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Forum Name: Hematology Topics

Question: Painful Lump in Back of neck raised WBC for months went down


 laurieb92 - Mon Aug 16, 2010 11:24 pm

I am so hopefull that maybe someone can have some insight into medical problems I have been dealing with for 4 months. Initially I went to see my Primary care doctor for painful swelling and lump on the back of my neck by the base of my upper back because it had become so painful I couldnt stand it at work. He initially said he thought it was a ball of muscle spasm and prescribed Soma and methylpresnison 6 day pack. I went back to see him a few weeks later and swelling did not go down despite having been on the steroids but energy level was terrible prior and had somewhat improved ( I must note other symptoms I had were redness with non itchy spots and swelling on my arms and hands that also disappeared with the steroids but came back within days of completing the pack). He ordered bloodwork and another 6 day pack of methylprednisone and to go back a few weeks later. Once again redness and swelling of arms and hands went down but not back of neck which pain seemed to have worsened in that I was also getting pains in hands and what felt like rigidness that would cause me at times to drop things. My doctor therefore ordered a ct scan of my neck.....went back a few weeks later and was told swelling and glandular problem was seen of lymph node and wbc from the bloodworks he had been performing were consistently high....ct scan suggested possible non hodgkins lymphoma and was referred to oncologist. A week later when I saw the oncologist all of sudden after several months of high wbc it went down to 9.9...he therefore told me it is most likely auto-immune and did tests for that having follow up a month later. When I returned wbc still was in normal range although mid was slightly elevated and he said all autoimmune tests came back normal that maybe I have firbromyalgia to see a rheumatologist. I went to a rheumatologist who currently has me on prednison 5mg 2x a day to control the rashes and swelling of arms and hands (neck is still painful and lump is still same)...he said he does not feel I have fibromyalgia but is not sure what is going on and wanted me to do another ct scan since once again lupus/ra came back negative. I am awaiting the new ct results and very frustrated as months have gone by .....is it possible that this is still lymphoma since no biopsy or testing was done other than bloodwork? The pain seems to have progressed over the last months and I am really worried so much time is going by with no diagnosis (note...symptoms have been so bad both rheumatologist and primary care have had me out on short term disability and have had many problems with everyday functions). Any suggestions or help would be greatly appreciated.
 Dr.M.jagesh kamath - Tue Aug 31, 2010 6:00 am

User avatar Hello,In your case there is a need to differentiate a neuropathy and a myopathy.EMG will differentiate a neurogenic one from myogenic.Serum creatinine phosphokinase levels(CPK),myositis specific antibodies,Anti-jo-1 Antibody test would help in differentiating from polymyositis/Dermatomyositis and other conditions.Gottron sign are violaceous papules on the hand in dermatomyositis.Your skin presentation is vague yet might give a clue to diagnosis.
Best wishes.

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