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Are
Nov 25, 2001

I read somewhere that lymph nodes are normally "pea sized" - this leads me to ask a couple of questions...

1. Is this the case?

2. If so, is this enlarged/normal size?

3. If this is the normal size, it is possible to feel a lymph node that is not swollen.

Many thanks for your help.

Response from Dr. Dezube

Lymph nodes are part of the body's immune system. They commonly enlarge when there is an infection. This is your body's attempt at fighting off the infection. You ask a good question which is "what is the size of a normal lymph node?". Unfortunately there is NO simple answer for the following reasons:

1) YOUTH- Young people, particular children, but also young adults develop an exuberant lymph node response to common viruses (e.g. upper respiratory illnesses) so even when these folks recover, the health care provider can often feel residual lymph nodes.

2) LOCATION- Some locations for lymph nodes are just sooooooo common that finding a pea-sized lymph node in that area, hardly makes me raise my eyebrows. The neck and the groin area are particularly common locations. The neck is a common site because of either upper respiratory infections or bad teeth; the groin is a common place particularly for those of us (including me) who walk around bare foot.

3) HIV INFECTION- Folks, who are HIV+, typically have for most of their illness enlarged lymph nodes. For them, enlarged lymph nodes are their "normal" state.

So what make a particular lymph node particularly worrisome??

If one lymph node is out or proportion to other lymph nodes, then that's worrisome.

If a lymph node is in an unuusal location, then that's worrisome.

If the patient has lymph nodes in the setting of systemic symptoms (fever, chills, night sweats, and weight loss), then that's worrisome.

In these and other worrisome cases, a lymph node biopsy would typically be the next step.


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