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Forum Name: Lymphoma

Question: Small lump in groin


 laurel - Tue Feb 07, 2006 3:44 pm

I am 38 yrs old and have found a small lump in my right groin. It feels a little harder than rubber and seems to be attached to something, like maybe a vien. I have been having pain in my joints, especially my hips and knees. My family doc seems to think I have degenerative joint disease. I have also been running a low-grade fever for about 9 mos. that never usaully gets higher than 100, but just high enough to keep me constantly tired . It stays around 99.6 on most days. I can always tell when it's coming on because I always get a headache. Sometimes they turn into migranes. I can usually get my temp down to 99.0 when I take something for my headaches. I have also been having night sweats, but not real bad ones. Just enough to make my skin moist and sticky and keep me from sleeping real good. Thought maybe I might be going through perimenopause. My skin is a little more itchy than normal and seems to be more itchy on my chest, neck and arms but may be due to winter weather.

Lymphoma has of course crossed my mind, but also lupus. I have had a ANA test come back borderline lupus but the doc could not tell me what that means. Can you give me some guideance?
 Dr. Tamer Fouad - Thu Feb 09, 2006 2:00 am

User avatar Hello,

The inguinal lymph nodes are situated in the crease between the leg and pelvis (more on the outside of that crease, ie, laterally). They drain the penis, scrotum, vulva, vagina, perineum, gluteal region, lower abdominal wall, lower anal canal. Common causes of enlargement include infections of the leg or foot, STDs (eg, herpes simplex virus, gonococcal infection, syphilis, chancroid, granuloma inguinale, lymphogranuloma venereum), lymphoma, pelvic malignancy, bubonic plague.

Nodes are generally considered to be normal if they are up to 1 cm in diameter; however, some authors suggest that epitrochlear nodes larger than 0.5 cm or inguinal nodes larger than 1.5 cm should be considered abnormal [1,2].

Concerning your night sweats, they are clinically significant when they are drenching in nature.

A borderline ANA test is of little significance alone.

To diagnose lupus the American College of Rheumatology (ACR) has issued a list of 11 criteria for the diagnosis of this disease. These include malar rash (rash over the cheeks), discoid rash (red raised patches), photosensitivity, oral ulcers, nonerosive arthritis (two or more peripheral joints), serositis (pleuritis or pericarditis), renal disorder, neurologic disorder (seizures (convulsions) and/or psychosis), hematologic disorder (hemolytic anemia or leukopenia or lymphopenia or thrombocytopenia), antinuclear antibody positivity, immunologic disorder (positive anti-double stranded anti-DNA test, positive anti-Sm test, positive antiphospholipid antibody such as anticardiolipin, or false positive VDRL syphilis test).

A person should have four or more of these symptoms to suspect lupus. The symptoms do not all have to occur at the same time.

Given the limitations of the internet as a diagnostic tool, I urge you to refer to your doctor for a proper clinical evaluation.

Best regards.

References:
==========
1. Libman H. Generalized lymphadenopathy. J Gen Intern Med 1987;2:48-58.
2. Morland B. Lymphadenopathy. Arch Dis Child 1995; 73:476-9.
 laurel - Mon Feb 20, 2006 11:17 am

Thank you for responding. I have since had some tests run by my dermatologist because my hair has also been falling out. I had him check the lump in my groin thinking it might just be a cyst and he said that it was definately an enlarged lymph node. He did a ANA test that came back negative, a CBC that came back with a WBC of 4.2 K/ul, RBC of 3.83 M/ul, HGB of 11.4 g/dl and HCT of 34.1 %. He also did a TSH test that came back 0.28 ulU/ml. I of course don't know what this all means but he did say that the thyroid test could show the reason for my hair falling out. I still have a low grade temp, very fatigued, headaches, joint pain, etc. and now have found another small lump in my right armpit. Should I go to my gynocologist for further evaluation?

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