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Forum Name: Lymphoma

Question: Possible lymphoma


 BUSCHCLUB - Sat Dec 31, 2005 5:23 pm

Hello,
I am a 26 year old man who has been unwell since feb of 05. It all started with a bad cold and fever I was not getting better so they sent me to be admitted with fuo low grade for 2 months plus. Etiology unknown. I did multiple blood cultures all negitive. MRI which was normal. Pelvic scan, checked for endocarditis, HIV, hepatitis. Whites were a little high and IgG was a little low - 600. CRP was a little high at 14 everything else normal was treated with doxcycycline and felt a little better for two weeks then the symptoms came back with low grade fever the did egd and colon I had multiple ulcers in the post bulbar duodenum. No H. pylori was negative many times no anti-inflammatory abuse. They were puzzled I still was feeling bad. Doctors just keeping their fingers crossed when bowel trouble got worse 10 bm a day stomach pain they did a pelvic scan - acute acalculas gallbladder with hemorrhage.
It was removed I was released hoping this was the end. All I have lost is fever but still feel terrible. Postive hemocult current heavy chest fatigue headaches. I was sent to John Hopkins in Baltimore and they did a cystic fibrosis test which was eq pos and tb was neg and refered me to GI dept. This is where I am now.
Then my neck swelled all along the right side, hence the question: My submanbular has been swollen for years but never the whole neck down to the color bone and seems to radiate to my right arm could this be lymphoma which has to do with the GI tract..
Please help, CBC normal, sed rate normal and going for biospy or removal next week...
 Dr. Tamer Fouad - Sat Dec 31, 2005 6:00 pm

User avatar Hello BUSCHCLUB,
I am sorry to hear that you have been through so much. Sometimes cases are like that, though. They present with significant symptoms, you do all the tests and they come back normal. The policy in such cases is to wait and see. To put the patient under observation so that as soon as the underlying disease presents itself with a clinically significant finding you can catch and treat it.
In your case that means your lymph node swelling. If it is indeed as large as you describe it to be that is clinically significant. A lymph node biopsy may give us a definitive diagnosis which will enable your doctors to treat you.
It is difficult to tell for sure what the possible diagnosis is. Your question is if this could be a lymphoma. Its possible but not so likely. You do not present with any other lymph node enlargements (although this is more common in Hodgkin's disease). You also do not have constitutional symptoms such fever, night sweats and weight loss. It is still possible that it may turn out to be lymphoma. Apart from lymphomas some cancers of GI tract may spread to the supraclavicular lymph node (above the collar bone). Based on the pathology obtained from your lymph node your doctors may request further evaluation of the GI tract or another CT scan, tumor markers or repeat the colonoscopy.
Its even difficult to tell for sure if this is a malignancy or not. Being of young age certainly decreases the likelihood of malignant disease. It could turn out to be a condition that is unrelated to your GI problems such as an infection or granulomatous diseases (ie, tuberculosis or sarcoidosis).
You have waited long enough, I think its best not to jump to any conclusions and wait a little longer to find out what this really is.
Please keep us posted.
Best regards,
 BUSCHCLUB - Mon Jan 02, 2006 11:29 pm

Hello and thanks for your remarks. I have noticed that I seem to have two adams apples. The top one is higher than the bottom and pointy the bottom feels like my adams apple. Am I just going crazy or is this abnormal? I did not notice until my wife pointed it out I felt hers even though she is a women and it felt like what I would consider normal.
 Dr. Tamer Fouad - Tue Jan 03, 2006 1:12 am

User avatar Hello BUSCHCLUB,
I am unable to properly assess you. This is something that requires clinical examination. Please relax as it probably will turn out to be nothing at all. When are you getting the biopsy done?

My regards to you and your wife.
 BUSCHCLUB - Tue Jan 03, 2006 4:53 pm

Hello and thanks for your fast response i went to a gi doc today who felt my neck area and said my nodes still fell shotty and my adams apple did feel a little large but i have lost 35 pds also over the coarse so he thinks no big deal just to let you know biospy is on thurs and i will let you know the out come.gi guy says he is thinking chrons or cystic fibrosis. i just want to thank all the doctors and folks who help make this possible it is nice to know that there are such great people willing to give their time..
 Dr. Tamer Fouad - Tue Jan 03, 2006 5:59 pm

User avatar Thank you BUSCHCLUB for your kind words and Good Luck with the biopsy!
 BUSCHCLUB - Thu Jan 05, 2006 11:55 pm

Hello again iwent for the biopsy today but he could'nt do it because he said it was to close to a vein so i go for removal on the 19th i will keep you posted..
 BUSCHCLUB - Wed Jan 18, 2006 11:45 am

