Swollen lymph nodes did NOT start this journey for me. In fact, it was a weird “popping” sensation in my neck. Painless but unnerving and then some feeling of tenderness. I then noticed my right tonsil was larger than the other and saw an ENT. She scoped, wasn’t concerned, prescribed antibiotics. Said she would order a CT if it would ease my anxiety and because she felt that given my profession, I probably needed some more definitive info (I’m an SLP).

During 2 week wait for CT, I felt 2 nodes on either side of my neck... level 2 I believe. Pea sized or a bit bigger. Had CT. CT results normal. Several prominent nodes noted, largest 9mm at short axis. Tonsils mildly enlarged bilaterally but believed to be pretty symmetric. Follow up ENT said nothing to be concerned about, go enjoy my youth! (I’m 35). Saw another ENT for 2nd opinion, viewed scans and scoped and pretty much said she didn’t see anything to worry about. Wasn’t sure why I was on week 5+ of antibiotics though. Saw tonsil stones but no signs of infection.

I’ve done LOTS of research. Obnoxious amounts. Journal articles mostly but some from well-respected institutions with citations. If my largest lymph node is 9mm at the short axis, is this even enlarged? Or does the fact that I feel them in general make them enlarged? The CT report just said “prominent”. Which read to me: ENLARGED. But the research is mixed. 2nd opinion said they don’t worry about them unless 15mm or larger. CT report said size doesn’t meet criteria to be considered pathological. Presumed reactive. Dx with chronic hypertrophy of the tonsils. Lymph node size is unchanged, I think. I’ve read enough on here to know that lymph nodes with cancer can be small... though research does support this as being low incidence. 15mm seems like a high cutoff though... sensitivity is quite low with that cut off. I don’t know if my ENT will do a FNAB if I request it. I plan on asking why if she doesn’t specifically state why one isn’t warranted. I also read that it’s not only size but the necrosis that should be evaluated. Should I assume this was evaluated and not just a “it’s smaller than 15mm so it’s all good!”

If anyone reading this who had a suspicious node evaluated would care to share size and whether it was benign or not, I’d appreciate it. And whether you had a FNAB. I’m guessing since I’ve had a CT, an US wouldn’t be useful other than if it was to guide the FNAB.