Enlarged lymph node in my 10 year old son

[brinkx6]

The doctor found an enlarged lymph node on my son's neck during a recent physical for school. He said to watch it for a a couple of weeks to see if it would go away. He was not sick then nor is he now. After 3 weeks it was still there so. Doctor said it could be an infection, asked if he had been scratched by a cat as that could cause an infection, but then said it could be something worse. After 3 weeks it was still there. Doc put him on 600mg augmentum, so far after 1 week, no change. My question is, should I just sit back and wait for another week, or should I be more pro-active and insist on a possible biopsy? I don't know what the chances of this being a lymphoma is, but I was quite un-nerved over the way the doctor said that it could be something worse. He had bloodwork done, and it showed no infection. I know I am a worrywart, but this is my son. Thanks in advance.

[Dennis MD]

Hi.
Just have some clarifications.  How is your son doing?  What are your son’s symptoms?  When did you notice the appearance of the lymph node?  What other examinations were already done?
Infection is a common cause of enlargement of the lymph nodes in the neck.  Both acute and chronic infections can cause this enlargement.  Even with treatment of antibiotic, there are times when the lymph nodes do remain enlarged.  
I believe your concern is valid.  There is a need to rule out other conditions that can cause enlargement of the lymph nodes like lymphoma.  Other examinations like chest x-ray may be needed before pushing for a biopsy.  

[brinkx6]

Thank you for your response. The lymph node has been there for several months. Never gave it a lot of thought. The doctor noticed it about 4 weeks ago during routine physical for school. I don't know what it was about it, maybe that it is firm and does not move. He did test for a cat scratch as well as cbc/diff. No infection found. He did actually say it could be something worse than an infection, and was point-blank that it needed to come out if it was still there after antibiotics were done. I guess the only other concern is that my son sweats terribly at night. His weight has gone down a pound or two but mothing drastic. I might be worrying more than necessay, but my husband had prostate cancer at age 42, and we never expected that, so this is very concerning to me. I just feel so unsettled with the whole thing. I guess if we did do the biopsy and nothing showed up, I would finally feel at ease, it's always that fear of waiting and regretting that we did.

[Dennis MD]

Hi.
Thanks for the clarifications.  
Your son has non specific symptoms and that warrant further examinations.  I think the best thing to do is to perform other diagnostic examinations with his doctor in order to have a more definite diagnosis.  A biopsy of the lymph node may be needed in order to rule out the presence of lymphoma.  
Good luck.