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I am a healthy 33-year old male, and I have recently noticed one slightly enlarged lymph node (around 1 cm or maybe just slightly bigger) in the lower left neck area behind the ear (I am guessing a posterior cervical node). I think it's been there for months if not years as I have had frequent respiratory problems over the years (chronic sinus infections, removed third tonsil as a kid, bacterial infection in nose area earlier this year, etc.). It's actually my girlfriend who pointed it out upon touch, otherwise it hasn't bothered me in any way. In certain neck positions it protrudes slightly through the skin.

Went to the doctor, he guessed the node was inflamed due to a prior respiratory infection, but never shrank back which is not uncommon. He did blood work (CBC, CMP, TSH) and ordered soft tissue X-rays on chest and neck. All came back "normal", so he has no further concerns on anything serious (lymphoma, etc.) and no need for further testing. I have no other symptoms of any kind now or recently (no fatigue, pain, fever, headaches, etc.)

My question: Is it normal to have one enlarged lymph node permanently? Can this really be due to a prior infection and nothing else? Would you ever need to do a biopsy in cases like that?

I pushed the doctor whether we need biopsy, and he said he is confident we don't need one at all, but me being the OCD Hypochondriac that I am, I cannot setlle until I get a second opinion.

Any insights would be welcome, thank you.

Category: ENT Specialist

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Category: ENT Specialist
Dr. Sunil Jalan is online now

Expert:  Dr. Sunil Jalan replied 4 Days.

Thank you for posting your query at DoctorSpring.com

I can understand you problem.
Eustachean tube dysfunction is very common and recovery as well as, daily in opd I see patients with ETD and most of them recover fully from three weeks to three months time.
First we need to confirm the eustachean tube dysfunction and factor responsible for it. So you need to do hearing test including audiogram and tympanometery. Rigid nasal endoscopy can be done so eustachean tube opening can be seen directly and if anatomical factor causing obstruction can be treated. If needed after these examination a CT PNS (paranasal sinuses ) can be done, to rule out sinus pathology.
Till you finish all these investigation you can start following medication including-
Tab. Levocetrizine 5 mg once in night for 20 days.
Mometasone nasal spray on spray in each nostril two times daily for 6 weeks.
Valsalva menovure also helps if eustachan tube dysfunction is confirmed.
If medical management fails for more then 3 months , we can do grommet insertion also.
So there are options, you need not to be upset by seeing net, because most of people who don’t get relief they only put comments, those who are fine they don’t write.
I hope this helps

Best regards

Dr. Sunil Jalan
Category: ENT Specialist
DAA (Diploma in asthma and allergy) : Christian Medical College, Vellore, 2012
D.N.B (ENT), 2011
Residency - M.S. (Master post graduate degree in otorhinolaryngology),  Christian Medical College, Vellore, 2009
D.L.O. (Diploma in otorhinolaryngology) - Christian Medical College, Vellore, 2007
Medical School - M.B.B.S, S.P. Medical college, Bikaner, 2004
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