"So I guess I’m wondering is 1cm in the long axis something that can be ‘original from birth’ so to speak?"
"Still I’m just curious if having a handful of 1.2-1.4 cm lymph nodes is something worrisome or just natural anatomy..."
Fibrosis, maybe granulomas... maybe also some reactive proliferation.
I don't think that a node that is just sitting and waiting for some stimulus would be 1.4cm in length. It would be smaller. You have several hundred nodes, some hundreds are in the neck -- most are not big enough to be seen on a US.
it says: "Lymph nodes ranged from 0.4 cm to 2.7 cm in diameter... The largest lymph node analyzed was an extraglandular parotid lymph node, which measured 2.7 cm."
But I don't see any 2.7 in the actual table. If there is a real 2.7, maybe it's a genetic fluke or else some reaction.
"Ultimately though my sizes aren’t concerningly large though?"
The are not near to where one would think that a cancer is the likeliest explanation.
"I’m assuming the very long period of no growth would also be a bigger indicator eliminating the potential ‘false negstives’"
Yes, quite true. A cancer would have had to stop growing, lying dormant now after having been more aggressive. Very improbable.
"That also concerns me though because it says small nodes should be considered for the fact they can contain malignancies that ‘do not expand the node’ is that saying that there are cancers that just wouldn’t grow the node over time?"
I would take it more that a small node cancer is just beginning to grow and would be larger when scanned again later. But that small node cancer would still tend to be rounded.
Thanks, and a [belated] Merry Christmas to you, too!
Let's try a few:
"The largest node in my upset neck almost under my chin is 1.4 centimeters long and .4mm in diameter."
Cancer makes nodes go toward roundness, so therefore that very long and thin node seems fine. When cancer cells proliferate, they go willy-nilly in all directions at once; but normal cells proliferate in a controlled manner.
"So basically is being basicall 1.4 centimeters ‘tall’ as she put it, concerning or can nodes under the jaw normally be that large?"
Reactive nodes are 'normal'. Now, just to show how terms are confusing, reactive nodes fall also under 'lymphadenopathy' even though there is no pathology as in 'abnormal'.
A reactive node can certainly be normal at 1.41cm length, yes. Maybe 2cm and more. (But check this, just show how things can vary and there is no hard limit: I'd once read a paper which showed than reactive nodes in Brazil get longer than in other countries.)
Look here at Figure 1, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5073388/
The long axis is called 'largest diameter'. Other authors use 'diameter' as meaning short axis. Some say the upper limit for neck short axis is 1cm, some say it is 1.5cm. (Inguinal is generally bigger.)
"Because the radiologist report said even the nodes over a cm in long axis (a handful of them) weren’t considered enlarged so I don’t understand how that could be."
Does it say "not enlarged", or does it say "not pathologically enlarged" or "not abnormally enlarged"?
It turns out that your own cite handles the question of size quite nicely:
It's about head and neck cancers, not lymphoma, but still applies.
"Evaluating abnormal nodes by size is confusing because there are multiple size criteria reported in the literature for cervical lymph nodes..."
"In clinical practice, size is not a reliable marker of malignancy."
But there's a lot more to be garnered from that article than just those conclusions. E.g., when they talk about sensitivity versus specificity - that really gets to the heart of most of these questions of yours. IOW, if you set the size limit too low, you get too many false positives. If you set the size limit too high, you get too many false negatives. The grand lesson: overall, the size limits are not something set in stone anyway.
Here was the other article I mentioned about how occasionally lymph nodes remain permanently enlarged but should be under a centimeter in size; https://meded.ucsd.edu/clinicalmed/head.htm
Are they referring to short axis? Is that the ‘default’ measuring parameter so to speak or are they saying long axis as well?
I mean I read articles like this regarding sizing; https://www.ajronline.org/doi/pdf/10.2214/AJR.12.8960
And I read other articles saying ‘any node larger than 1cm is considered abnormal’ and it has me concerned again. When they say larger than 1 cm are they always speaking in terms of short axis or how ‘fat’ a node is? Is the long axis of 1.4 cm truly abnormal? Because the radiologist report said even the nodes over a cm in long axis (a handful of them) weren’t considered enlarged so I don’t understand how that could be.
I guess I should also ask if that .7 lymph node would be concerning? Assuming it was measured short axis and she didn’t mean long axis. That’s pretty close to the centimeter mark