Hello again just a quick update they removed my lymph node yesterday without any problems the node was 6cm plus the doc said should have been taken out along time ago since it has been enlarged for some tome now he said it looked good and not to worry can you get an idea of cancer by looking at the node if you are a doc or is a path report the only way of course i know that the path report is the one that counts just curious.i will update when path report is avalible.
thanks
 BUSCHCLUB - Mon Jan 23, 2006 2:00 pm

Hello just rec. cat scan results for sinus and neck they read as follows mucus retention cysts are again identified off of the medial wall of the left maxillary sinus. there is opacification of the left ethmoid air cells,mucosal thickening of the inferior left frontal sinus. the osteomeatal complex on the left side is obstructed by mucosal thickening. it is narrowed on the right side the sphenoid sinuses are clear. ct neck mucous retention cysts are again identified within the left maxillary sinus. there is mildly enlarged anterior right jugular chain measuring 11 x 16 mm also notes the patient has some residual sinus tissue in the anterior mediastinum. the lung apices are otherwise clear. i am still waiting on path report for submandbular node removal so i guess i have another node that is enlarged and the sinus residual sinus tissue is worysome because when i punch this into a search engine it shows all types of sinus cancer what do you think pls respond if i don't hear from you i will still post path report thanks for all your help please give me any helpful info..
 BUSCHCLUB - Wed Jan 25, 2006 12:36 am

path report inflatory cause so a ok thanks for your help
 Dr. Tamer Fouad - Fri Feb 10, 2006 5:46 pm

User avatar Congratulations BUSCHCLUB! I apologize for not getting back earlier. I am glad it all turned out well.

Best regards.
 BUSCHCLUB - Mon Feb 13, 2006 10:31 am

Hello again and thanks for your response i am still very ill and still have lymph node swelling on latest cat scan anterior juglar was moderatly large it is still swollen a month later and i also have arm pain with this they also noted i had residual tymus tissue in anterior mediastinum but did'nt recomend any thing my doctors said he wants to wait for the underlying ilness to present but i have been waiting for 1 year now do you think i should get biospy of other node they biospyed my submandbular node not jugular or does it matter my doctors have sent away a genotype test for cystic fibrosis but i think that is a long shot i was eq. on the sweat test even though i have had terrible sinus problems and only 16 months after second sinus surgery i show moderate sinus diease already on ct with polyps and cysts i have benn thinking about going to the mayo clinic what do you think of this am i being to worrysome or should i persue what i feel in my gut. still muffled voice swollen neck to adams apple down to colar bone terrible headache joint aches low grade fever from time to time foul bulky smelling stool that floats and is light in color with alot of bile dizzy feeling pressure on chest no lung problems as far as the last xray goes which was 8 months ago just had egd no problems there
 Dr. Tamer Fouad - Tue Feb 14, 2006 1:12 am

User avatar Hello again,

If there is the possibility of going to the Mayo Clinic then you should do that. I think you should keep at this until you get a satisfying answer. Obviously your doctors are doing the same thing otherwise they would not have sent the genotype test.

Best regards.
 BUSCHCLUB - Sun Mar 12, 2006 4:03 pm

Hello last time i left off they did a lymph node removal those nodes were benign when i went in to the doc he tells me get the cat scan so he can see it this is after the surgery well i saw the report they did'nt even mention that node they talked about anterior juglar which has continued to enlarge they just put me on more antibiotics no help swelling waxes and waines but is getting larger in general my whole neck and face are swollen and my right arm hurts seem to have on and off low grade fever 100.1 plus or minus i have apt at mayo not until august i fell like i have no energy headaches every day really bad flu like stuff they did a chest ct and it showed a 2mm intermediate pulmanary nodule but same answer that they always give me we need to wait well they don't understand i have a house a nd a wife to take care of what can i do what should i demand or am i wrong and waiting is a good answer i think pet scan should be done doc says no way.....
 Dr. Tamer Fouad - Mon Mar 13, 2006 1:56 am

User avatar Hello BUSCHCLUB,

Have you been evaluated by an oncologist/ hematologist? If not maybe you should try to get an appointment with one.
 BUSCHCLUB - Wed Mar 15, 2006 7:39 pm

Hello again thanks for your comment my doc wants do do a biospy now node is 4 cm x 6cm it was 2.5 4 months ago now they want to do another lymph node removal do you think i should see an oncoligst first or get the node removed also could this pulmanary nodule be related to my lymph node could they be connected also i don't know if to trust this ent he did biospy last time before seeing film and removed a node that was not even mentioned in the cat scan the one they are doing now is the one they mentioned do you think i should go to different doc i know this is my choice but what would you do if you were me. the reason why i ask is because of the time it will set me back
 Dr. Tamer Fouad - Thu Mar 16, 2006 12:50 am

User avatar Hello BUSCHCLUB,

Speed is the issue here. If getting an appointment with an oncologist won't cause additional delay then do it. If it will then get the biopsy done right away while you wait for the oncologist's appointment.

Best regards and good luck!

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