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Permanent swollen lymph node and inflamed tonsil

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For over a year, I have a lump, a permanent swollen lymph node, in the left side of my neck. I had an ENT look at it. After some time of monitoring the size of the node the Doctor stated that it was fine though I did continue to have a lump and pain. I pushed for a needle biopsy and the results came back negative for cancer. Three months later, I still have the lump and I am still experiencing pain in the surrounding area, the lump does not cause any pain, from the middle of my neck to the top. Recently, I have found myself to be sleepy. I sleep about 9-10 hours and still find myself wanting more. Please note that I was diagnosis with Hypothyroidism and receiving medication. My last follow up, blood test a few weeks ago, showed that my hormone levels are in the optimal levels. These sleepy feelings have just recently started. I do lose my breath while walking quickly, but I am not sure if it is a symptom of illness or just an indicator that I need exercise. I am not experiencing anything more. My question is should I go back to my doctor and insist on the entire removal of the node and that more test be done?

Category: ENT Specialist

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Category: ENT Specialist
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Thank you for asking your query at DoctorSpring.

Let me assure you, there is no reason to be worried. There is no reason to insist on entire removal of the node.
You need to understand the Lymph Node is a normal structure in the human body (as opposed other swellings). They are the protective warriors. From simple infection to wounds, anything can cause inflammation of the lymph node and enlargement. This actually means your immune system is working well ! Moreover single node enlargement can be insignificant most of the times.
So I would recommend you to keep a watch on the node and go for a repeat FNAC (biopsy) once more after discussing with your Doctor. Your Doctor will examine and see whether it is really needed . It is needed only if it is a Left supraclavicular lymph node.
The sleepiness and breathlessness seems non-specific. Probably related to thyroid hormone deficiency. This should improve with treatment.

Hope this helps
Please feel free to ask follow-up questions
Thank you

Patient replied :

Hello, My question to you is mixed in with new turn of events. I went to a pulmonary doctor today, regarding my heaviness of my chest and shortness of breath. He did an x-ray, which showed the bronchiole inflamed. My lungs sounds were normal, no liquid, no mucus, no fever, no cough, nothing. His diagnosis is early bronchitis and prescribed me with symptom reliever meds. I believe that my lung issues may be related to my lymph node. I have an appointment with a new ENT doctor, to get a second opinion, on my lymph node. I will be bring in all my medical test results conducted by the previous Doctor. I guess my question is, should I push for the new ENT to push for a closer look into to my lung problems? Is my lymph node enlargement related to my lung issue? Should I push for a CT scan? I already did one for my lymph node, it did result in an approval for my node to be biopsied, which was negative, but I still have no answer into why the node is enlarged or why the tonsil on the same side is inflamed. What should I be pushing for? I really am scared that I have early stages of lung cancer and that Doctors may not be concerned with it and keep telling me that I do not have cancer without doing proper tests because I do not show classic signs of cancer. I have been exposed to all things that would cause lung cancer: I have smoked for 1-2 years but quit 7 years ago, I was exposed to asbestos 5 years ago, air pollution, and second hand smoke. I just want to be sure that the lymph node is not cancerous or indicating to me that their is cancer. What should I do? I am sorry I asked like 12 questions in here, anything you can tell me would help a lot.

Hello, You need not worry about cancer in my opinion. A lung cancer to reach the lymph nodes in neck it will take time. In that case there will be definite visible lesions in the Xray. So an investigation in this direction, like a CT scan will not yield any result. You can ask for the repeat biopsy of the node. You need not push for it, but if your Doctor also thinks that some thing needes evaluation repeat biopsy will be a good and reasonable option as next step. Moreover the symptoms, xray findings are also not suggestive of cancer. The lymph node enlargement in cancer occurs by spread. So it has to grow into a reasonable size into lungs itself to spread to the nodes. That is why I said it is unlikely. I hope you got the logic Hope this helps Please feel free to ask followup queries.

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
Dr. Sunil Jalan and 4 other Medical Specialists are ready to help you

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