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Forum Name: Lymphoma

Question: Biopsy on lymph node?


 lucky - Tue Feb 06, 2007 10:56 pm

I am a 39 year old female that has a family history of breast cancer, cervical cancer and fibroid cysts in the breast. I have had a total hysterectomy because of fibroid tumors and 2 sinus surgeries for polyps in my sinuses because of allergies to powdered medal.

I have recently had an enlarged lymph node at my left collar bone that was about an inch and a half in length and a half inch wide. It was not hurting me, just very big. I went to my doctor and was diagnosed with an infection from my ears draining into my lymph node. I was given an antibiotic for 2 weeks (amoxicillian 850mg.) It did not shrink it. I made another appointment 3 days after my antibiotic was finished and the lymph node started going down. I went for a ct scan and at the time of the scan the lymph node had shrunk to 3/4 x 1/4".

The ct results showed 2 more "masses" or enlarged lymph nodes. One on my breast bone and the other on right side of thyroid. The doctor wants to do a biopsy on one of the masses to see the outcome. Would they all be similar? What if one is cancerous and one isn't? Could this be due to sinus drainage?
 Theresa Jones, RN - Tue Feb 13, 2007 5:21 am

User avatar Hi lucky,
When Lymph nodes enlarge as a result of an infectious process it is the bodies mechanism of defense to fight infection. Lymph node enlargement in the location that you state is a little more disconcerting. Clinical features of lymph nodes:
Abnormal lymph node enlargement tends to commonly result from infection / immune response, cancer and less commonly due to infiltration of macrophages filled with metabolite deposits (eg, storage disorders).
Infected Lymph nodes however, tend to be firm, tender, enlarged and warm. Inflammation can spread to the overlying skin, causing it to appear reddened.
Lymph nodes harboring malignant disease tend to be firm, non-tender, matted (ie, stuck to each other), fixed (ie, not freely mobile but rather stuck down to underlying tissue), and increase in size over time.
Sometimes, following infection lymph nodes occasionally remain permanently enlarged, though they should be non-tender, small (less the 1 cm), have a rubbery consistency and none of the characteristics described for malignancy or for infection. These are also known as 'Shotty Lymph nodes'.
Consistency: Stony-hard nodes are typically a sign of cancer, usually metastatic. Very firm, rubbery nodes suggest lymphoma. Softer nodes are the result of infections or inflammatory conditions. Suppurant nodes may be fluctuant ( enlarge then recede). Constitutional symptoms such as fever, weight loss, fatigue or night sweats could suggest disorders such as tuberculosis, lymphoma, collagen vascular diseases, unrecognized infection or malignancy. The presence of fever is commonly associated with infections. An increase in nodal size on serial examinations is significant. Diagnostics such as CT Scan can assist in identification of "suspicious areas". Lymph nodes drain in a certain order in both benign and malignant conditions. Essentially, what I am saying is that lymph nodes are in chains and when enlargement occurs it begins in a particular area of the chain and proceeds to the next one down the line. (Hopefully that makes sense) If the recommendation is to have a biopsy I would strongly suggest that you do so. Best wishes and if your time permits an update would be appreciated.
Sincerely,
Theresa Jones, RN

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