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Ask David L. Hill, MD, FAAP Your Own Ques...

David L. Hill, MD, FAAP
David L. Hill, MD, FAAP, Doctor
Category: Pediatrics
Satisfied Customers: 415
Experience:  Adjunct Assistant Professor of Pediatrics, UNC Medical School. Vice President, Cape Fear Pediatrics.
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My child has had swollen lymph nodes in his neck and I was

Customer Question

My child has had swollen lymph nodes in his neck and I was wondering if enlarged adenoids could cause swollen neck lymph nodes?
Submitted: 2 years ago.
Category: Pediatrics
Expert:  David L. Hill, MD, FAAP replied 2 years ago.

David L. Hill, MD, FAAP :

Hi, and welcome to Just Answer! Which nodes are swollen, and how big would you say they are? Are they tender to the touch?

Customer :

There is one on the right side of her neck, below her ear that is the largest, maybe 1.5-2cm. The others are not large like that one though

Customer :

Not tender to the touch

David L. Hill, MD, FAAP :

I see. And is she having other signs of illness now? Fever? Sore throat? Stuffy or runny nose? Fatigue?

Customer :

No, no others signs of illness. it has been there for about 7 weeks

David L. Hill, MD, FAAP :

That's something I would urge you to have a doctor check out, then. Children often get swollen neck nodes from various illnesses, but whenever we see a node over about 1 cm in size we start thinking of odd infections and even scary things like lymphoma. Most of the time a simple exam and some lab work is enough to rule out the frightening stuff, but a persistent large node like that deserves at least an examination.

Customer :

She was examined by an ENT and he was not really concerned about it after he felt it. She had a CBC and the lymphocytes were elevated 3.9 absolute lymphocytes 59%. he said that her adenoids were enlarged after he did a test that stuck a camera in her nose, and I was wondering if enlarged adenoids could cause swollen lymph nodes.

Customer :

Do you think her lymphocytes numbers are concerning?

David L. Hill, MD, FAAP :

That, then, is very reassuring! While conditions like allergic rhinitis, sinusitis, and colds may lead both the adenoids and the lymph nodes to be swollen, it's more a matter of both resulting from a common cause and not the one causing the other. The lymphocyte count you've given me is, in isolation, not at all concerning.

Customer :

One causes adenoids to be swollen

Customer :

I meant to say what caused adenoids to be swollen

David L. Hill, MD, FAAP :

Conditions like allergic rhinitis, sinusitis, and colds may contribute to swelling of the adenoids.

Customer :

Well I know I have been told she has allergic rhinitis in the past, and she has a nasally voice and mouth breathes.

David L. Hill, MD, FAAP :

In cases like that we often find a trial of inhaled corticosteroids like fluticasone (Flonase) or mometasone (Nasonex) to be very helpful.

Customer :

Okay, thanks. I am just hoping they are right about the lymph node swelling. The stuff I read on the internet is scary

David L. Hill, MD, FAAP :

Indeed it is! But the fact that a qualified ENT has already examined her and gotten some appropriate lab work should be immensely reassuring. I have to say, seeing these every week, I have yet in my career to identify a single case of malignancy this way.

Customer :

Okay, thanks!

David L. Hill, MD, FAAP :

You bet! Please, if you don't mind, remember to click "accept" before leaving this chat. Thanks, and good luck!

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David L. Hill, MD, FAAP
David L. Hill, MD, FAAP
Pediatrician
415 Satisfied Customers
Adjunct Assistant Professor of Pediatrics, UNC Medical School. Vice President, Cape Fear Pediatrics.