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Forum Name: Lymphoma

Question: New symptom: low grade fever for past 6 days

jots_in_nj - Wed Jan 24, 2007 7:07 pm

Hello! I'm a 30 year old healthy female, have had a swollen Lymph node of 1. 1 by 1. 8 cm in the submandicular region for 9 months with on and off ear pain and pressure and occasional hot flashes at night (no sweating at all during them). One week ago I had another node swell, this one on a direct line out and down from my ear. I've also now had a constant low grade Fever since then, between 99. 5 and 101. 4, with bone pain. Not joint pain, but bone pain in the middle of my arm, leg, etc. My family Dr sent me in for a head/neck MRI and bloodwork (awaiting results) but was not ready to refer me to a surgeon for a biopsy. My concern is that this is an ongoing issue, and now the new symptoms have appeared. Do you think I should push to be evaluated by an ENT surgeon for a biopsy? Thanks, Michelle

Dr. Safaa Mahmoud - Fri Jan 26, 2007 12:06 am

Hello, Abnormal Lymph node enlargement commonly results from infection / immune response, cancer. There is a high probability that the Lymph nodes you have are reactionary to infection in the area drained by this Lymph node group especially that you have a history suggestive of recurrent Ear infection. Following infection Lymph nodes become enlarged, painful and tender. Of significance, an increase in nodal size on serial examinations. Hence nodes that continue to grow in size are important and those that regress in size after infection control tend to be more reassuring. There is a list of routine investigations that are done as initial step for diagnosis. Their results direct doctors for further investigations. So, you have to wait for the results of the tests and radiological investigations requested by your doctor before going directly to biopsy as it may not be needed. Follow up with your doctor is essential. Keep us updated. Best regards.

jots_in_nj - Fri Jan 26, 2007 12:41 am

Thanks for your reply. I just got my bloodwork back and my LDH was 689, liver fundtions elevated as well. I am scheduled for a biopsy tomorrow. My MRI report is not back but the films are, and they show every node in my neck "lit up" as the tech told me. I assume this is only a bad thing ... =[ I plan to ask my ENT to move to a PET scan, full body CT etc right away, as the Fever has now lasted 8 days, and my right ear is also full/has pressure now. Are there any other tests I should ask for right away?

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