Q. Why do I have pain in my neck and feel tired for the last four months?
Hi doctor,
I am 47 years old, 5 feet 3 inches tall, weigh 165 pounds. I am a MS patient and I take Aubagio 7 mg. My MS is under control with no problem and it is stable. I was feeling very tired, had pain on the neck before four months. I went to the doctor and she sent me to do a neck ultrasound and told me that my lymph nodes were inflamed and gave antibiotics just in case it was an infection. I am still having the same symptoms, and she sent me to do a neck sonogram again and the lymph nodes were bigger. I have 5 nodes 2 of them almost 2 cm and in the right side another of almost 2 cm. The sonogram impression is: Bilateral neck soft tissue hypoechoic lesions as described, suggestive prominent lymph nodes correlation with CAT scan with contrast. Can you please let me know or advise your impression about it?
Thank you.
Hello,
Welcome to icliniq.com.
I have read your query, and I can understand your concern. Lymphadenopathy is benign and self-limited in most patients. It refers to lymph nodes that are greater in size than 1 cm or abnormal inconsistency. A detailed and relevant medical history and physical examination are needed to find the etiology of the lymph node enlargement.
In the USG report done four months back, it was present only on the left side of the neck, and now the report of this month says it is bilateral that is present on both sides of the neck. The report in itself does not give any clue towards etiology except it suggests prominent lymph nodes. You also mentioned taking an antibiotic course after the first test. I would like to know the answers to the following questions:
1) Does lymph node swelling or your symptoms get resolved after taking antibiotics?
2) Did you have any recent fever or chills or sore throat, or viral infection?
3) Have you experienced any weight loss?
4) Do you have any constitutional symptoms like fever or night sweats or malaise, or fatigue?
5) Do you have any autoimmune symptoms like arthralgia, rash, joint stiffness?
Physical examination, including lymph node quality like warmth, tenderness, mobility, consistency, has to be assessed, which gives a clue to the possible etiology of the enlarged lymph node. You should visit your doctor. Doing a physical examination along with medical history might give her a hint. She may prescribe another course of antibiotics if it is related to infection, or you may need to undergo CT (computed tomography) scan along with a blood test. If needed, FNAC (fine needle aspiration cytology) can also be done to rule out the cause.
Would you please reply to the above questions to find a better solution?
I hope you find my reply helpful. Thanks.
Hi doctor,
Thank you for answering. I had complained to my doctor that something was bothering me in my neck when I was drinking. I had tremendous hot flashes that woke me up during the nights, but there was no sweating. She advised me of the first sonogram, which was before four months. I have extreme fatigue, and there is pain and discomfort in my neck. I just felt that the two balls in the back of my knees were very painful. She told me the characteristics of the lesions in my neck are worrying her as they are well-rounded, hypoechoic, and increments in size and quantity. Kindly help.
Hello,
Welcome back to icliniq.com.
Compared with the earlier scan, the number and size have increased, and the well-rounded, hypoechoic nature of the lymph node is worrying, as your doctor told. The duration between the two scans is around five months, and it is one of the risk factors. Pain in the lymph node after taking alcohol is also a worrying symptom.
You have symptoms like hot flashes, discomfort, and extreme fatigue. If it is an enlarged lymph node, it points towards generalized lymphadenopathy. I would suggest you visit your doctor at the earliest. You should undergo a CT scan, specific blood test, FNAC, or lymph node biopsy to evaluate the lymph node.
I hope you can detect the cause of lymphadenopathy and treatment accordingly as early as possible.
Take care.
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