I have an enlarged lymph node. Will it be cancer?

Question

Hi doctor,

I am a 25-year-old female with a height of 5'6 feet and a weight of 220 lb. I take tablet Propranolol for fast heart rate. I am not diagnosed with anything other than this. I recently had a neck CT because of some swelling. It was ectopic thyroid tissue. But in the impression, it also noted that I had mild left axillary adenopathy, likely reactive, and a few enlarged axillary nodes, one being 14 mm short axis containing normal fatty hilum and correlating with any recent vaccine in the left arm. I have gotten both COVID-19 doses in the latter half of this year, as well as two weeks before this neck CT, and I received a Tdap vaccine after a cut on my finger. I have not had any swelling in my armpit or symptoms of anything related to that. Is this finding of particular concern? How were my armpit lymph nodes even visible on a neck CT? Are my armpit nodes located in my upper chest? The bottom limit of the CT scan seems to be the aortic arch, and I thought I would let you know even though maybe thats how they all are, and you already knew that. I have been worried about that lymph node finding, and I do not know if I should be concerned. And it is also somewhat strange that the radiologist could see those nodes from that particular view of my body. I would appreciate any insight. Please help.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you for making a clear and elaborate account of your medical findings and pointing out your concerns. I understand that you are worried about the following:

1) Why was one of the left axillary lymph nodes enlarged?

2) How could they even be seen on a neck CT?

3) Is it serious?

So, firstly, you have already noted that neck CT (computerized tomography) is always extended upto the aortic arch, and in that way, it covers both axillary regions almost wholly. And just as a side note, the armpit is only the floor of the axilla (in a medical way), and its apex is as high as close to the shoulder joint level. In short, it is not of any concern that your axillae were included in a neck CT: it is standard FOV (field of view), and all CT necks are like that.

Secondly, 14 mm short axis means the node is enlarged, and that is why the radiologist has clarified that although it is enlarged, its fatty hilum is normal, which in particular means that no cancer has gone there. Therefore, as per the guideline, the radiologist reminded you to check whether you have received vaccines in that same arm because that is perhaps what caused the left-sided lymph node to be enlarged as a reaction.

So, to summarise, if you have received any of those vaccines on your left arm, you need not do or think anything about the lymph node. If you have received no vaccine on your left arm, it may still be a no worry situation, but you could also review it with your General practitioner.

I hope this helps.

Thank you.