Q. Can I still have reactive lymphadenopathy if my scan repots says no enlarged lymph nodes?

Answered by
Dr. Zubayeralam
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Oct 23, 2021

Hello doctor,

I took an ultrasound of the neck, and it says no enlarged lymph nodes, more hypoechoic areas, and have some fatty hila. The impression notes that there is reactive lymphadenopathy and to follow up after three months. I am not sure what is causing the lymphadenopathy, as the notes say there are no enlarged lymph nodes.

Kindly help.



Welcome to

Thank you for the query. I can understand your concern. According to your statement, you have recently done a neck ultrasound. The report has suggested that reactivate lymphadenopathy is primarily hypoechoic, and some have fatty hila (attachments removed to protect the patient’s identity).

Reactive lymphadenopathy means the swelling of the lymph nodes in response to infections, injuries, or any other reasons. Hypoechoic lymph nodes mean a dark gray area on the ultrasound. Fatty hilar lymph nodes mean the lymph nodes contain echogenic fatty hila, which contains blood vessels of lymph nodes. A normal lymph node is usually hypoechoic and contains echogenic fatty hilum.

A larger than 1 cm lymph node is considered pathological or abnormal, but it may vary by lymphatic area. So, according to your neck ultrasound report, your lymph nodes may become swollen or detectable on ultrasound due to previous infections, injuries, or any other reasons.

Your doctor has advised follow-up to see the growth of these lymph nodes after two to three months.

Suppose your lymph nodes grow larger on the subsequent follow-up. In that case, your doctor will advise you to undergo the ultrasound guidance FNAC (fine needle aspiration cytology) or biopsy to confirm the underlying etiology for your lymphadenopathy and treat them accordingly. At present, your lymph nodes are normal.

Take care.

Hello doctor,

Thank you for the reply.

From the report, most of my lymph nodes are under 1 cm. Are my lymph nodes normal?

Thank you.



Welcome back to

Yes, according to your neck ultrasound report, the lymph nodes are under 1 cm. They are small in size and regular in structure. I have already mentioned it. Your lymph nodes are detected on neck ultrasound but do not confirm anything. Only if they become more significant, your doctor may advise you to undergo an ultrasound-guided FNAC or biopsy.

So, do not be worried.

Take care.

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