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Dr. D. Love
Dr. D. Love, Doctor
Category: Oncology
Satisfied Customers: 18663
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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30/F When I raise my left arm and feel along my clavical

Customer Question

30/F
When I raise my left arm and feel along my clavical space and my mastoid muscle, I feel a lump. It feels different at different angles. It cannot be palpated unless my arm is up and I'm leaning back.
I went to two doctors. An internal med doctor and a gp. They did upper lymph examine and said there's nothing concerning. That I shouldn't raise my arm to look for nodes and that I'm feeing muscle but they didn't actually feel it.
It can feel firm and round at one angle and soft and less round at others.
I'm worried about a hiding lymphoma node.
Submitted: 2 years ago.
Category: Oncology
Expert:  Dr. D. Love replied 2 years ago.
Hello from JustAnswer.

If there are no abnormal lumps found by two different doctors, then it would be extremely unlikely that there is anything concerning. If there had been an exam by only one doctor, then it would be reasonable to seek a second opinion, but you have already done this.

They also are generally correct that it is usually better to examine for lymph nodes by relaxing the muscles, rather than using the muscles to lift the arm or move the neck.

Obviously, I cannot perform an exam over the internet, but with exams done by two different doctors, I can say that it would be extremely unlikely that there is anything concerning that is present.

If I can provide any further information, please let me know.
Customer: replied 2 years ago.
Why would I feel something when my arm is raised? It's at the connect of the mastoid and the clavical. It jumps away when pressed up and moves.
Expert:  Dr. D. Love replied 2 years ago.
There are many structures in the neck that may be felt that are not concerning.
Customer: replied 2 years ago.
Can you describe to me what a lymphoma node would feel like? And are they usually surface nodes??
Expert:  Dr. D. Love replied 2 years ago.
There is no single way that a lymphoma node would feel like. If the way that the lymph node felt was reliable, then we would never need to ultrasound or biopsy lymph nodes. However, a larger, firmer, and persistent lymph node would be more worrisome.
Customer: replied 2 years ago.
Movement? Or none?
I just don't understand why raising my arm, raises palpable node?!??
Could this be a deep cervical node and not a clavical node? I'm so so worried.
The internalist checked me closely. She kept saying we don't raise our arms during lymph examines. And that I'm
Feeling muscle.
Expert:  Dr. D. Love replied 2 years ago.
They may be moveable or not. There is no verification that raising your arm has raised palpable nodes.
Customer: replied 2 years ago.
I know. I don't know what else it could be that feels like a node. It's probably the size of a dime. Soft feeling. Moves.
Only palpable with arms up.
Should I just wait this out?
I have a lot of anxiety here over rhis
Customer: replied 2 years ago.
Are lymphoma nodes very noticeable?!?!
Expert:  Dr. D. Love replied 2 years ago.
From a medical perspective, it would be appropriate to wait, but you obviously do not trust the opinion of the two doctors that have examined you. So, the issue becomes how many doctors does it take for you to be reassured and accept that nothing more needs to be done. If seeing another doctor to examine you and say that there is nothing concerning will relieve your anxiety, then a third opinion would be worthwhile. But if you are also not going to trust that doctor, then you are wasting your effort and money.
Customer: replied 2 years ago.
Relist: Answer quality.
Expert:  Dr. D. Love replied 2 years ago.
What further information are you seeking?
Customer: replied 2 years ago.
Why is a lymph node exam done with arms down only?
Expert:  Dr. D. Love replied 2 years ago.
An exam is more likely to detect lymph nodes when the muscles are relaxed. The examining fingers can feel deeper into the neck.
Customer: replied 2 years ago.
When lymphoma is diagnosed...are nodes generally noticeable or could someone have it and have hidden nodes and not know and the disease is spreading
Expert:  Dr. D. Love replied 2 years ago.
This is irrelevant to your situation. All cancers, including lymphoma, are not detectable in their early stages and only become detectable later. But that does not change this situation, because two doctors did not feel a lymph node on examination. If two doctor do not find a lymph node, then it is extemely unlikely that there is a lymph node.
Customer: replied 2 years ago.
Ok this is on both sides.
Bilateral. Does that indicate anything?
Expert:  Dr. D. Love replied 2 years ago.
Something that is bilateral is more likely to be a normal structure, but that is already indicated by the fact that two doctors did not feel anything concerning.
Customer: replied 2 years ago.
You keep saying that. I know. That's why I'm on here. Because if I raise my arms and lay back on a pillow. In the hollow where my mastoid sten muscle meets my clavical, there's a palpable node about the size of a dime on each side. That is soft to firm and moves around a lot. Hides totally sitting or standing with arms down.
Expert:  Dr. D. Love replied 2 years ago.
I understand what you are saying, but as I said above, if two doctors that examined you say that it is not a lymph node, then it is extremely unlikely that it is a lymph node, regardless of what you think you are feeling. This is why doctors undergo years of training. There is nothing that can be said over the internet that is a stronger indication than examination by two different doctors.
Customer: replied 2 years ago.
They didn't say what I feel isn't a lymph node. They just didn't find it. And they said that we don't do examinee laying back and raising your arms.
So I didn't force them too.
I guess I was looking to know if it's normal to feel lump bumpy tissue in your clavical.
Expert:  Dr. D. Love replied 2 years ago.
Correct. Two doctors did not find a lymph node by doing the proper examination for lymph nodes.

