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Lumps in my neck, what could it be?
Since many years ago (about 15) I have noticed palpable lymph nodes on the posterior triangle, on both sides of my neck, one week ago I felt a little pain (it only lasted for some hours) on the right side of my neck, and noticed it was swollen, it's clearly visible specially if I turn my neck towards the opposite direction, about 2 cm in diameter, it feels rubbery, no redness on skin, no pain at all, I don't feel like it moves at all, maybe bend a little but no displacement while touching it. About 4 days later I noticed a small lump, maybe less than a cm, in what I believe is called the "upper jugular" area, I think it corresponds to level 2 lymph nodes, it feels hard, unmovable and clearly visible if I look upwards (towards ceiling).
What could be the cause?
I'm 30 years old, have smoked a pack a day for about 15 years, social drinker.
Don't know if relevant but about a year ago I started losing weight (unintentionally), followed after by lack of appetite. I also sleep 12 hours a day. But this last symptoms could be due to depression (not sure if I have that, but I do show a lot of signs)
Thank you for your time.
What could be the cause?
I'm 30 years old, have smoked a pack a day for about 15 years, social drinker.
Don't know if relevant but about a year ago I started losing weight (unintentionally), followed after by lack of appetite. I also sleep 12 hours a day. But this last symptoms could be due to depression (not sure if I have that, but I do show a lot of signs)
Thank you for your time.
COMMUNITY LEADER
Hi, first off the original bumps are extremely unlikely to be cancer without growing or multiplying over 15 years.
Next, the current mystery bumps are likely to have the same cause as the original ones. That might be cysts, lipoma, or a node with granuloma, or a mystery immune reaction.
Having pain and swelling and a resulting new bump sounds like an immune reaction, whether to an infection or some immune dysfunction.
If you are very worried, or if they start multiplying a lot, a sonogram might be in order.
Do you have a lot of gastrointestinal symptoms?
Next, the current mystery bumps are likely to have the same cause as the original ones. That might be cysts, lipoma, or a node with granuloma, or a mystery immune reaction.
Having pain and swelling and a resulting new bump sounds like an immune reaction, whether to an infection or some immune dysfunction.
If you are very worried, or if they start multiplying a lot, a sonogram might be in order.
Do you have a lot of gastrointestinal symptoms?
4 Comments
Hi, thank you for answering.
No gastrointestinal symptoms, except maybe a little bit of constipation (specially when I was younger), and also at times I have seen a tiny bit of blood in stool (light red/fresh), this has also happened over many years but not every day of course, at times, yesterday I noticed it again, hadn't happened in a while.
I just remember about 10 years ago I was feeling sick (headache, fever, vomit), at the 3rd day my mother noticed my neck was swollen, I had swollen tonsils, the doctor prescribed antibiotics and it went away. about once every year or two my tonsils would start to get swollen and I would always use the same antibiotic and problem solved, but now is less frequent, haven't had that for at least 2 years.
I'm still going to a GP on monday for a checkup, I should write down all this things so that I can remember to ask him.
Thank you.
No gastrointestinal symptoms, except maybe a little bit of constipation (specially when I was younger), and also at times I have seen a tiny bit of blood in stool (light red/fresh), this has also happened over many years but not every day of course, at times, yesterday I noticed it again, hadn't happened in a while.
I just remember about 10 years ago I was feeling sick (headache, fever, vomit), at the 3rd day my mother noticed my neck was swollen, I had swollen tonsils, the doctor prescribed antibiotics and it went away. about once every year or two my tonsils would start to get swollen and I would always use the same antibiotic and problem solved, but now is less frequent, haven't had that for at least 2 years.
I'm still going to a GP on monday for a checkup, I should write down all this things so that I can remember to ask him.
Thank you.
I'd asked about the GI symptoms since that seemed a probable cause for the weight loss. (There's no reason to think you have the cachexia that comes from cancer.)
I bet that the doc will disregard the occasional GI bleeding, but I wouldn't. Unless you are taking daily aspirin or something like that, it's probably all related. I'd guess that you have some infection that gets sometimes reactivated, or some immune dysfunction that will affect your health for all your years - though not very seriously.
Good luck, let me know what the doc says.
