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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 32801
Experience:  Over 20 yrs of Family Practice
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My 4 year old son has a hard lump on the underside of his

Customer Question

My 4 year old son has a hard lump on the underside of his arm, about an inch distal to the armpit. I noticed it because of the bruise around it. If he hit it on something would it cause a hard lump in it? Or can a swollen lymph node cause a bruise? It feels like a lymph node. He has no sign of infection otherwise, was not bitten by anything, no fever, nothing. I just want to make sure it's not something I should be concerned about or get biopsy or blood tests.....
Submitted: 5 years ago.
Category: Health
Expert:  RK replied 5 years ago.
Hi,
Welcome to JustAnswer!
The lesion you have described is most probably an inflamed lymph node.
The "bruise" you see on the top of the swelling is due to inflammation of the lymph node.
A complete blood count may be done to find the cause of this enlargement.
He may need a course of antibiotics and also tylenol if it is painful.
If the lump does not disappear or if it keeps increasing or persists for a long time, then he may need a fine needle aspiration or excision biopsy to find the cause.
Expert:  RK replied 5 years ago.
Any more questions?
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Expert:  Dr. Chip replied 5 years ago.
Hi--so this isn't tender at all but does looked like it's bruised?
Customer: replied 5 years ago.
it is only tender to him when I push on it trying to feel how big the lump is, otherwise he didn't even notice it. I only did when I saw the bruise.
Expert:  Dr. Chip replied 5 years ago.
How large is it and does it seem to be just under the skin or close to the ribs?
Customer: replied 5 years ago.
just under the skin, raised about the size of a pea to look, but when feeling it, it feels like its twice the size.
Expert:  Dr. Chip replied 5 years ago.
Then it isn't a lymph node. More than likely it's folliculitis--a hair shaft infection. Nothing serious, and warm moist heat to the area may help. If it gets any larger or seems to look infected, the doctor should see it.
Customer: replied 5 years ago.
I just dont see how it could be a hair shaft infection, he doesnt even have any hair there. he is 4 and his skin is perfect, no open areas. But if it was a lymph node (just to see all the possibilites) , I also want to know what the cause could be seeing as how he has no other problems. What kind of infections cause a swollon lymph node in that spot? He has had infections before with his ears when he was younger but never any swelling of the lymph nodes. And like I said, no fever, no sores, no pain anywhere. And if it does happen to go away on its own with no atb, should I worry an infection is still present if I don't get a cbc to determine the cause? OR, is it possible he bumped it on something that could cause that? or cyst? I just want to ease my worries that it couldn't possibly be something like a cancerous cyst or anything.
Expert:  Dr. Chip replied 5 years ago.
Well, a child can still have folliculitis since the hair shafts are there even if there's no hair apparent. It could also be a small cyst. Are there any cuts, breaks in the skin--anything that looks like a site of infection further down on the arm? And did he say whether he bumped it.?
Customer: replied 5 years ago.
oh and it is one inch away from the armpit on his arm towards his hand, not rib area. I just noticed you said something about ribs. But no, no breaks in the skin or other signs of infection. The area is smooth, no irritation, doesnt itch or anything, not red. just raised looking just like a pea is under the skin with a bruise around it. He doesnt know if he bumped it. I asked him what happened and he just said "I dont know, maybe I bumped it or something" but he was just guessing, he didnt remember bumping it when I tried to get more out of him.
Expert:  Dr. Chip replied 5 years ago.
how can you be certain it isn't an insect bite?
Customer: replied 5 years ago.
i've examined it and there is just no opening or anything that even remotely looks like an insect bite.
Expert:  Dr. Chip replied 5 years ago.
But there is something like a bruise there?
Customer: replied 5 years ago.
yeah there is a bruise around it and the center is the lump
Expert:  Dr. Chip replied 5 years ago.
Well, a small spider bite won't show much in the way of a hole, and the fact that there's a bruise and a small lump makes me think that could be what's going on here. A simple contusion to the arm wouldn't leave a lump like that--a bruise, yes, but not a small lump. If it is a spider bite, it really has to take its course since there is no antivenom. Except for a small cyst, folliculitis, or a spider bite, there really isn't anything else that acts like this. If it starts to give him trouble and looks like it's getting inflamed and maybe infected, let his doctor look at it.
Expert:  RK replied 5 years ago.
Can you send a picture?
You can upload it by clicking the "Pin" icon.
Customer: replied 5 years ago.
that is as good as i could get on my crappy phone
Expert:  Dr. Chip replied 5 years ago.
Hi--how long has it been there?
Customer: replied 5 years ago.
I only noticed it 2 days ago, so I'm guessing 2 or 3 days ago it started.
Expert:  Dr. Chip replied 5 years ago.
the lump is in the center of all this?
Customer: replied 5 years ago.
I posted a picture above, but here it is again
Expert:  Dr. Chip replied 5 years ago.
Saw it. Are you still concerned this is something serious?
Customer: replied 5 years ago.
I will always be concerned about anything that is abnormal, I'm a mother thats what we do best, haha. If you think there is a possibility that it could be serious, I will take him to his Dr. but I just dont want to spend money on tests and appointments if it is nothing to worry about. I know I will spend $80 to take him in for them to just tell me to keep an eye on it. Then more if it doesn't go away. Figured I would try to get some answers on this site first. So is there a possibility it could be something serious? Is a cyst something to worry about? I know when I was little I has a cyst on my head that the Drs were worried it could be cancerous so I had it removed and biopsied. It was nothing, but better safe than sorry.
Expert:  Dr. Chip replied 5 years ago.
I fully understand......Perhaps the best thing I could tell you is that, if this were my son, I wouldn't be worried about it and I'd think it might well be an insect bite. Certainly the bruising is resolving, and if this were a nasty brown recluse spider bite, by now it would have announced itself. It's also possible the lump has been there for much longer than the bruise and that you only noticed it because of the bruise. Next time you have the chance, if the lump is still there, have a doctor look at it, but I really don't think it's anything serious.
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 32801
Experience: Over 20 yrs of Family Practice
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