From the Guidelines
A submental lymph node size of 1.1 cm is generally considered borderline abnormal, but according to the revised response criteria for malignant lymphoma, it should only be considered abnormal if its short axis is more than 1.0 cm. When evaluating lymph node size, it's essential to consider both the long and short axes, as stated in the study published in the Journal of Clinical Oncology 1. The criteria for considering a lymph node abnormal include a long axis of more than 1.5 cm, regardless of the short axis, or a long axis of 1.1 to 1.5 cm with a short axis of more than 1.0 cm. Some key points to consider when evaluating lymph node size include:
- Lymph nodes with a long axis of 1.0 cm or less are not considered abnormal for relapse or progressive disease.
- A 50% increase from nadir in the size of any previously involved nodes or lesions can indicate progressive disease.
- Lesions should be PET positive if observed in a typical FDG-avid lymphoma or if the lesion was PET positive before therapy, unless the lesion is too small to be detected with current PET systems. In the context of a submental lymph node size of 1.1 cm, if the short axis is 1.0 cm or less, it would not be considered abnormal, but if the short axis is more than 1.0 cm, it would be considered abnormal, as per the criteria outlined in the study 1. It's crucial to note that these criteria are part of a broader set of guidelines for evaluating response to treatment in malignant lymphoma, and clinical judgment and careful history and physical examination are essential components of monitoring patients after treatment.
From the Research
Submental Lymph Node Size
- A submental lymph node size of 1.1 cm is considered abnormal, as the mean size of lymph nodes in the submental region is approximately 5.28 mm, according to a study published in 2020 2.
- However, it's essential to note that lymph node size can vary depending on the individual and the presence of any underlying conditions.
- A study published in 2018 found that the mean number of submental lymph nodes was 7.2, with a range of sizes, but did not provide specific information on what constitutes a normal or abnormal size 3.
Comparison with Study Findings
- The size of 1.1 cm is significantly larger than the mean size reported in the 2020 study 2, which may indicate an abnormality.
- However, without more specific information on the individual's medical history and the presence of any symptoms, it's difficult to determine the cause of the enlarged lymph node.
- Further evaluation, such as imaging studies or a biopsy, may be necessary to determine the cause of the enlarged lymph node and develop an appropriate treatment plan.
Clinical Significance
- Enlarged lymph nodes in the submental region can be a sign of various conditions, including infections, inflammatory diseases, or malignancies 4, 5, 6.
- A thorough medical evaluation, including a physical examination, imaging studies, and laboratory tests, is necessary to determine the cause of the enlarged lymph node and develop an appropriate treatment plan.