<s>[INST] hello doctor this shaila from bangalore india. i have painfull swellen lymphnode on the right side of the neck. i did various test like, chest x-ray, mantoux test, fnac, complete blood test , and ultrasound also. in blood report there is ESR level is 42 which is higher. and despite this all the test report is normal. please help doctor plz [/INST] Hi! thanks for writing to us sharing your problem of painful lymph node on the right side of the neck with normal  chest x-ray, mantoux test, fnac, complete blood test , and ultrasound reports!Only ESR is raised and surprisingly FNAC or needle biopsy is also normal!Therefore, I must consider few possibilities as follows:1. viral infection2. throat, thyroid, ear or oral infection3. toxoplasmosis4. Kikuchi's disease Therefore, you have to consult a hematologist or immunologist for a detailed examination and necessary steps;regards, </s>