I bet that the doc will disregard the occasional GI bleeding, but I wouldn't. Unless you are taking daily aspirin or something like that, it's probably all related. I'd guess that you have some infection that gets sometimes reactivated, or some immune dysfunction that will affect your health for all your years - though not very seriously.
Good luck, let me know what the doc says.
Hi, I know it's been over a month, so here's what has happened so far:
BTW, I'm going to be translating results from spanish to english, so some words may not be very accurate.
I had full blood work done, everything was within normal range. The tests also included HIV, Epstein-Barr and Cytomegalovirus, all of these came out negative.
Also had an ultrasound of neck, thyroid, abdominal area(?) and a chest x-ray.
Thyroid ultrasound: everything perfect.
Abdominal area: Everything perfect.
Neck ultrasound: Radiologist wrote that the lumps on the side of my neck were possible lipomas, but he wasn't sure because he recommended looking into it. He described them as "Bilateral Symmetrical", they are located in the posterior triangle. The other one, near the throat he did say was a lymph node.
Chest X-Ray: Exerything fine, something about Hilar engorgement or enlargement(not sure how to translate the word) of vascular origin.
Went back to doctor, showed him the results (this was one week ago). He said the chest x-ray looked like the chest xray of a perfectly healthy 45 yo man. I'm 30 yo... he explained is due to smoking (I have smoked a pack a day for about 15 years).
Doctor said that while the neck ultrasound suggested lipomas, he said it was very strange that 2 lipomas would simultaneously show up symmetrical and bilateraly. He said it was possible, but a somewhat rare coincidence, and since the radiologist didn't seemed convinced either, he told me to get another ultrasound to confirm. Also the fact that there is one swollen lymph node along the 2 suspected lipomas made him doubt even more. I asked him if an MRI would be better and while he felt it wasn't necessary, he gave me the order for neck MRI anyways.
Today I got the results for the neck MRI, it says: "Posterior bilateral cervical adenopathy"
So I'm going back to the doctor monday or tuesday.
Also, 2 days before I went to the doctor, I had noticed what seemed like swollen lymph nodes near the inguinal(?) area. They are alongside the "V" looking part of your body, bottom of the V being the genitals, the "V" extending upwards and outwards diagonally towards the sides. (Sorry for my bad english, I know this is a horrible explanation). So anyways, doctor checked and took note of that.
If you are still reading this, thanks a lot for your time!
So currently I have no clue as to why my lymph nodes are swollen, but they have remained exactly the same, thought I get the feeling that at least one of them may have expanded a little, specially around the vein that goes near it.
BTW, I'm going to be translating results from spanish to english, so some words may not be very accurate.
I had full blood work done, everything was within normal range. The tests also included HIV, Epstein-Barr and Cytomegalovirus, all of these came out negative.
Also had an ultrasound of neck, thyroid, abdominal area(?) and a chest x-ray.
Thyroid ultrasound: everything perfect.
Abdominal area: Everything perfect.
Neck ultrasound: Radiologist wrote that the lumps on the side of my neck were possible lipomas, but he wasn't sure because he recommended looking into it. He described them as "Bilateral Symmetrical", they are located in the posterior triangle. The other one, near the throat he did say was a lymph node.
Chest X-Ray: Exerything fine, something about Hilar engorgement or enlargement(not sure how to translate the word) of vascular origin.
Went back to doctor, showed him the results (this was one week ago). He said the chest x-ray looked like the chest xray of a perfectly healthy 45 yo man. I'm 30 yo... he explained is due to smoking (I have smoked a pack a day for about 15 years).
Doctor said that while the neck ultrasound suggested lipomas, he said it was very strange that 2 lipomas would simultaneously show up symmetrical and bilateraly. He said it was possible, but a somewhat rare coincidence, and since the radiologist didn't seemed convinced either, he told me to get another ultrasound to confirm. Also the fact that there is one swollen lymph node along the 2 suspected lipomas made him doubt even more. I asked him if an MRI would be better and while he felt it wasn't necessary, he gave me the order for neck MRI anyways.
Today I got the results for the neck MRI, it says: "Posterior bilateral cervical adenopathy"
So I'm going back to the doctor monday or tuesday.
Also, 2 days before I went to the doctor, I had noticed what seemed like swollen lymph nodes near the inguinal(?) area. They are alongside the "V" looking part of your body, bottom of the V being the genitals, the "V" extending upwards and outwards diagonally towards the sides. (Sorry for my bad english, I know this is a horrible explanation). So anyways, doctor checked and took note of that.
