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Forum Name: Lymphoma

Question: Lymph Node Question


 Mezzolady - Wed Feb 07, 2007 11:09 am

Hi -

I have a story about my situation and then my question. Any comments or help would be much appreciated.

I am a 34-year old female who discovered several enlarged lymph nodes in my upper neck last January. I went to my family doc and she was not concerned, after going back with no change a month later, she still seemed unconcerned since they were mobile and not hard. She did ultimately send me for a neck ultrasound and referred me to an ENT who is a Fellow at our Cancer Centre and also a professer teaches ENT interns through the Univeristy Medical Centre.

The largest lymph node is 1.5 x 1.4 with a depth of about .3 I think. I have now had two ultrasounds 6 months apart and the radiologist said they were "relatively unchanged" only "mildly enlarged" and seemed "begnin in appearance". The ENT said that since they were not larger than 2cm and bilateral that he didn't think it warranted biopsy. They have been there a year now that I can tell. I also had a clear chest x-ray, abdominal ultrasound last year, no other symptoms and my blood tests a regularly fine (except I have EXTREMELY high thyroid antibodies).

I am still very concerned and have now gone back to my family doc. She is still unconcerned but has ordered a repeat chest x-ray and a CT of my head and neck.

I hear so many stories of missed lymphoma diagnosis and hearing that people have nodes that are neither huge nor hard at the time of diagnosis. There is very little cancer in my family and none in my immediate family.

My Question: With no change after a year, should I stop worrying or push for a FNA or biopsy? I did have Mono as a young teenager.

Thanks so much!
 Dr. Chan Lowe - Wed Feb 07, 2007 9:19 pm

User avatar It appears that you have had very good follow up and evaluation of your lymph nodes. With persistently enlarged lymph nodes, one does begin to wonder about a lymphoma or other process. However, in your case, it appears that at this point there is an abundance of reassuring data to suggest that what you are experiencing is not a lymphoma.

Often, lymph nodes will remain enlarged after they have initially been increasing in size due to infection. They may remain enlarged even after the infection goes away. Often these are referred to as "shotty" nodes.

While it's probably a good idea to have the nodes checked by your regular doctor with your yearly exams or if you think that a node is beginning to change, you can be reassured that at this point it seems everything is alright.

Lymph nodes that are "going bad" tend to become very hard and immobile. While this is not 100% it gives a good starting place.

Hope this helps.

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