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Forum Name: Lymphoma

Question: Swollen Lymph Nodes on Neck and night sweets and weight loss


 irisheyes2006 - Fri Nov 14, 2008 4:32 am

Hello there I am a 43 year old female well soon to be 44 this month and I am new to this site and actually just signed up this evening.

I Would like some advise on this. For the past few months I have noticed that the lymph nodes on both sides of my neck have been somewhat swollen and noticeable and heat radiats from my neck as well as the back of my neck is always very itchy although there is no rash there it feels like hte itching is coming from deep within my neck and that is it always feeling like it is on fire. At night I wake up quite frequently soaked and very sweety I have taken my temperature and it usually runs around 100 to 101 my throat has been sore lately and feels like there is a lump there at all times. My right ear itches very badly inside and I have used a q-tip but my ears are not dirty or anything. I have gone to my family doctor and she has checked my ears and everything looks fine inside she has felt my lymph nodes and said she wants to keep an eye on them for now, I also mentioned to her about the back of my neck being itchy and she didn't really say to much on that. in the past 3 weeks I have lost 14 pounds and I am not dieting mind you I am overweight and love the idea of loosing the weight but when I am not really trying or changing what I eat it worries me. I am always feeling neauseated(sp) and still try to eat ...my father had passed away when he was only 21 years old with Non-Hodgkins Lymphoma and from what I have heard NHL is not what they call hereditary. There is cancer that runs in our family both breast colon and brain tumors. I worry about myself as I had blood work done and my SED rate was at 72 which I think is high and my white count was at 35000 I am at work right now but my results are at home so I may have to send them in a later post if you need more information. I work the overnight shift and usually when I get home at 7am in the morning I go right to bed and sleep right through until 9pm that night and wake up a few times to use the washroom and that is it...but when I do get up I feel like I have not slept at all and I always have to change the bedding as it is always damp once I get up from me sweeting. I think I should make another appointment with my family doctor and get her to check me out more or sent me for an MRI or CT scan...also I have now noticed a lump in my armpit it is not sore at all but I am getting alot of pain down through the right side of my neck and my ear pains now not like an ear ache but just feels different and very hot.

Thank you for listening to what I have typed and any adivce would be greatly appreciated and if you need more information from y blood wook let me know and I can post that on here to you.

Sincerely
irisheyes2006
 irisheyes2006 - Wed Nov 26, 2008 2:32 pm

Here is an update on my blood work and the results I am not sure what they all mean and if they are within normal ranges:

T. Protein 92
Albumin 42
A1 Globulin 8
A2 Globulin 16
B Globulin 17
Gamma Globulin 19

This was one set of tests Comment .....There is a diffuse increase in the Gamma Globulin

Next Set of blood work:

C-Reactive Prot 27.4
LKC 14.9
ERC 8.32
HGB 172
HCT 0.526
MCV 113.6
MCH 39.3
MCHC 371
EDW 59.3
PLT 461
MPV 13.9
NEUTS 9.47
LYMPHS 5.44
MONOS 0.71
EOS 0.57
BASO 0.25

ESR 78
FE 8
TIBC 85
SAT 0.11
SODIUM 132
POTASSIUM 3.6
CHLORIDE 103


I am not sure if there should be other blood tests done other then these and if so what are the other blood tests?

Yesterday I woke up and noticed on my left side where my throat is well under my jaw line there is a swollen gland that is oblong and not tender at all but quite noticeable without even touching it you can see the swelling with the naked eye. I made another appointment today to see my family doctor and my appointment is not until December 15th at 8:30am I feel that is too long of a wait. I am still having the low grade temps aorund 99-100 and the sweats at night when I am at work and other around me are cold. Sometimes I feel my doctor must think I am loosing my mind. I just worry about it being something serious. I usually am a very calm and collect person and have been through alot lately with my youngest son having two major operations within 4 months of each other. He had a Spinal Fusion from T-2 down to L-2 plus he had surgery on his chest of Pectus Excavatum I was stressed with that but now I am worries about my health. Please if you can give me some advise.

Thank you again for taking the time to read my information I hope that these results help somewhat.

