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I am pregnant, should I undergo surgery for a lymph node?

Q: I am 18 weeks pregnant. A lymph node was detected just below my jaw line one month before my pregnancy and it continued to be there without any change in size. Its been there for about 5 months but it has no effects on me, I dont feel any pain associated with it. I don't have any symptoms of sore throat, which might show that I have TB, which my general physician suspected. I have done blood tests, fine needle biopsy and ultrasound scan. Blood tests are normal and needle biopsy didn't show anything. The ultrasound mentioned that there is a lump of chronic condition. My consultant says that it would be better to remove the node under general anaesthesia as it would be uncomfortable doing it under local anaesthetic. I am aware of the risks associated of surgery under general anaesthesia, that it can lead to abortion. I don't want to do this unless its done under local anaesthetic. Consultant suspects that it might me TB or lymphoma. Do I really need to remove the lymph node in my present condition or leave it till I deliver? Can the surgery be done under local anaesthesia? Would there be any risks for me and my child if the surgery is not done? Should I undergo surgery? I am in dilemma whether to undergo a surgery or not. Can you please advise?

A:From what I understand, you have either a submandibular lymph node or a sialoadenitis (inflammation of the salivary gland). A lymph node usually enlarges if there is infection any where in the area that it drains. Do you have any tooth abscess or did you undergo any root canal treatment? If your doctor is suspecting Tuberculosis, surely it can be diagnosed by a FNAC - fine needle aspiration cytology (needle biopsy). It maybe a good idea to repeat a FNAC. If it is a sialoadenitis, it can be removed only under general anaesthesia. Another condition which your doctor might be suspecting is a Lymphoma (carcinoma of the lymph glands), which is best diagnosed by a lymph node biopsy under general anaesthesia. If at all necessary, general anaesthesia is safest in the second trimester of pregnancy (a normal pregnancy duration is divided into 3 trimesters of 3 months each). A diagnosis of lymphoma is unlikely if there is only one lymph node, it is usually associated with lymph nodes elsewhere.

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