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Is fatty hilum in a lymph node on a CT scan always indicative of a benign node?

Discuss Lymphoma, Hodgkins Lymphoma, Non-Hodgkins Lymphoma

Is fatty hilum in a lymph node on a CT scan always indicative of a benign node?

Postby rye71 » Thu Mar 22, 2012 2:57 pm

I am a 34 year-old woman in good health that has had a lump under my jaw for many years. I'm thinking at least 10 years. I asked my primary doctor about it a few years ago, and he seemed to think it was scar tissue from an infected lymph node that I had when I was a child. For some reason, I decided to get a second opinion just now about the lump. I went to an ENT who ordered a CT of the neck with and without contrast. The CT results were normal except for submental lymph node 1.2x2.4cm in size appearing with normal fatty hilum. It said it was most likely reactive. My doctor called in Augmentin and told me to see him in a week. When I went back to see him, the lymph node did not go down in size. He said he was ok with following up in 4 months to see if was getting bigger, that if it were malignant, it would most likely grow in that time. If I've have the lump for many years and have not noticed it getting bigger, is it most likely not cancer? Also, I read that submental glands drain your teeth and mouth. With having an infected lymph node as a child, could it possibly have made the lymph node permanently enlarged? Also, I had chronic dental issues with infection in one of my lower front teeth, actually had a hole drilled into the tooth to let it drain and had to have my gums pulled down and infection scraped out a couple of times. I now have a root canal and bridge as a result. Could this infection cause an enlargement of the node? I know that everyone is saying the only way to know if it it cancer is to have a biopsy of the node, but with the dental issues and prior infection, also with the fatty hilum, are my risks of lymphoma low? Should I get a biopsy now rather than wait 4 months or am I generally a low risk?
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Is fatty hilum in a lymph node on a CT scan always indicative of a benign node?

Postby fogarty » Thu Mar 22, 2012 3:02 pm

A fatty hilum is a good sign since most normal lymph nodes contain one. However, some cancerous lymph nodes can contain a fatty hilum and still be malignant. It's your doctor's duty to assess all the characteristics of the lymph node that is in question and whether there is any benefit in biopsying it or waiting.
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