoxifen, tenormin and effexor (for hot flashes).  I often wake up sweating at night and sometimes very wet in the morning (effexor had stopped night sweats a long time ago).  Current history of removal of ovaries due to an ovarian cyst (negative pathology).  Even during chemo I worked full-time, drove 80 miles/day on on chemo week ocasionally travelled 200-300 miles.  My doc wants me to get 2nd opinion at local cancer center here.  THEY want node biopsied before I can see their hemo.  My desire is to have their hemo see pics to determine IF node should be biopsied (biopsying a mediastinal node is not simple).  Going to try to break deadlock.    

Should I insist on a retake of the chest ct scan now that the fluid in lungs is resolved?  Should I push for avenues other than an infection process (depending on scan results) and should I be concerned about NHL?

Thanks!  I just want my life back and to get back to work.  Normally very active person.  Work as typesetter for newspaper and independent computer consultant (0wn company).  Needless to say, these are on hold.
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by Malaysian, Jul 08, 2002
Hi my name is quek a malaysian, age 52 male,
would anyone be able to help me. below is my histopathology report.
Nature of Specimen: Left Cervical lymph node

Macroscopic description: lymph node measuring 7cm x 6cm x 2cm.RS 3 Blocks

Microscopy: Lymph node showing complete effacement of the nodal architecture by a monotonous population of neoplastic lymphoid cells.
A follicular arrangement is discernible.

Immunohistochemistry:
CK:Negative       CD20:Positive
LCA:Positive      BCL2:Positive
CD3:Negative      CD30:Negative
Conclusion:Left cervical lymph node:B-cell follicular lymphoma

Does this mean I have lymphoma? What should I do? I was advise to undergo a chemotherapy. but am afraid of complications
and futhermore it is very very expensive here.

please help