OpenHealth Q&A

Advice Requested on Enlarged Cervical Lymph Node During Pregnancy

I appreciate you taking the time to consider my situation. My specific question can be found at the end of this message. - 30 years old - 33 weeks into my pregnancy - Experiencing an enlarged and painless left cervical lymph node since 2020 - Discomfort present (not typical pain associated with swollen lymph nodes during illness) I am worried about a swollen cervical lymph node I’ve been monitoring since 2019/2020. Initially, I felt discomfort and discovered a hard, immobile lump located behind my left jaw, just beneath my ear. An ultrasound was conducted, which yielded the following results: - **Date**: February 2020 - **Examination**: Ultrasound of the soft tissues in the neck - **History**: Presence of lymphadenopathy; no previous comparisons made. - **Findings**: No lymph nodes were found to be pathologically enlarged. Several small, non-pathologically enlarged nodes appeared normal in the anterior cervical chain. These findings did not warrant further follow-up at that time. Fast forward to 2025, I continue to experience discomfort along with the enlarged lymph node, prompting me to request a second ultrasound of my neck. The outcomes from the recent ultrasound raised some concerns: - **Date**: June 2025 - **Examination**: Soft tissue ultrasound of the head and neck - **History**: Noted swollen lymph nodes located below the parotid gland for several years; comparison made to the February 2020 examination. - **Technique**: Grayscale and color Doppler imaging of the relevant area beneath the left parotid gland. - **Findings**: A solid-appearing avascular mass or lymph node measuring 2.2 x 0.7 x 0.8 cm was identified adjacent to the left submandibular gland, parotid gland, and left internal jugular vein and carotid artery. A benign-appearing lymph node along the lower margin of the left parotid gland measured 1.3 x 0.2 x 0.7 cm, retaining its normal shape and containing fatty hilum. The radiologist suggested a CT scan to further examine the 2.2 cm mass. However, since I am pregnant, my obstetrician recommended against undergoing a CT unless absolutely necessary. My primary care physician conducted blood tests and noted some changes that can likely be attributed to my pregnancy (the routine blood profile from November 2024 was normal), and he advised monitoring the situation with routine ultrasounds until after my delivery. I consulted with an ENT specialist who evaluated the ultrasound findings and conducted his own examination in the office. He did not express significant concerns, suggesting a needle biopsy but ultimately deeming it unnecessary at this stage. We agreed to wait until after delivery for a CT scan. Although I felt somewhat reassured after these discussions, my current worry stems from a subsequent routine ultrasound conducted in July 2025. I received a notification indicating the node showed a "very slight" increase in size, likely related to the changes brought on by pregnancy, and the recommendation was to continue monitoring until after I deliver. I do not have access to those ultrasound results as of now. **My Question**: Should I go ahead and arrange a needle biopsy with my ENT based on this new information? I feel anxious about waiting until October for my scheduled CT scan, especially with even a small increase in the lump’s size noted within only a month.

Answers (1)

8/8/2025, 3:02:22 PM

OpenHealth AI

It's understandable to feel anxious about changes in your health, especially during pregnancy. Given your situation with the enlarged cervical lymph node and the ongoing monitoring, here are some key points to consider regarding whether to proceed with a needle biopsy.

Summary of Key Points

1. Current Findings: You've been monitored for a non-painful cervical lymph node for several years, with the latest ultrasound showing a slight increase in size. However, the specialist did not consider a biopsy necessary at this time.
2. Reassurance from Professionals: Your obstetrician, primary care physician, and ENT specialist have collectively recommended continued monitoring until after your delivery, which indicates that they are not currently concerned about malignancy.
3. Potential for Change: While any increase in size can be concerning, the recommendation from multiple healthcare professionals to wait aligns with common practice during pregnancy.

Recommendations

1. Trust Professional Guidance: The recommendation not to rush into a biopsy is based on the consensus of specialists familiar with your case. This indicates that they believe the risk of complications from the procedure may outweigh the potential benefits at this time.

2. Plan for Monitoring: Continue with routine ultrasounds as advised. You may want to document any new symptoms or changes in the lump's characteristics (like pain, tenderness, or rapid growth) to discuss with your healthcare team.

3. Communicate Your Feelings: Share your concerns and anxiety about the lump with your ENT or obstetrician. They may be able to provide additional reassurance or decide to adjust your monitoring plan if they feel it’s warranted.

4. Access Your Results: As you have been notified of a slight increase in size, try to obtain the details of your July ultrasound. Having full information can often help alleviate anxiety.

5. Post-Delivery Plans: Discuss a follow-up plan for after delivery, including the option for a CT scan or biopsy. This will help ensure that you are ready to address any lingering concerns once your pregnancy is over.

Next Steps

• Keep communication open with your healthcare providers and express all of your concerns.
• Focus on your pregnancy and take care of your well-being.
• If you notice any significant changes in your symptoms, contact your healthcare provider earlier.

It’s completely normal to feel apprehensive about health matters, particularly in such a crucial time as pregnancy. Remember that you are taking proactive steps by seeking information and staying in touch with your medical team.