Five month inexplicable lymphadenopathy
I (19M) noticed enlargement of the right submandibular lymph node about five months ago. After quite some time of trying to express to my GP that I was legitimately concerned and then trying to find time in my schedule, I had an ultrasound done. The radiologist’s impression was as follows: “Bilateral enlarged lymph node in the submandibular region measuring 4.2 x 2.4 x 1.3 cm on the right and 1.7 x 1.2 x 3 cm on the left. Recommend short interval follow up.” Like I said, I noticed the right side several months ago, and as far as I can tell, any change in size has been very subtle if it has occurred at all. No persistent or worsening B symptoms. Last time I had labs done (about two months ago) CMP/CBC were normal and I have a normal chest X-Ray from that visit as well. It is firm but highly displaceable/motile on both sides, non tender on the right. For reference I’m in good health and fitness, no personal/family history of autoimmune/endocrine/lymphatic disorders. I was a long time user of nicotine pouches (very recently stopped) and have persistent acne, which as I understand it these are both chronic inflammatory processes that could be causing lymphadenopathy. What are any likely causes? What should I expect on my next ultrasound? Should I request an ENT exam or biopsy too? Most importantly, could this be lymphoma?