Oncology (General Cancer)/Lymph nodes


I just wanted to follow up with you on a question I asked a few days ago regarding swollen lymph nodes in my neck on a ct scan. I had my appointment with my ENT and he recommended having the largest lymph node biopsied. He said he would do an excissional biopsy over a sono with a FNA because the FNA do not delays rule out lymphomas. He says it a small chance but he would like to rule it out. Of course when he told me this my anxiety shit through the roof. My appointment is not until may 2 for the surgery. I hsve doing done tease arch online and eagles syndrome came up. My lump that I feel is on the right side where the 1.8 cm node is. My jaw hurts and I can feel the lump when I turn my head and swallow. Would my ct have showed eagles syndrome? Can this cause the enlarged glands? My dentist said I gating my teeth and I know I clench my jaw ESP when I am stressed like I am now. I wear a night gaurd to bed at  night. Is there a chance all my issues could be eagles syndrome?

ANSWER: I think the fact that your ENT (and you) feel a lymph node probably rules out Eagle's syndrome.  The CT would have shown it in any event.  Eagle's syndrome would not have caused enlarged nodes.  Please take a few deep breaths and find something to take your mind off of the problem.  It really isn't likely to be anything life-threatening. Waiting till May 2 isn't a problem, except for your anxiety, which you can control.  Hope this helps.  

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QUESTION: Thanks for your reply and I apologize for all the typos, I was half asleep when I typed the question. Is the size of the lymph nodes 1.8 cm considered very enlarged? What size is considered normal? I have got my anxiety under control and I am just trying to do some research. I had alot of questions I wanted to ask my ent but I didn't get the chance to. My primary care doctor said sending me to the ENT was more of a pre cautionary measure but my ENT recommend the biopsy over watching and waiting I think because of the duration of the swelling and the lack of an infection. Also info have occasional drainage and seasonal allergy a could this cause the swelling? They haven't been to bad recently though. Thanks do answering my questions I appreciate your time.

ANSWER: 1.8 cm is enlarged.  We don't see normal nodes larger than 1 cm, and most are about 0.5 c m.  seasonal allergies and drainage problems, when they affect nodes, generally cause tender nodes which disappear when the insult is gone.  I think you are on track with what your doctors are recommending.  Keep me posted.  

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QUESTION: Thanks. Sorry I keep thinking of questions that I forgot to ask my doctor. If the results come back from the biopsy and it doesn't show lyphoma will it say it was benign or will it be more detailed in figuring out why was the causing the swelling like an infection? Also I didn't tell my ent but in my teenage years and twenty a I did smoke off and on but I never considered myself a smoker. I would always quit before I became addicted. I never smoked over 10 a day if that and I went in spurts without smoking at all. Would this type of smoker cause any other type if cancers like mouth cancer? I still have the hard lump inside my tongue which I have pointed out to both my doctor and dentist. Could that have anything to do with it? Would the biopsy show other cancers other than lymphoma? Thanks.

It is faintly possible that you may have a mouth cancer, but highly unlikely, given that they grow faster than what you are describing.  And the soft lymph node would not be part of that.  However, strange things happen.  The biopsy of the node may show a benign process, and generally the pathologist would write down a clue as to what he thought it was.  However, some physicians simply tell their patient "it was benign", since that is the big question.  I hope you will ask for the details.  

Oncology (General Cancer)

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Donald Higby, M.D.


I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.


I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

American Society of Clinical Oncology

New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

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America's Best Physicians, last 14 years

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