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Gastroenterology (Expert Forum)
lymph pain
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
lymph pain
by Fishmael, May 09, 2004 12:00AM
Hello.
I have a couple of specific medical questions (but rather general, almost theoretical).
Maybe you could help me with them, or at least point to where and how I can get some authoritative answers.
They have to do with "pain", and they have to do with the "lymph system".
Most of what I have read so far about lymph nodes assume that the nodes are enlarged, and then there are explanations for the enlargement.
My primary question: Is it possible for lymph nodes to cause pain, and not be noticeably swollen (no detectable enlargement in imaging studies -- CT, MRI, xray, ultrasound)? (I am particularly interested in the mesenteric lymph glands.)
Is there any literature that documents, or hints at this possibility?
My secondary question: Is it possible for a pathogen in the lymph nodes to cause this pain, and still not have WBC's or lymphocytes noticeably elevated? (Or whatever other indicators to be found in the average CBC, that would show evidence of a pathogen?)
Is there any literature that documents, or hints at this possibility?
I have a couple of specific medical questions (but rather general, almost theoretical).
Maybe you could help me with them, or at least point to where and how I can get some authoritative answers.
They have to do with "pain", and they have to do with the "lymph system".
Most of what I have read so far about lymph nodes assume that the nodes are enlarged, and then there are explanations for the enlargement.
My primary question: Is it possible for lymph nodes to cause pain, and not be noticeably swollen (no detectable enlargement in imaging studies -- CT, MRI, xray, ultrasound)? (I am particularly interested in the mesenteric lymph glands.)
Is there any literature that documents, or hints at this possibility?
My secondary question: Is it possible for a pathogen in the lymph nodes to cause this pain, and still not have WBC's or lymphocytes noticeably elevated? (Or whatever other indicators to be found in the average CBC, that would show evidence of a pathogen?)
Is there any literature that documents, or hints at this possibility?
Doctor's Answer
by Kevin Pho, MD, May 10, 2004 12:00AM
, May 10, 2004 12:00AM
Surgeon has eloquently provided an answer in the comments below and I will reprint it here (since comments do not get saved):
"Any primary process involving lymph nodes which is of clinical significance would cause enlargement. It's possible to have pathology in lymph nodes which would not cause abnormalities in the CBC. Mesenteric lymph nodes in particular would not be a source of pain if they were of normal size. It's possible to have small deposits of metastatic cancer in lymph nodes that would not cause enlargement; but in that case there would not be pain from the nodes, and if there were symptoms it would be due to the cancer in whatever location was the source of the spread to the nodes, and not the nodes themselves. If you have specific symptoms for which you are trying to find info, it might help to describe the situation. Mesenteric lymph nodes, and especially ones that are normal size on imaging, would not be a primary source of pain or any symptoms."
I would like to add that in cases of immunosuppression (i.e. in HIV patients or patients receiving chemotherapy), the WBC would not be elevated in the presence of a pathogen.
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.
Medical Weblog:
kevinmd_b
"Any primary process involving lymph nodes which is of clinical significance would cause enlargement. It's possible to have pathology in lymph nodes which would not cause abnormalities in the CBC. Mesenteric lymph nodes in particular would not be a source of pain if they were of normal size. It's possible to have small deposits of metastatic cancer in lymph nodes that would not cause enlargement; but in that case there would not be pain from the nodes, and if there were symptoms it would be due to the cancer in whatever location was the source of the spread to the nodes, and not the nodes themselves. If you have specific symptoms for which you are trying to find info, it might help to describe the situation. Mesenteric lymph nodes, and especially ones that are normal size on imaging, would not be a primary source of pain or any symptoms."
I would like to add that in cases of immunosuppression (i.e. in HIV patients or patients receiving chemotherapy), the WBC would not be elevated in the presence of a pathogen.
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.
Medical Weblog:
kevinmd_b
Member Comments (1)
by surgeon, May 10, 2004 12:00AM
Any primary process involving lymph nodes which is of clinical significance would cause enlargement. It's possible to have pathology in lymph nodes which would not cause abnormalities in the CBC. Mesenteric lymph nodes in particular would not be a source of pain if they were of normal size. It's possible to have small deposits of metastatic cancer in lymph nodes that would not cause enlargement; but in that case there would not be pain from the nodes, and if there were symptoms it would be due to the cancer in whatever location was the source of the spread to the nodes, and not the nodes themselves. If you have specific symptoms for which you are trying to find info, it might help to describe the situation. Mesenteric lymph nodes, and especially ones that are normal size on imaging, would not be a primary source of pain or any symptoms.
