Posterior Cervical Lymph Nodes

[martonius]

A little over a year ago, I discovered three small lumps in my neck.  I started to get anxious about them, so I decided to go to the doctors.  He said that I had a few slightly enlarged posterior cervical lymph nodes and they were probably due to a recent cold or virus.  A few months later they were still around the same size so I went back.  He told me they were around 1cm (though they felt larger to me) and that I should keep an eye on them to see if they get larger, and that sometimes they can become permanently enlarged.  Well, it's been over a year and as far as I can tell, they haven't gotten any larger, but I can still easily feel them.

The thing that bothers me is that I read about this particular lymph node group, and almost every site I look at says that if the Posterior Lymph Nodes become enlarged, it is commonly due to malignancies, leukemia, or lymphoma.

I am a 25 year old male.  I've had no fever, night sweats, or any other symptom besides the lymph nodes.  I've had blood work done on two separate occasions, which have both been fine.  I've also had a monospot, HIV test, and TB test, also OK.  

I've just had a bit of anxiety lately, and have grown a little concerned over this.

Any advice would be helpful.

Thanks!

[nyla123]

I am a 28 year old female. from age 22 until recently I suffered from chronic lyme disease.
I have a node in my posterior cervical chain. it is said to be 1.2 cm according to ultrasound tech. (done friday, discovered node earlier in week on tuesday)
doesn't hurt. i suppose it feels rubbery.
What should I do? Should I be concerned?
Doctor put me on antibiotics, so far doesn't seem smaller. Also waiting for chest X-ray to come back.
I am worried sick. I can't function until I know that I am okay!
PLEASE HELP?
Do you think I am okay?

[cuckfancer27]

did you get the results to this biopsy?

[KahnKan]

There is no single test that can accurately diagnose if a lymphnode is malign or benign in nature, except excisional biopsy. Even if it is made, the experience of the pathologist and the prediagnose of the clinican takes importance for the pathologist to prepare the materials for specific diseases. For example burkitt lymphoma requires additional procedures the pathologists didn't make in routine.

There are specific points clinicans take for consideration for diagnosis :

If a node is most likely benign in nature;

- It will be enlarged after an infection (Appeared after inf in max 2 weeks)
- Most likely bilateral (Infection most of the time spreads fast)
- In ultrasound it is ovoid in shape (Length-short axis ratio is under 0.5)
- Not supraclavicular (And may be not posterior cervical)
- Respond to antibiotics theraphy in 2 weeks (Most nodes are not affected because EBV and atypial mycobacterium infections are not responsive to classic ab theraphy. They require specific agents to be cured.)
- Has fluctuation (infection causes necrosis)
- Is movable (Metastasis invade and don't move)
- Does not change size in follow-up (Infections regresses or stabilizes)
- Is painful (Because of enflamation)

If it is malign in nature;

- Axis ratio is bigger then 0.5
- Long size is over 2 cm
- Supraclavicular (Atypical location for enlarged nodes)
- Does not respond to antiobiotics theraphy
- Increase in size or change shape in follow up (Shows progress)
- Is fixated (Invaded adjent soft tissue - metastasis) and hard (Hypercellular - lymphoma)
- Stayed enlarged over 2 months

Risk increases if malign characteristics be together or decreases benign characteristics group together.

FNAB has high risk of being psudonegative (Meaning it is malignant but pathology reports as indecisive or as reactive which renders it uneffective. About 4 of 10 patients which had cancer will be pseudonegative in FNAB before undergoing excisional biopsy.).

My 1.5 years old child also had a posterior cervical lymphnode for 6 months, the doctor couldn't even able to find the node (My child was being really uncooperative), he dismissed us. Over the six months, the node didn't get any larger or got minimally enlarged but I'm thinking of excisional biopsy to be just sure after ultrasound followup.

Excisional biopsy seems like the best option in any case for every one.

[Ken_PA]

I'd also take yogurt or something similar while on antibiotics.

[Ken_PA]

Ahlan. I'd wait to see if the antibiotic handles it. Sometimes, it might take two courses of antibiotic. There are lymph nodes in those locations which might be "reactive" to an infection.

It's also somewhat possible to have lipomas or cysts, but two together like that makes such a diagnosis less likely.

Did they both pop up closely together in time? That tends toward infection. Did you have an earache or scalp problem?

To be prudent, you can also check underarms and groin for other enlarged nodes.

[kristina961]

Hi,
I have two sowllen lymph in the back of my head and nick, one is bean size in the back of my neck left side just within the hear line at the left corner. The other is in the back of my head behind my left ear.
I went to Dermatologist and she started one week Keflex treatment. Should I check ENT doctor or just wait for the one week treatment.