News  |  Journals  |  Conferences  |  Blogs  |  Articles  |  Forums  |  Twitter   
 

 Headlines:

 
 

Doctors Lounge - Oncology Answers

"The information provided on www.doctorslounge.com is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her physician."

Back to Oncology Answers List

Forum Name: Lymphoma

Question: Bilateral Zoster & Lymphadenopathy


 dorothyparker - Sun Dec 10, 2006 3:14 pm

Question: Should I proceed with biopsy?

I have been referred to a surgeon for an excisional lymph node biopsy in my neck. My doctor thinks I am probably just fine, but is still sending me to surgeon because the lymph node hasn't shrunk.

Age: 43, Sex: F, Race: northern european

2004-present: night sweats (must change bed clothes in middle of night). Occurs occasionaly (maximum of 4x month). May just be perimenopause.

June 2006: Diagnosed with bilateral, multi-dermatomal herpes zoster. Outbreak presented in right trigeminal nerve and left back and arm. Bilateral zoster is extremely rare and is usually associated with a significant compromise of the immune system (AIDS, malignancy, etc.). Herpes Zoster in patients younger than 50 years suggests the possibility of underlying immunosuppressive condition.

June 2006:diagnosed with Hashimoto's thyroiditis. Titrated (Synthroid) to optimal levels as of November 2006.

September 2006: diagnosed with fibromyalgia (I have had it for years, and it is mild).

September 2006 to present: aching spleen; and enlarged right submandibular (or maybe jugular) lymph node >1cm. Lymph node is painless, rubbery, and gets bigger at night or when I have a cocktail.

November 2006 to present: unusual unexplainable dark bruising on legs. I have not had such bruising before.

-CT Scan shows non-specific splenic lesion, otherwise chest & abdomin look clear. They did not perform scan of neck.
-Blood tests ruled out Strep, Mono, HIV, SLE, HepA, HepB, HepC
-EBV past exposure: positive (VNA high, EBNC high)
-Sed rate: normal
-Lymphocyte count: low in August, normal in October.
-MPV - high
-Urine tests: normal

Thank you for any insights you may have.
 Dr. Tamer Fouad - Tue Dec 12, 2006 4:31 pm

User avatar Hello,

Your doctor would be better at answering that question than me. If there is even a slim possiblity that you may have lymphoma then its always best to get a biopsy.

This should be conducted on any significantly enlarged lymph node. However, lymph nodes of the head and neck are a bit more tricky. First they are usually more difficult to excise than the axillary lymph nodes. Second I would personally recommend a CT scan of the head and neck first before going on to doing a biopsy from the neck.

Sometimes lymph nodes of the head and neck are not lymphoma but could be due to a head and neck cancer. By performing a biopsy of neck lymph node some say you may compromise the efficiency of head and neck radiotherapy by distortion of the muscular planes.

Just because your doctor referred you to a surgeon for a biopsy doesn't mean your surgoen will do it right away. He will evaluate your condition and whether or not a biopsy is performed will depend on his assessment.

Keep us updated.

|

Check a doctor's response to similar questions

 

advertisement.gif (61x7 -- 0 bytes)
 

Are you a Doctor, Pharmacist, PA or a Nurse?

Join the Doctors Lounge online medical community

  • Editorial activities: Publish, peer review, edit online articles.

  • Ask a Doctor Teams: Respond to patient questions and discuss challenging presentations with other members.

Doctors Lounge Membership Application

 
     

 advertisement.gif (61x7 -- 0 bytes)

 

 

Tools & Services: Follow DoctorsLounge on Twitter Follow us on Twitter | RSS News | Newsletter | Contact us

 
Copyright © 2001-2010
Doctors Lounge.
All rights reserved.

Medical Reference:
Diseases | Symptoms
Drugs | Labs | Procedures
Software | Tutorials

Advertising
Links | Humor
Forum Archive
CME Articles

Privacy Statement
Terms & Conditions
Editorial Board
About us | Email

We subscribe to the HONcode principles of the HON Foundation. Click to verify.We subscribe to the HONcode principles.
Verify here