Yes, it is common that laypersons may feel something that is thought to be a lymph node, because there are many structures in the neck.
Customer: replied 2 years ago.
I do to want to leave anything amiss.
I'm obviously worried about lymphoma. I have no other symptoms.
I am 30. No history or cancer in my family.
I don't know the chances of hodgekins or non hodgekins but obviously worried about possibilities
Would this grown quickly if it were a lymphoma?
Expert:  Dr. D. Love replied 2 years ago.
Different lymphomas grow at different speeds. Some grow more aggressively than others. Even within the same type of lymphoma, there is variability in aggresiveness.
Customer: replied 2 years ago.
Ok. So my chances are...
I'm literally in a mayor panic. Is NHL common in 30 year old?
Expert:  Dr. D. Love replied 2 years ago.
No, it is not common in 30 year olds. Non-Hodgkins lymphoma is the seventh most common type of cancer, but the average age at diagnosis is 66. Only about 5% of cases occur in people under 35 years of age.
Customer: replied 2 years ago.
Ok. Hodgekins is pretty rare too, right?
I need to stop digging for this. Laying down to dig and find it. What I feel is soft, like a tendon would feel and moves. I guess it's deep and in both sides. Hopefully that's a good sign.
Expert:  Dr. D. Love replied 2 years ago.
Hodgkin's is much less common than non-Hodgkin's lymphoma.
Customer: replied 2 years ago.
Could these be jugular lymph nodes? I had a phelgmy cough and post nasal dri left over from a viral cold.
Expert:  Dr. D. Love replied 2 years ago.
It would be extremely unlikely to be any kind of lymph node when an examination by two doctors did not detect any lymph nodes.
Customer: replied 2 years ago.
Ok. So overall, and in general, a diseased node can be easily felt and found?!? No turning or digging needed?
Expert:  Dr. D. Love replied 2 years ago.
once it is of a certain size, but that is also irrelevant to this situation. An exam by two doctors will be more accurate than an exam by a layperson, regardless of whether there is a disease to cause an enlarged lymph node.
Customer: replied 2 years ago.
Ok. It's not the I don't trust my internalist. She's wonderful. She made me get undressed and checked well.
What size is concerning for a lymph node jn this area?
What's a size that would call for a biopsy!?
A m&m size?
Expert:  Dr. D. Love replied 2 years ago.
There is no size that would call for a biopsy, because enlarged lymph nodes from infection can get very large.
Customer: replied 2 years ago.
Ok. Well this node I have been pushing and prodding and moving for 5 days now. I believe when I found it, it was a tiny soft pea and now it feels bigger.
I do have a phelgmy cough I'm getting over. I don't know if this could be related to that.
Overall, I guess I should just wait. If this becomes easily felt or seen. Go back in? Otherwise stop digging? I w
Have been checked by a doctor, their exam, and wasn't found.
Expert:  Dr. D. Love replied 2 years ago.
it would be appropriate to wait.
Customer: replied 2 years ago.
Ok. I was up all night. I appreciate your replies.
Maybe when I am feeling is tissue or tendon or something else and it isn't a lymph node. At different angles, it feels different shapes.
Does lymphoma typically present with symptoms?
Expert:  Dr. D. Love replied 2 years ago.
It can present with symtoms, such as fatigue, fever, or night sweats, but it more often presents with persistent swollen lymph nodes.
Customer: replied 2 years ago.
Ok so would she have felt other nodes that would be inflammed or would there just be one node?
Expert:  Dr. D. Love replied 2 years ago.
It can be any number of nodes.
Customer: replied 2 years ago.
Ok. Well I feel like this is totally vague.
Expert:  Dr. D. Love replied 2 years ago.
I am sorry, but any condition that causes swollen lymh nodes can cause a single swollen lymph node or many swollen lymph nodes, so it can be any number of lymph nodes. You may perceive that as vague, but that is the way it is.
Customer: replied 2 years ago.
Could you please give me some options a to what you believe this and how I should proceed or refer me to a new expert
Expert:  Dr. D. Love replied 2 years ago.
There are many structures in the neck that this could be, including several different muscles, tendons, or skin structures. Since your doctor thought that you were feeling muscle, that would be the most likely structure.