If you are still reading this, thanks a lot for your time!
So currently I have no clue as to why my lymph nodes are swollen, but they have remained exactly the same, thought I get the feeling that at least one of them may have expanded a little, specially around the vein that goes near it.
Hello, again. It seems that essentially nothing has changed, except for the one, new important development(more on that later).
There are still many possible causes for what you are experiencing. The doctors' approach was to rule out the worst possible causes such as lymphoma, and that has been accomplished even more so than before.
I don't think that anything with your chest is relevant to this, as chest cancers and sarcoidosis weren't found.
The reason that the ultrasound showed possible lipomas would be that they didn't see the "fatty hilum" in the nodes. The loss of the hilum happens in lymphoma, but relevant to you it also happens with a severe inflammation in the node. The normal components (like the hilum) inside a node get destroyed and get replaced with scar tissue called fibrosis. The fibrosis is created by immune cells during inflammation. The fibrosis can last a long, long time just as does scar tissue in the skin.
So that likely explains why the nodes have not gone down in size. Some infection in the nodes resulted in fibrosis. What kind of infection? Since you've had long experience with infections that got better from antibiotics, then this problem is probably from that same bacteria (as opposed to a virus or fungus or parasite).
One other part of this is that sometimes a person's immune system cannot wipe out an infection and so the immune cells have no choice but to wall off the infection to contain it. This is called "granuloma". Forming the granuloma is what eventually also leads to fibrosis. Examples of well known granuloma diseases are tuberculosis and cat scratch fever.
Lastly, we come to that one, new important development, which is that the infection seems to be spreading to the groin (inguinal) nodes. If so, you have what is categorized as "generalized lymphadenopathy" -- which reduces somewhat the possible causes because not all bacteria result in a widespread pattern like that. There might be other enlarged nodes in the abdomen. But so far, things don't seem too serious.
It's good that you keep examining yourself, but don't be too worried. The underarm (axillary) area is also a likely spot for nodes to enlarge.
A node can get irritated and enlarge a little from too much pressing.
You can ask for a needle biopsy, and hope that by chance the needle draws out the immune cells and bacteria that let them make a diagnosis.
Do you have a family history of mystery infections or any odd immune conditions?
Btw, your English is very good :)
There are still many possible causes for what you are experiencing. The doctors' approach was to rule out the worst possible causes such as lymphoma, and that has been accomplished even more so than before.
I don't think that anything with your chest is relevant to this, as chest cancers and sarcoidosis weren't found.
The reason that the ultrasound showed possible lipomas would be that they didn't see the "fatty hilum" in the nodes. The loss of the hilum happens in lymphoma, but relevant to you it also happens with a severe inflammation in the node. The normal components (like the hilum) inside a node get destroyed and get replaced with scar tissue called fibrosis. The fibrosis is created by immune cells during inflammation. The fibrosis can last a long, long time just as does scar tissue in the skin.
So that likely explains why the nodes have not gone down in size. Some infection in the nodes resulted in fibrosis. What kind of infection? Since you've had long experience with infections that got better from antibiotics, then this problem is probably from that same bacteria (as opposed to a virus or fungus or parasite).
One other part of this is that sometimes a person's immune system cannot wipe out an infection and so the immune cells have no choice but to wall off the infection to contain it. This is called "granuloma". Forming the granuloma is what eventually also leads to fibrosis. Examples of well known granuloma diseases are tuberculosis and cat scratch fever.
Lastly, we come to that one, new important development, which is that the infection seems to be spreading to the groin (inguinal) nodes. If so, you have what is categorized as "generalized lymphadenopathy" -- which reduces somewhat the possible causes because not all bacteria result in a widespread pattern like that. There might be other enlarged nodes in the abdomen. But so far, things don't seem too serious.
It's good that you keep examining yourself, but don't be too worried. The underarm (axillary) area is also a likely spot for nodes to enlarge.
A node can get irritated and enlarge a little from too much pressing.
You can ask for a needle biopsy, and hope that by chance the needle draws out the immune cells and bacteria that let them make a diagnosis.
Do you have a family history of mystery infections or any odd immune conditions?
Btw, your English is very good :)
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