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Forum Name: Hematology Topics

Question: Need Dr.s advice before my Hematologist Appt.


 Jackie H - Sat Feb 25, 2006 3:10 pm

My name is Jackie and I am 36 years of age.

First lets say I have been pretty fatigued for a few months. I have been seeing an acupuncturists due to a car accident I had a year ago. He was also an MD in china (internal medicine) for 10 years.

About 5 weeks ago, he felt my nodes in my neck and collar bone area and they were enlarged and easy to touch (more prominent on left). He asked me if I was sick or anything and I said no but I had been fatigued. He did not want to alarm me but just to keep an eye on it. I went back to my primary for a follow up blood test I took on 1-12-06 due to the fatigue. Apparently it showed anemia with hemoglobin at 11.3 and hematocrit at 33.1

At the appt, the pcp doc told me it could be a virus that is new in my system and I just have not shown signs yet. She gave me a 10 day prescription of amoxicillin to rule out infection. 875 mg twice a day X 10 days. She also told me to get a multi with 100% iron which I did. I was to come back in 4 weeks after I stopped the antibiotics, re-check nodes and take a new blood test. I guess they have to give time for the lymph nodes time to go down. If the lymh nodes are still swollen - we will have to do a biopsy. If blood is stll low then it may mean other things.

Well just a week later went back to my acupuncturist and he noticed a pretty big lump under my left arm that was shaped like an egg and was 2 inches long and 1 inch wide. It is bigger now and this appeared day 7 of antibiotics which should not have happened if it were just a cold or virus. Lymphnodes were still swollen and a few were fixed. My husband and I went in with no appt. She felt the mass there under my arm (axillary lymph node) and it is cause for concern and further testing. She also felt around and my neck & collar bone area lymphnodes which were still swollen. Mainly on the left . I was also still very fatigued even after taking more iron, b-12 and vitamin c.

She wrote me an order to get a double mammogram and a double ultrasound and they both came back fine except showing swollen lymphnodes.

The mammogram stated mutliple bilateral lyphnodes more prominent in left than right.
The ultrasound stated - At least 4 and probably 5 lymphnodes seen in the left axillary area. They are hypoechoic but with hyperechoic centers and some of these are notched. Lymph nodes are present. All these reange in size from 5mm to 2.2 cm. I also took an MRI for my neck (to look at glands and nodes) . The MRI report states at least 4 nodes seen on left (neck) and approx 2 on right.

I had a neck node biopsied one on the left side of neck. It came back benign. What is worrying me is the collar bone lymph node. The others are of concern too. They are not going down. This has been going on for about 6 weeks now..

Went back to my acupuncturist yesterday and he said they are getting larger and the one on my left groin is now present. Not as big as the others. Oh and just last week I went on Omnicef because I actually did come down with a fever, bad cold, I caught from my son, etc.. That still did not do anything to my nodes or the lump just got slightly bigger.

I took new blood count on 2/17 and it appears my white blood count is down - 3.0L - hemoglobin is 11.6 and iron is quite low at 21. PCP says white blood could have dropped due to the cold I just got over but she is not certain. Mono test came back negative but showed I had it in the past which was new to me.

My left collar bone lymphnode is scaring me and I am just afraid. I am a mother of twins who are only 3 1/2. Anyhow my appt with the hematologist is wednesday and a chest x ray Monday.

Can you give me your opinions? Am I going in the right direction? If so what kind of things shall I talk to the hematologist about? Thank you in advance for reading and taking the time to respond.
 Dr. Tamer Fouad - Wed Mar 08, 2006 3:19 am

User avatar Hello,

I hope your visit to the hematologist was a fruitful one. Please let us know the results of your visit.

There are many causes of generalized lymphadenopathy of which the mononucleosis type syndromes are the most common. They usually present with fatigue, malaise, fever and atypical lymphocytosis on examination of the blood picture.

Splenomegaly may be present in 50% of patients due to Epstein-Barr virus infection. These cases can be diagnosed using the monospot test, IgM EA or VCA.

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