lymph node behind ear

[Brychni]

Hello all

I usually post in NRAS as I have Inflammatory Arthritis and Raynaud's, among other things and symptoms of rheumatic disease can includes lumps and bumps including swollen lymph nodes that come and go and are quite tender and often accompany a 'flare' - I have checked this out with my GP and rheumatology nurse and it's definitely a symptom.

However, I also have one lymph node on the bony bit behind my left ear which is not tender and is always 'up'. It's quite hard and has been there for about 6 or 7 months. I recently read that if they don't hurt and are always there, they should be looked at. I should add that it is very small, about the size of a petit pois (!)

My father had CLL (Richter's Transformation) and my grandmother (his mother) also had blood cancers and PRV.

It is easily felt and my husband can feel it and see it, but because it's small and because I am constantly at the surgery and appointments already, with blood tests etc for methotrexate, and because of Covid, I am reluctant to go the the GP or even report it to rheumatology. Can anyone advise? Thanks

[AussieNeil Partner Founder Admin]

Hi Brychni,

I'm glad that you mentioned your background and that of some of your blood relatives. Posting in this community would otherwise result in replies from well meaning members assuming you had Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL) blood cancer.

It is probably worth checking out that small pea sized lump, given CLL/SLL is the most common adult Leukemia/Lymphoma, with about 10% of cases being familial. So while your risk is probably higher than average, it is still quite unlikely you have a lymphoma. If your complete blood exam results are normal, in particular lymphocytes, haemoglobin and platelets, you could have the SLL presentation of CLL/SLL, which is of the order of around 1% of CLL/SLL diagnoses. In the UK, that would be perhaps 50 cases a year. The lump is most probably a node that swelled in response to a past infection/inflammation and scar tissue has stopped it from shrinking back to its normal size. If a biopsy shows a collection of monoclonal lymphocytes and you have no other nearby swollen nodes, that might well be the end of your concerns. Likewise, if you have some nearby swollen nodes, therapeutic radiation can shrink them and potentially cure the lymphoma. It's done in early stage SLL, but very rarely, because of the very low incidence of early stage SLL diagnoses. Note that I'm not medically trained, but my CLL/SLL first presented as the SLL form of this particular blood cancer.

Neil

[Brychni in reply to AussieNeil]

Hi Neil - thanks for your detailed reply. I forgot to mention that RA (autoimmune inflammatory arthritides) also increases the risk of lymphoma twofold, along with heart and lung disease. So I am more than doubly worried given my family history - seems to be something drastically wrong with the blood!

[Brychni in reply to AussieNeil]

Forgot to say I take hydroxychloroquine and methotrexate which is a type of chemotherapy drug. the standard approach with inflammatory arthritis is aggressive precisely because of risks such as lymphoma and disability - but it is difficult to get under control and people typically try lots of different drugs. MTX doesn't seem to be doing anything for me at themoment.