Dear Parent,
EBV infection is one of the commonest infections in children causing lymph node enlargement. Only a few cases of thousands affected with EBV changes to lymphoma and that too after a prolonged period of time. MOST OF THE VIRAL,INFECTIONS ARE VERY MUCH SELF LIMITING IN THIS AGE GROUP. PLEASE BE ASSURED THAT YOUR CHILD HAS A NORMAL INFECTION APPROPRIATE FOR THE AGE AND THE GLANDS ARE ENLARGED IN RESPONSE TO THE TONSILLAR ENLARGEMENT CONSISTENT WITH HER GOOD AND HEALTHY IMMUNE STATUS.
Mostly the child will be diagnosed to have adenotonsillitis in this age which is in response to her immune reactions against environmental infections. Many children will get this corrected by itself by 6 to 10 years without any treatment. Few may require antibiotics. Very minimal patients may require surgical removal of tonsils and adenoids after which the neck nodes will regress automatically.
SO PLEASE BE ASSURED THAT THIS NODE IS ENLARGED BECAUSE OF HER GOOD IMMUNITY LEVELS AND NOT BECAUSE OF LYMPHOMA. YOU CAN MEET YOUR ENT SURGEON AND GET HIS OPINION TOO
Happy to clear doubts if any.
Kind regards
Patient replied :
Thank you doctor! So to be clear to ourselves:
1) Does it mean the nodes can remain swollen untill the weather becomes normal and she picks up the daycare viruses or catches simple cold?
2) The fact in itself that one of them has been over 2.5 cm (was 2.7) and the have last for a longer period, it does not automatically indicate automatically cancer e.g. lymphoma? I just googled and these kind of seemed to be the red signs but I am surely no doctor.
On the other hand the oval shaped node seems to move nicely so it is not hard and stuck as it was also said...
With best regards,
Kaido
Hello Kaido,
You need to take consideration into the fact that lymph nodes are normal organ glands . They can be palpable at times, especially in the children. Sometimes it could be infection , sometimes inflammation or at times a normal phenomenon. There is nothing to worry about that. The child had a physical examination and blood tests. So there is no reason to be concerned . So it is possible that the node can remain enlarged until the winter is over / till the child grows up (as children and more prone to infection)
The enlarged node is not a red flag sign, if the general physical examination and the blood tests are normal. Persistent fever is a red flag sign. Bleeding spots is red flag sign, gum bleeding is a red flag sign. The only way to know for sure is a needle biopsy. But I feel it might be bit extreme approach. Prudent observation should be enough.
Hope this helps
Feel free to ask followups
Thank you
Patient replied :
I apologize, hope this would be one of the last questions. Today when brushing her teeth there was a very little bleeding from upper teeth. It looks more like an area where we have had some hygiene problems. It was not a massive bleeding, the brush picked ul some pink.
As you mentioned this would be a red flag, we wanted to check it out. I am sure i looki like a kind of not normal person, but this is truly freaking me out.
With kind regards
Kaido
Ok. To answer precisely, could you send me a picture of her mouth area where you suspect to have bleed ? Look for any abnormal area in mouth in the inner cheeks, behind the teeth and in between teeth and cheek.
Patient replied :
I could not really see anything abnormal but the bleed on the toothbrush came from the upper area we photographed.
The lymph node is still present under the jaw (but it is on the opposite side), oval shape and moves around pretty freely. Just the size i can not get when the chin is up, it feels bigger, when she faces downwards, it feels smaller.
not sure if you got the pictures?
Hello, thanks for the pics.
Everything looks normal to me.