When there has been two examinations that do not show any lymph nodes, the usual way to proceed would be to wait, which is what I have said a couple times now. Your only other option would be see a third doctor to examine you.
Customer: replied 2 years ago.
Would an xray show these nodes?
Customer: replied 2 years ago.
My last chest x ray was in October. Is that still reliable or should I go again
Expert:  Dr. D. Love replied 2 years ago.
A plain x-ray would not. It would require either an ultrasound, CT scan, or MRI, and these studies are typically not indicated if there is nothing found on exam.
Customer: replied 2 years ago.
Ok. My last chest x ray was in May and then October. Is that still reliable for growths or tumors in my chest or should I go in?
Expert:  Dr. D. Love replied 2 years ago.
The area that you are feeling is in your neck. A chest x-ray is irrelevant.

As it turns out, regular chest x-rays are also relatively worthless for evaluation for chest tumors, which is why it is recommended that they not be done routinely, even in smokers.
Customer: replied 2 years ago.
lymph nodes that are inflamed feel round? Like a ball in tissue?
Expert:  Dr. D. Love replied 2 years ago.
They can be round or oblong, but this is also irrelevant, since your doctors did not feel any lymph nodes.
Customer: replied 2 years ago.
Relist: Answer quality.
Keeps repeating that I was examined.
Expert:  Dr. D. Love replied 2 years ago.
because that is the key reason why you should not be concerned. If you trust these doctors, then two exams would make it extremely unlikely that there is anything concerning, regardless of all these other factors. If you do not trust these doctors, then it certainly would be appropriate to be examined by a third doctor. But there is no value in considering factors that do not change the fact that an examination by two doctors would make it extremely unlikely that there is anything concerning.
Customer: replied 2 years ago.
I went to an urgent care today. A walk in and a PA did the examine.
She said she felt the tendons and wear I was feeling with my arms up.
That she could feel small lymph nodes there. Maybe from excessive rubbingg and prodding. They are deep and lift when I lift my arms.
Expert:  Dr. D. Love replied 2 years ago.
OK. That also does not sound concerning.
Customer: replied 2 years ago.
I'm having a nervous breakdown.
I wish I could just say bilateral nodes that are soft are nothing.
I don't know what else to do here.
Expert:  Dr. D. Love replied 2 years ago.
Shotty lymph nodes would be considered nothing. If the urgent care also said that there is nothing that needs to be done, then there is nothing that needs to be done.
Customer: replied 2 years ago.
A PA isn't even a doctor. And she basically said she feels tendons and lymph nodes but they aren't a concerning size.
This is where my trouble is. Will this continue to grow and change into a firm hard lymphoma node?
Expert:  Dr. D. Love replied 2 years ago.
It is impossible to know. I can tell you that it is very unlikely that small shotty lymph nodes will change into firm hard lymph nodes. But it cannot be predicted and can only be determined with time.
Customer: replied 2 years ago.
What I feel isn't shotty like a buck shot. It is like a large pea. Lkke if I drew a circle on the pad of my index finger.
Expert:  Dr. D. Love replied 2 years ago.
The majority of lymph nodes that are pea sized are also nothing, but this statistic is less significant than the opinion of a health care professional that has examined you. If the urgent care PA felt what you are discussing and said that it is not concerning, then there is no reason for you to be concerned.
Customer: replied 2 years ago.
What I'm trying to understand is this
If a lymph node isn't palpable on traditional exam by a professional. But I can lay down and raise my arm and deep in they triangle fosse I feel a soft lump...then...I should just wait to see if it grows?
Expert:  Dr. D. Love replied 2 years ago.
you should wait.
Customer: replied 2 years ago.
Ok. And lymphoma nodes in general, most you don't have to go digging for?
Expert:  Dr. D. Love replied 2 years ago.
Correct.
Customer: replied 2 years ago.
They gave me 3 xanax to calm down this weekend. And stop digging and irritating my neck nodes
I have been digging since the 10th.
My skin is broken out with acne above the spot from my content touching.
