Avatar universal

Swollen nodes slowly growing

Hi, i have recently found two swollen lymph nodes, one above my collarbone and one at the top of my jaw under the ear (not sure what this one is called?) both on the right. I have had night sweats for about 18 months, very run down and tired, and itchy armpits of all things. My doctor is thinking lymphoma so done blood tests and chest xray which came back fine. I am being sent to see a hematologist so just wating for the appointment. Im guessing a biopsy is going to be the only answer to if it is or isnt lymphoma, im trying not to worry, hopefully it will all be fine.

My question is, the lymph nodes are slowly getting bigger every day, not by much but they seem to be growing. Is this somewhat normal? Or could this be a sign that it is somehow getting worse?
12 Responses
1081992 tn?1389903637
At this point everything has to do with probabilities. E.g. the node above the collarbone being *not* hard tends a lot against a metastatic cancer that spread from somewhere inside the chest or abdomen. But the neck node being over 2cm is not good, since a neck node can't typically get that large except from cancer... EXCEPT from some circumstances.

Tuberculosis can result in very large nodes, without there being cancer. Also, an affected node being above the collarbone and also in the neck can be consistent with tuberculosis. Yet you don't have the typical coughing, but then again coughing isn't necessary in every case of tuberculosis.

So the speculation can go round and round until a biopsy  is done wherein a node is removed and examined. An ultrasound has the possibility of maybe giving peace of mind quicker. The reason that TB can create very large nodes is that the node fills up with something called granulomas -- and there are other diseases that create granulomas, too. So there is no need so far to assume that there is a cancer present. It's probably best to be aware of all possibilities, then just choose to believe in the best :)

Best wishes to you.
1081992 tn?1389903637
Hi, do you happen to be pressing on the nodes a lot? If so that can cause irritation that makes them grow a little.

A lot depends on this question: What is the current size?
1081992 tn?1389903637
Avatar universal
Yes i guess i am, so i must be irritating it then. I would say its it roughly 3cm in size

Sorry to say, but 3cm is very large.   Did your doctor see the node at that size? If not, I'd call and tell them that it is that size now, which is important.

With a node above the collarbone  being enlarged, the x-ray was probably done to see if there were any masses in the chest or maybe to look for a fluid buildup called ascites.

You can ask for an ultrasound which is not so certain in diagnosis as a biopsy, but still can tell a very lot about a node. E.g., if a node has a "fatty hilum" as seen in an ultrasound then it's almost always not cancer. You should probably be able to get an ultrasound sooner than a biopsy.

Or maybe even the size is not really 3cm, since it is difficult to tell the size of a node from any surrounding swelling.

Is any node "rock hard"/
Avatar universal
Thank you for your reply.

It is hard to tell the size, the doctor didnt comment on size, and it has got larger since I saw him. Feeling the node in my neck again to try and determine size, I think it is more approx 2.5cm, maybe not quite 3cm which is a big difference i know.. its very hard to tell as there probably is swelling from me messing with it... I cant quite tell the size of the node on my collarbone, possibly somewhere between 1.5cm to 2cm... I know that is a big difference in size.. it is quite a bit smaller than the one in my neck.

I will go back to my doctor and see if I can get an ultrasound in the meantime while waiting for the biopsy, that might calm my mind down if there is fatty hilum in the node.

The nodes are hard, but I wouldnt say rock hard. More like the rubbery type feeling that ive read about.

Im hoping im just freaking out and it turns out to be something less serious.
Avatar universal
I dont know if this helps but I can see the nodes, thats how I first noticed them.

I was looking in the mirror and noticed the lump on my collarbone first. Then felt the one in my neck after that.
Avatar universal
I dont know if this helps but I can see them. Thats how I found them first.

I was looking in the mirror and noticed a lump on my collarbone then felt the one in my neck.
1081992 tn?1389903637
And another thing: it's probably unusual for a lymphoma to start on the neck and then pop up above the collarbone -- or vice versa.

