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lymph node with no fatty hilum

TL;DR: Has anyone seen or had a lymph node with no fatty hilum that was benign? And has anyone had a feeling in their throat when swallowing a month after a tooth extraction?

Hi, all. I'll try not to make this too long, but I have a lot of info. My concern is a lymph node that was found on ultrasound June 1st and confirmed by CT June 3rd in my left upper neck that is firm, movable, slightly enlarged (1.2cm, I think), and was described as hypoechoic with no fatty hilum. It added that the surrounding fat stranding suggests reactive adenopathy. The ENT told me that some good signs were that it wasn't necrotic and didn't seem to have grown from the CT to my visit with him on June 16 (he just felt it and guessed), and also that there weren't other lymph nodes in the area that were enlarged etc. He said given that I had 2 infected teeth on the left side of my mouth, that it was really likely that it was due to that. So the plan was to get the teeth out and see what the lymph node did. He told me to get the US in September.

I had a bottom left molar that had broken a chunk off a few years ago, which I never did anything about because it didn't hurt (and I'm an idiot). I recently discovered a huge cavity in it. And also a few years ago a top left molar broke out in chunks completely, but I neglected to get the roots removed. I treated the infection myself. I did go to the dentist for that but never followed through with the root removal. I had both removed July 9, and both were infected according to my dentist. I got dry socket, and the next week I came down with a head cold or something (my son did, too) - mostly just major congestion and sinus pressure. I was miserable and scared and my PCP prescribed augmentin for me. Later that week the pains weren't any better, and I thought I was running a fever 99-100 (idk if that thermometer was working right, but I did feel slightly warm), so I went to the clinic and a different NP prescribed 3 daily shots of Rocephin. I really thought I felt better when I was getting the shots. The Rocephin interrupted the course of Augmentin, so I finished the Augmentin after the shots were complete. I think I finished the Augmentin on a Friday, and that Saturday I had virtually no symptoms at all. Sunday they returned and have been bothering since.

Leading up to the tooth/roots extraction, I had some left ear aching and fullness and aching down the left side of my neck and around my lower left occiput (bottom of skull behind ear). I also had tinnitus, which is long-standing but seemed worse recently, and worse in the left ear. The dentist explained the nerve pathway to me, and it made perfect sense considering my bad teeth, which had been hurting intermittently/briefly but somewhat badly. After the extraction, I had the same symptoms but also the left side of my throat hurt when I swallowed. That is normal, but it usually goes away after a few days, or so Google told me. it's much better, but I still feel "something" in my left throat when I swallow.

I've also been feeling "infectiony"/virusy or something. I've just felt like I've been fighting infection. My eyes have been feeling sort of foggy/burny like when you have a virus. The left side of my face/neck felt warmer than the right, but not hot.  Friday the lightheadedness felt worse. Saturday at work I felt like you do when you're breaking a fever, recovering from an infection/virus or something - hot and clammy and just sort of woozy or something (I work in a nursing home where it is very warm though). My aches were worse Sat morning, but all of a sudden, boom it all just about went away midday. The aches minimized to almost nothing, and the lightheadedness stopped. It was so weird. Today I have some mild aching mostly in my left posterior neck when I turn it a certain way, and it's tender when I rub it. The tinnitus is still there. I don't really feel the fullness in my ear now. The lightheadedness is...gone? much better anyway.

At some point, I did start to feel a few aches on the right side of my neck and corner of my jaw. That's just vaguely/faintly present right now.

I will add that since March I've had an EGD, which revealed small esophageal polyps at the proximal esophagus that had some eosinophils in them (I had terrible GERD); a colonoscopy which revealed a polyp which was removed and found to be pre-cancer; an abdominal/pelvic CT scan which showed a left kidney stone, a small hiatal hernia, diverticulosis, left ovarian cyst, and my uterine fibroid had grown a hair; a normal mammogram; normal pap; normal CXR (chest xray); neck ultrasound showing just the node as an abnormality; neck CT scan with similar findings as the US. I also had a ton of lab work in March which revealed a low D level, borderline blood sugar, negative electrophoresis, negative celiac, elevated CRP 1.5, negative FANA, negative electrophoresis, normal CBC, ALT 26 (one point too high).

I've also been having weird migraine pains in my back since March 2020, but that's another story. I'm trying not to tie it all into one huge ugly picture, but since the chances of the lymph node being metastatic seem high (like 90%?), it's hard not to. Lately my back has been hurting around the left shoulder blade. It was really tender to touch toward the base of my scapula, but now it's not. It's much better and is intermittent.

Oh, and today my left ear and throat have felt itchy inside. Also, I noticed that my face has pitting edema on the cheek, left worse than right, which I read can result from infections, inflammation, trauma, and malignancy. No breathing problems. No trouble swallowing or talking or opening my mouth or turning my head. Good appetite. No unexplained weight loss. Loose stools ever since the Augmentin, but they're improving some.

I'm having a repeat EGD in August, another colonoscopy in three years, and the neck US in Sep. I think I might ask for the US to be sooner though, what do you think? I'm super nervous. I'm 53. I have 4 kids, 1 still at home who's 16 and have been widowed since 2011. My husband died of cancer. :(



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