Asked by fabiennefox 0; 78762 ) on Sun 20, Jun 2010 09:51pm for $19.00:
	What is the cause of this swollen lymph node? Should I see a doctor? Appeared five days ago. Growing every day. Less than half an inch in size. Today it became very tender to the touch, even in the surrounding area. No known infections in my body. No surgeries. No prescriptions except Nuvaring, and today I took one Valtrex pill for herpes simplex A (because sometimes the node on my jawline swells when I'm about to get a cold sore; the jawline lymph node is not swollen.). Been on Nuvaring six months. Haven't had this problem until now. No food allergies. No drug allergies. Not menstruating. Work as a tax accountant. Haven't been out of the country for years. Haven't stayed in hotels recently. No bite marks. Not taking vitamins or supplements. Not a drinker or smoker. I don't do drugs. 5'4'', 120 lb, physically fit. Chinese ancestry. Haven't experienced weight loss, fatigue, or loss of appetite. No history of Hodgkins. No leukemia in the family. Only cervical cancer (paternal), breast cancer (paternal) women diagnosed in their 60s, 70s). I do suspect a cavity on the RIGHT side of my jaw,upper molars, but the lymph node on the right side is not swollen or tender. Normal.
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	Answer by Dr JS Anand (doctor) on Sun 20, Jun 2010 10:12pm: Hello, Welcome to the forum and thanks for posting on it. I can understand your concern for the swollen lymph node because it is not normal to find swollen lymph node. Lymph nodes are small (1-2cm) and bean-shaped nodes. they are very important to your body keeping you healthy. Lymphadenopathy (swollen lymph nodes) is usually caused by a viral or bacterial infection. Other causes include allergic reactions, arthritis, cancer, metabolic diseases, and an overactive thyroid (hyperthyroidism). Usually the lymph node which is in the vicinity of the infection is swollen but sometimes a lymph node in the nearby area may also get swollen. From your post the swollen lymph node can be due to the molar infection or due to the preceding herpes simplex 1 infection causing cold sores. Soft nodes are most likely infection or inflammation, firm but rubbery nodes could be lymphoma and rock hard nodes are more likely from some other type of metastatic cancer not lymphoma. I suggest you to get an examination and fine needle aspiration cytology( FNAC) or fine needle aspiration biopsy( FNAB) if needed done from a physician. It is aspiration of the fluid of the swollen lymph node which is done by a fine gauge needle (22 or 25 gauge) and a syringe. Treatment for inflamed, swollen lymph nodes, also known as lymphadenitis, depends on the cause. In some cases, over-the-counter (OTC) pain relievers and warm compresses may be all you need. For more serious cases, treatment of swollen lymph nodes involves treating the underlying cause. So I suggest you to get it seen from a physician. I hope it helps. Take care and please do keep us posted on how you are doing or if you have any additional doubts. Kind regards.
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	Comments: Comment by Dr Ajit Singh on Sun 20, Jun 2010 11:54pm: Hello fabiennefox, welcome to ask medical doctor.com. The possible causes – Herpes simplex and Molar infection {in your case} for lymph nodes swelling was very well explained by Dr.J.S.Anand. I would like to high lighten some other causes which might need to get evaluated, as your post suggests no significant history either from the past or now. Apart from Bacterial and viral infections which are acute causes of lymphadenopathy, also exist chronic infections like Tuberculosis Lymphadenitis and Cat Scratch disease – this is rare, which needs to be evaluated. In your case I would suggest to get basic work up done for Tuberculosis and Infectious Mononucleosis – this is characterized by enlargement of cervical lymph nodes. Lymphadenopathy can also be a symptom of certain diseases like cutaneous Anthrax, African Trypanosomiasis and Measles. Primary tumors like Hodgkin’s Lymphoma, Non-Hodgkin’s Lymphoma, Hairy cell Leukemia and Secondary tumors like Neuroblastoma and Virchow’s node, auto immune diseases like Rheumatoid Arthritis, Systemic Lupus Erytheomatosis, Sarcoidosis and immune compromised diseases like AIDS and HIV has to be also evaluated. All these diseases needs to be worked up and investigated. FNAC as suggested by Dr.Anand is the ideal one. Complete blood picture, ESR, serum creatinine, Sputum for AFB {acid fast Bacilli}, Monteux test, CRP {C reactive protein}, HIV Elisa method and Rheumatoid factor may also be required for investigations. Have a Physician’s opinion. Hope this additional information helps you. If any doubts keep posting. Regards