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Dr. Gehring
Dr. Gehring, Doctor
Category: Medical
Satisfied Customers: 24202
Experience:  Doctor of internal and general medicine self employed
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Hoellering, we spoke before about a swollen lymphnode I have

Customer Question

Hello dr. Hoellering, we spoke before about a swollen lymphnode I have had on the side of my neck since mid July. It started with an aphthous ulcer I had near the left corner of my mouth that made my gums in that area swell, it was hard to open my mouth
and I had a sore/swollen lymphnode and apparently pretty large tonsils. The doctor couldn't find an infection but gave me doxycycline. I took it and I'm not sure if the medicine did it or just the healing of my ulcer but my mouth improved, my lymphnode got
a "little" smaller and stopped being tender. However, my lymphnode never went down. I had blood counts, sed rate done which was all good. I had an ultrasound...they found my lymphnode to be enlarged with the biggest measurement of 1.1 cm. they also found a
solitary thyroid nodule on my isthmus (center of thyroid) that measures 1.9 cm. I have to get a biopsy of this nodule this coming Wednesday. I am very, very scared. I realize that this nodule could be malignant. The doctor said that it is better to have several
nodules than just 1 like I have but the percentages of it being malignant are fairly low, 5-10 percent. I have now been taking 2 rounds of acyclovir and although my lymphnode has gotten slightly smaller it is still enlarged and is roughly around the same size
each day. I am worried that if I do have thyroid cancer that it has spread into my lymphnode. My lymphnode is a lump that I have move around and clearly feel as a lump on one side that isn't on the other. I have never had a lymphnode do this or not go back
down. I am very scared that I am terminally ill or that it has spread. The doctor said my lymphnode didn't feel like cancer but he of course can't make any promises. I should also add that the ultrasound says the nodule on my thyroid is part cystic and part
solid nodule. Thank you for all your help!
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Gehring replied 1 year ago.
Hello again,
I understand your worries, but: Thyroid carcinoma is very rare, and this partly cystic partly solid nodule is no sign of malignancy.
I assume that the lymph node's swelling was caused by the aphtous ulcer. Other reasons may be chronic tonsillitis or tooth conditions.
Some lymph nodes decrease in size when the inflammation decreases. But others don't, because they converted into fibrous tissue by inflammation. In these cases they keep up their seize, and this may be the reason in your case.
So please don't worry! If the lymph node is mobile and if the knot in your thyroid has a clear order, there is no reason for fretting.
Please let me know the result of your biopsy!
Customer: replied 1 year ago.
I realize it is pretty rare, which is good to hear! I am just worried that it has spread to my lymphnode or is connected somehow. I'm partly worried because back in early spring my rheumatologist said my thyroid felt enlarged but all he did was bloodwork which came back good (I didn't know any better) so I am worried I've had it for awhile and that now my lymphnode is involved. I realize this isn't likely. The ultrasound didn't notice any strange characteristics about the lymphnode just that it was considered enlarged at 1.1 cm. the nodule on the thyroid is only part cystic and part solid nodule. I'm so scared about all this. I know it doesn't matter but I keep thinking I am terminally ill or have spreading cancer. I am only 28 and have a 1 year old and a toddler. And yes, I can move the lymphnode from side to side, it doesn't really increase in size but never gets smaller. Thank you Dr! I'm sorry about my previous thread, I know I annoyed you.
Expert:  Dr. Gehring replied 1 year ago.
You never annoyed me, everything is perfectly oak. But you talked to my colleagues again and again (much work for a tip....), and that should be enough.
Try to let go the worry, there are no more informations we can give you. Disctract yourself and have faith in your health.
Customer: replied 1 year ago.
Thanks! I'm sorry! I know thyroid cancer itself is rare but if it were to be malignant you think it's unlikely to have spread into my lymphnode or for my lymphnode to be involved despite it being enlarged for awhile? thanks again.
Expert:  Dr. Gehring replied 1 year ago.
It's very unlikely! Thyroid cancer takes ages to spread.
Expert:  Dr. Gehring replied 1 year ago.
Please don't forget to push a positive feedback- button (hopefully excellent) for my help. Thank you and all the best!
Customer: replied 1 year ago.
Thanks for your help! I'm worried about it spreading to my lymphnode bc the thyroid nodule may have been there since April or before and of course the persistence and size of the lymphnode. I am sorry to buy you..just worried. I will def hit the feedback button.
Expert:  Dr. Gehring replied 1 year ago.
I understand your worries, but hope wrote you everything necessary to relax.
Customer: replied 1 year ago.
you did. I am of course still worried but appreciate it. My lymphnode stays the same size, enlarged, day in and day out and I am thinking I have had this thyroid nodule since at least April which is why I am worried the lymphnode is/are now affected by it...I can't see another reason for it to be enlarged for this long. I hope you are right about everything!
Expert:  Dr. Gehring replied 1 year ago.
Scar or fibrous tissue is a logic explanation.
Customer: replied 1 year ago.
Wouldn't the ultrasound have shown that instead of just measuring it and saying it was an enlarged lymphnode? I did touch it A LOT over the last month but still...its enlarged to the same size everyday any changes in it are slight. Again, I'm sorry to keep bothering you.
Expert:  Dr. Gehring replied 1 year ago.
Ok, but this is my last answer, because I can't write the same all over again. You should stop thinking over this topic, too, and distract yourself!!
Ultrasound can't differentiate between lymph node and scar tissues in little lumps. By touching it you kept up the inflammation.
Good bye and good luck!
Customer: replied 1 year ago.
Thanks I appreciate your time and of course will hit the excellent feedback button. I will hope and pray that if it is malignant it hasn't spread to my lymphnode which has been up for over a month. This has probably been the worst week of my life worrying over this and hoping I am not terminally ill. Thanks again!
Expert:  Dr. Gehring replied 1 year ago.
You are very welcome, and I promise: You are NOT terminally ill!!!
Customer: replied 1 year ago.
I hope not. I'm worried because my throat is scratchy and I have a cough as well bc my throat feels scratchy.
Expert:  Dr. Gehring replied 1 year ago.
I know.
Customer: replied 1 year ago.
You don't think thAt has any relation? I'm just so very worried about all of this and again that it has spread to my lymphnode since it is enlarged but I know that is unlikely. I just don't know how long the nodule is been there and I think it's been there for months. Thanks so much!
Customer: replied 1 year ago.
Hi Dr. Hoellering ! How are you doing? I'm concerned because I am definitely having a coughing problem that is getting worse recently (as in the past days). Like I said I also have an itch in my throat which makes it feel funny/uncomfortable when I speak, etc. I'm worried this is pointing to more of a malignancy since when I was in the endocrinologist appointment they asked if I was coughing as one of their pre set questions. So I'm just worried this indicates a bad diagnosis or that it has spread.