### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi my name is sal, for about 2 years now i have had swollen lymph nodes in my under arms, i have not went to the doctors to make sure they are acutal lymph node. Anyway i now have about 5 -7 nodes in both arms combined i dont feel any type of illness except for pain in my lower back. What can this be i cannot afford the doctors and I am extremly worried,

### output:

Hi, Dear,Thanks for your query to Chat Doctor virtual Clinic. I studied your query in all the details put forth by you. I understood your health concerns. Cause of the health problems you queried-There are many causes of the lumps in both of your underarms. In reference to accompanied lower back pain, these lumps could be either of -Lymphoma-(HL-Hodgkins and NHL -Non-Hodgkins type), TB lymphadenitis, Hi Chat Doctor. Plan of Treatment-Consultation by physician to rule out the above and other causes of under arm lumps. Xray Chest, Routine Blood tests and IRA(interferon Gamma Release Assay test) Blood test for old and subclinical /hidden TB infection, FNAC Biopsy By ER Surgeon if need be. After confirmation of the diagnosis of the cause of these lumps rule out other causes, I would advise you to consult ER Physician and ER Surgeon, who would examine it and treat it accordingly. Treatment-In the meanwhile you are waiting for the doctors consultation and needle biopsy and other tests-Anti-biotics and anti-inflammatory -to rule out any infective causes in lymph nodes and tissues around, could be started if need be after ER Physicians ER Surgeons opinion. In the absence of more information, I would advise Second opinion in your case, who would examine it and investigate it to treat it as per the cause of the lump. Do take his Second Opinion, on the above suggestion, as he would advise you with fist hand clinical information. Hope this would resolve your query with full satisfaction. Welcome for any further query in this regard to ME by direct question at Chat Doctor. Write excellent review and hit thanks, to narrate your experience, which would improve my rating for many other visitors to Chat Doctor. Wishing you fast recovery. Have a good day.