Also, itching under the arms is almost certainly from histamine, but that doesn't pin down any diagnosis. You might try an antihistamine cream or a cortisone cream for relief.
Avatar universal
The doctor did mention TB but said it most likely isnt that. I guess the biopsy is really the only way to find out.

When I found the node above my collarbone, i found the one in my neck at the same time. It does seem that there are a few other possibilities that may be causing this then other than the main one being cancer. And the itching under the arms, I have read there are many causes of this so it is most likely from something else.

Thank you so much for the information, it has given me more knowledge about lymph nodes and I feel a bit more at ease now. I will just hope for the best :)
I think that your situation is ambiguous enough so that no one can make a firm guess. I don't even think that cancer is necessarily the main suspect.

TB is more likely if you've had weakened immunity, possibly even from prolonged severe stress.

Btw, the itching is related to whatever is going on since histamine comes from the immune system and your immune system is definitely involved.

Please let me know how you make fare. I suggest asking the surgeon right after the biopsy about what he saw - rather than waiting in tension for some future office visit. The surgeon might have some very relevant observations just from what was visible with the baked eye.
Avatar universal
It does seem that TB symptoms are very similar. I didnt realize that basically anyone could catch it, I thought it was only most likely within certain situations such as being overseas or around cattle etc so I will keep that very much in mind. I will definitely ask the surgeon to see if he saw anything or can shed any light on it at the time.

I will post back after I have the biopsy with the results :)
Great, it will be good to hear that things turn out for you.

Btw, there has been something of a resurgence in TB - maybe partly from populations moving around.
Avatar universal
Ok i thought i would post an update.

I went to see a hematologist today (very quick refferal) and ive come out a bit more confused...

The doctor said that the nodes in my neck seem to be "shotty nodes", but he was concerned about the supraclavicular nodes. He was not 100% convinced it was lymphoma which is great and hopeful, but he was walking me through about the staging process and chemo etc

I need to have a CT scan from head to pelvis first before a biopsy as he said the nodes in my neck may be too tricky to biopsy. So ct scan is to look for more nodes (my chest and stomach are quite sore) and to tell staging... I also had 7 vials of blood taken to rule out tb etc but also to check for hepatitis as that can interfere with the chemo or something.

So, im not sure why hes talking about this if hes not thinking its lymphoma... And what are shotty nodes? Cant seem to find much info in that from google...
Since lymphoma is possible, that has to be investigated so that lymphoma can ruled in or ruled out.  That'd be true whether the probability was 90% or 10%.

Shotty nodes means a cluster of small, firm nodes - like pellets from a shotgun. They're usually not cancer.

Supraclavicular nodes get enlarged from whatever is occurring inside the chest/abdomen. That could be cancer but also could be inflammation from something like an infection. If the CT finds masses in the chest/abdomen thst the x-ray didn't see, then that would probably also mean metastatic cancer in the supraclavicular node(s). If the CT finds very large nodes, that would tend toward lymphoma, especially if TB can't account for that.  If the CT finds nodes with dead centers (necrosis), that would tend to cancer, except TB can also result in necrosis.

It's possible that you have *two* separate problems going on at the same time (neck and chest/abdomen), but it's more likely that they both have the same cause.

"my chest and stomach are quite sore"    I'd guess that tends against cancer and toward some non-cancer inflammation.

Some types of chemo suppress the immune system. If you have soreness around the liver area, then that could conceivably be hepatitis and chemo can "reactivate" the virus.

Unfortunately, you are in a nebulous situation but that's better than a confirmed bad diagnosis.
Avatar universal
It sounds likd there are quite a few possibilities for what is going on. I can see why they are called shotty nodes then.

I just need to try and take my mind off it until all tests are back and there is more of a clear picture as to what is causing this. Easier said than done unfortunately!

Thank you again for your time and knowledge, it has helped me learn much more about what may be going on and the more possibilities about it being something less serious.
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