Thank you. I pray I don't have lymphoma. I have no cancer family history. I'm healthy weight and I exercise and eat totally organic.
I pray I am ok.
Expert:  Dr. D. Love replied 2 years ago.
The odds are overwhelming that you are OK.
Customer: replied 2 years ago.
Sometimes I think my anxiety makes me feel things in my neck that aren't as they are. Like a tendon as a ball or a pea size soft normal reactive node as bigger then it is.
Expert:  Dr. D. Love replied 2 years ago.
That is very common..
Customer: replied 2 years ago.
I'm going to stop prodding this node. It's pea size and soft and might just be attributed to my cough and cold I'm getting over. I had a fever and took antibiotics for 7 days for strep. Although I tested negative for strep they treated me as so. I'm much better with a lingering cough here and there. Maybe this node if from that. I wouldImagine bilateral nodes are less pointing to lymphoma
Expert:  Dr. D. Love replied 2 years ago.
as we discussed above, bilateral findings are more likely to be a normal structure.
Customer: replied 2 years ago.
Could bilateral also be from a cold or virus so nodes on each side are palpable. Exact same location. And size.
Expert:  Dr. D. Love replied 2 years ago.
Bilateral findings are more often normal, rather than any disease process, but yes, a viral infection can cause bilateral findings.
Customer: replied 2 years ago.
Wonderful thanks. I'm going to trust God and move on. I have spent 5 days and 3 doctors later. Plus you. Sleepless nights. Worried to death.
Expert:  Dr. D. Love replied 2 years ago.
The odds are overwhelming that you are fine.
Customer: replied 2 years ago.
I know we have covered this but,
Lymph nodes that I need to seek a doctor for should be ones that are easily felt, bigger then a M&M, and easy to feel. I shouldn't have to dig and twist and move tissue around in my neck to find a lymph node that is concerning?
Expert:  Dr. D. Love replied 2 years ago.
is persistent. Since swollen lymph nodes secondary to infection can get very large, they would satisfy the characteristics that you list, but they resolve after the underlying infection clears, although it may take several weeks or even a couple months for the lymph node resolves. When there is an enlarged lymph node secondary to infection, it is only necessary to see your doctor if the underlying infection warrants seeing your doctor, not the swollen lymph node.
Customer: replied 2 years ago.
Ok. So say these bilateral nodes that are like peas or smaller remain. Do I need to go in!?
Expert:  Dr. D. Love replied 2 years ago.
No.
Customer: replied 2 years ago.
Ok. What happens is I dig and dig and move tissue around and feel bumps. When I lay flat and feel my clavical. It's soft and smooth and I just feel the tiny bb size node.
Expert:  Dr. D. Love replied 2 years ago.
None of this sounds worrisome, but the exam by three different health care professionals is even more reassuring.

You are continuing to seek less accurate reassurance when you have already received a more highly accurate reassurance. If someone has had a highly accurate assessment, then there is little value in performing an additional assessment that is less accurate. Any assessment over the internet based on a laypersons description of a self-examination is not going to be as accurate as a live examination by three different health care professionals.

Please provide a positive rating so that I am credited for assisting you.
Customer: replied 2 years ago.
I know. My problem is they just checked a normal check. They didn't dig around. And it's when I a
Dig around that I find them
Expert:  Dr. D. Love replied 2 years ago.
An examination by three different health professionals will still be more accurate than an internet assessment based on a laypersons description of a self-examination. Part of the training for health professionals is to know how to perform an accurate examination, including how to press.

Please provide a positive rating so that I am credited for assisting you.
Customer: replied 2 years ago.
What's the point of this service then?
I thought I would be able to get a 3rd opinion here. It's hard to force a doctor to dog into my clavicle.
Pea size is not scary I don't believe
Expert:  Dr. D. Love replied 2 years ago.
The point of this service is to educate customers, including the most accurate means of assessment. It is not intended to replace the care by a doctor.