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Ask Dr. R. Bora Your Own Question
Dr. R. Bora
Dr. R. Bora, Doctor
Category: Health
Satisfied Customers: 5233
Experience:  14 years experience in the emergency room.
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I have a constant pressure on the left side of my throat, near

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I have a constant pressure on the left side of my throat, near the tonsil/gland/jawline. Fells stronger when I swallow or turn my head left. The salivary gland on the left side feels larger then on the right. Ct with contrast came back normal. What could it be? How accurate are ct:s on cancer? Or could it be a swollen gland? Is that normal? Also have swollen lymphnodes, one on each side by the jaw line, 2 cm each. Fine needle punction on those came back normal. Had the nodes and the pressure for months now. A week ago I found a lump in my tongue as well, like a grain of rice. Should I try to get a biopsy on the nodes, the gland and the tongue to be shure? Or should I leave it entirely and see what happens? The pressure affects me a lot all days.

Dr. R. Bora :

Hello and welcome, I am happy to help you today.

Dr. R. Bora :

Can we chat?

Customer:

Yes please

Dr. R. Bora :

Thanks.

Dr. R. Bora :

Is it pressure or more like pain on the left side?

Dr. R. Bora :

Since when have you felt the enlarged lymph nodes?

Customer:

No pain. Just pressure. Like something is pressuring against my throat when I turn my neck. Not like that on the ritht side. Only the left side. Sometimes I also have pain near the lest jawline. Comes and goes. Bur the pressure is always there.

Customer:

Nodes since october. I found them by then. Dont know how long they had been there by then.

Dr. R. Bora :

Thanks for the info.

Customer:

As i said, the ct showed nothing. But the pressure is really there..

Dr. R. Bora :

Contrast Ct scans are usually accurate an can detect both infective and cancerous conditions, although the differentiation may not always be easy and some suspicious lesions may need a biopsy for confirmation.

Dr. R. Bora :

The lump on the tongue however needs to be seen by an ENT or oral dental surgeon for clinical examination initially.

Customer:

Ok. How accurate is a fine needle punction of the nodes? Do I need biopsy to be shure?

Dr. R. Bora :

No, FNAC is usually accurate and rarely needs a biopsy.

Customer:

Ok. But its so difficult to fine somone who wants to make a biopsy.

Dr. R. Bora :

The enlarged nodes are significant in size and if the FNAC showed nothing, they are likely to be due to infection.

Dr. R. Bora :

Such big nodes due to cancer will hardly be missed on FNAC.

Customer:

Ok i see.

Dr. R. Bora :

One more thing is that the constant pressure could be due to elongated styloid process on the left side.

Dr. R. Bora :

This may have been missed / not reported on the CT scan.

Customer:

What is that?

Dr. R. Bora :

It is a calcified ligament which becomes hard like bone.

Dr. R. Bora :

This can cause pressure on the tonsil or other structures in that area.

Customer:

Ok.

Dr. R. Bora :

You will have to get an X ray for that.

Dr. R. Bora :

X ray for STYLOID PROCESS.

Customer:

An mri?

Dr. R. Bora :

No, an X ray.

Dr. R. Bora :

If not seen on X ray than a CT scan in CORONAL POSITION.

Dr. R. Bora :

Talk to your doctor about it.

Customer:

The ct I made was from the nose and down to the lungs..

Dr. R. Bora :

That's OK but think the coronal position was not used.

Dr. R. Bora :

CT scan neck is normally done in AXIAL (supine position).

Customer:

Ok i see. Is it normal that one of the glands are abnormal in shape and grow a bit larger like mine feels?

Dr. R. Bora :

The glands are abnormally enlarged and could be due to throat or other infection.

Customer:

Read that bumps in tongue can be due to gland problem as well..

Dr. R. Bora :

Yeah, the bumps could be enlarged papillae or tongue buds.

Dr. R. Bora :

May be inflammatory. You need to see an ENT or oral surgeon.

Customer:

But do you think I can leave the fear of tumor causing the pressure for 100% due to the normal ct?

Dr. R. Bora :

YES.

Dr. R. Bora :

If there was anything suspicious, they would have surely reported it.

Customer:

Great! Thanks! And is the node are cancerous. How fast should they grow larger then?

Dr. R. Bora :

If cancerous, the nodes would be hard and non mobile.

Dr. R. Bora :

But you can get another FNAC if they do not subside with anyibiotics.

Customer:

They are hard and mobile..

Dr. R. Bora :

OK, likely to be infective but I cant be sure as I have not examined you.

Dr. R. Bora :

You should talk to your doctor about taking antibiotics and getting them re checked in another month.

Customer:

Ok. Could that solve the problem even though I dont feel ill? Antibiotict I mean?

Customer:

No fever etc..

Dr. R. Bora :

Yes, if they are infective they might respond. But your doctor have to exclude tuberculosis also.

Customer:

Ok. Will remember that to.

Dr. R. Bora :

So, get a repeat FNAC or excision biopsy if they persist after antibiotics.

Customer:

And the tongue bump; how long should I have it before asking for a FNAC of it? Months, weeks?

Dr. R. Bora :

Weeks may be if they do not seem to reduce in size.

Customer:

Ok.

Dr. R. Bora :

Thanks.

Customer:

Thank you very much!

Dr. R. Bora :

I hope my answer has helped you.


Please remember to rate my service once you have all the information you need. If you have any other questions, please ask me – I’ll be happy to respond. Thank you!

Dr. R. Bora :

You are most welcome.

Customer:

Yes! Thank you. Will remember wht you said!

Customer:

I will. Bye!

Dr. R. Bora :

If you have any new questions, please address me as DR. BORA.

Dr. R. Bora and 3 other Health Specialists are ready to help you
Lina, have a great day ahead!!