Minimally prominent submandibular lymph nodes

Ponkblossom

Hi there. I’ve been having some weird medical issues that I feel like are still up in the air even after some investigation and I’d love input if I should be pushing harder for more investigation/get a second opinion or just let it go. 

In November 2021 I noticed a small visible lump under my right side of my chin when I raised my chin up. The lump was painless and I hadn’t had any recent infections. I told my doctor and she ordered an ultrasound of the area. 

The ultrasound report said “FINDINGS: Targeted ultrasound evaluation of the right submandibular region at the site of palpable abnormality designated by the patient was performed.

2 lymph nodes are identified in the submandibular region corresponding to the palpable abnormality. These measure approximately 10 x 6 x 7 mm and 10 x 7 x 7 mm, respectively. No other mass lesion identified.

Impression

Minimally prominent right submandibular nodes corresponding to palpable abnormality. Continued clinical correlation is necessary.

If there is persistent or worsening symptomatology, consider followup CT or MRI study.”

My doctor then said to see if I needed any dental work and that other than that, we’d just watch it for any changes and if there were any she’d refer me to an ENT. 

I still have the lumps and they may have grown ever so slightly since then (no major growth or anything). 

Then in January I noticed what some swelling under my right armpit. I did not feel any lumps in my armpit in the area I have the swelling. I have dense breast tissue and thought I may have felt a lump in my breast so my doctor referred me for a mammogram and breast ultrasound. They did not completely scan into my armpit where my swelling was (just the area near it where the breast meets the armpit) so I don’t know if they were able to see the entire armpit area and they didn’t mention anything about it. The mammogram and ultrasound came back with no suspicious findings, so they would have been able to see if my swelling was caused by swollen lymph nodes, right?

I have been having issues with chronic fatigue for a while now, which is debilitating as a mom of young children. I get 7-9 hours of uninterrupted sleep every night and still feel exhausted to the point that I have to take a nap almost daily. I feel like I can only do the bare minimum energy wise and have felt like this for a while. My doctor did a bunch of lab work to try and find the cause and everything came back fine. My only abnormal lab results were low anion gap, low MCH, and low vitamin D, but I’ve been taking a supplement and my level is normal now and I feel the same. I also have been brain fog and extremely poor memory recall for years. I have also feeling out of breath with minimal exertion, but I had a chest X-ray and pulmonary function test that came back normal. Sleep function test came back normal, as did Lyme and vitamin b12 tests. 

I have been continually feeling exhausted and it’s hard not having answers. I am trying to figure out if the lymph node route is something I should keep on pushing and pursuing. I have spent so much money on testing, and I assume my doctor may also start being tired of all my issues. 

 I do not see my doctor again until next January. I’d love any insight or to hear about anyone else’s experiences that may help with what I’ve been experiencing. 

Thanks!

Max Former Hodgkins Stage 3

Ponk,

It seems your doctor has been pretty thorough thus far in investigating your symptoms. Most enlarged nodes are due to infections or some environmental trigger, and dissipate over time. You note that the jaw nodes have 'enlarged a little.' I would question how you can accurately determine this. It takes a lot of training and experience for doctors to correctly access enlarged ones. Similarly, 'swelling' in an armpit can have numerous causes: exertion, alcohol consumption, fluid retention for whatever reason. While the mamo may not have shown the axillary in detail, it is reassuring that it otherwise was completely normal. Your doctor is probably sound in recommending that you self-monitor for a time, but if I had any overt enlargements going forward, I would not wait until next January to follow-up.

Fatigue is one of the most common health complaints in America, the virtual norm today. With young children such as you mention, no big surprise.

Just my opinions and what I myself would probably do,

ShadyGuy

Ponk

I tend to agree with what Max says. My only comment, offered in good faith and with positive intentions, would be to re-write your post in summary form. One thing I learned in my many (I shudder to think how many) years giving presentations to audiences of all sizes is that most people have a short attention span. 20-30 seconds into it their minds start to wander. Short and concise usually gets the best response.