Irisheyes2006
 Dr. Safaa Mahmoud - Thu Nov 27, 2008 6:48 pm

User avatar Hello,
Normal values for while blood cell and its elements are:

White blood cells: 4,500-10,000 /mcl.
Neutrophils: 40% to 60%
Lymphocytes: 20% to 40%
Monocytes: 2% to 8%
Eosinophils: 1% to 4%
Basophils: 0.5% to 1%
Band: 0% to 3%

So, your total leukocyte count and lymhocytes count are higher than normal. In adults, absolute lymphocytosis is defined as an absolute lymphocyte count is greater than 4000/mcl, so you have mild lymphocytosis which can be seen in many conditions of chronic disease like arthritis and in infections. Some medications may also cause lymphocytosis.

However, you have other blood elements elevated too (RBCs, and Plateletes). Although it is a mild elevation, in the presence of symptoms like yours which are concerning, more investigations are needed.
There are group of symptoms known as B symptoms commonly but not exclusively seen in patients with lymphoma and chronic blood malignancy. B symptoms include Fever greater than 38°C, drenching sweats, especially at night, unintentional weight loss of >10% of normal body weight over a period of 6 months or less.
The presence of these symptoms, with newly developed lymph node enlargement and CBC changes warrants exclusion of malignancy.
Investigations would include CBC, LDH, and ESR. Blood culture may be useful to exclude infections if suspected.
Biopsy from a significantly enlarged lymph node, CT scans of chest abdomen and pelvis. Bone marrow aspirate and biopsy as indicated.

A thorough history and direct clinical examination are essential to proper diagnosis.
I advise you to follow up with your doctor.
Please keep us updated.
Best regards.
 irisheyes2006 - Fri Nov 28, 2008 1:31 am

Thank you Dr. Safaa Mahmoud for your reply to my information that I have provided. I will be so glad when I get back in to see my family doctor and go from there to whatever the next step will be for me. I know the past few times that I have had blood work done my SED rate has been going up higher and higher each time but my family doctor keeps telling me that the ESR rate doesn't pin point exactally what or where the problem is and that it just means there is something going on within my body. I would say for the past 2 years my ESR has always been elevated but each time it seems to be going higher..I know the normal range should be between 1-20 roughly and mine has been anywhere from 44 on up to the 80's and I have told my doctor on many visits that I do not feel like myself and that I am always tired and I feel sick to my stomach and have had bad pains in through the mid section of my stomach and the small of my back and she always tells me I must be coming down with the flu or something but this never goes away and there are times that the pain is so severe that it brings me to tears. I have had bleeding in my bowels and have had 4 colonscopies and had 6 pre-cancerous polyps removed in one of the colonoscopies and the others were because of the constant bleeding that I have gotten but nothing was found and nothing further has been investigated as to if maybe the bleeding was coming from somewhere else in my body. I just hope and pray with my next visit she will send me for a CT or MRI or ultrasound or something along with more blood work ups.

Thank you again.
Irisheyes
 Dr. Safaa Mahmoud - Fri Nov 28, 2008 7:17 am

User avatar Hello,
Thank you for updating us.

I would like to know if you have been tested for the reticulocyte count, B12 and folic acid deficiency and what are their results. Having increase in the three blood elements (TLCs, RBCS, PLTs) makes the exclusion of polycythemia with bone marrow examination essential especially if they are constant in serial testing and no other causes or explanations could be found by investigations.

The precancerous polyps in the colon that are most probably causing bleeding per rectum should be also monitored regularly with for simple stool testing for occult blood and annual colonoscopy.

Follow up with your doctor is essential.
Please keep us updated.
Best regards.
 irisheyes2006 - Tue Dec 16, 2008 3:22 am

Hello Dr. Safaa Mahmoud:

I have been to my family doctor yesterday and she is sending me for more blood work and has put in a request for me to have a PET scan some of the blood work she wants done is different then from the last round. She also weighed me and I have lost another 7 pounds so all together I have lost 21 pounds in the past 2 months and this is without trying to loose weight. I am just so tired all the time and feel so run down like I have been hit by a Mac Truck or something, I know it is not the flu because I do not have any symptoms and the sweats that I have when I am sleeping they wake me up because then I get cold from being so drenched. I have also noticed allot of bruising on my legs and arms and some on my abdomen and I know I didn't bang myself however I even bruise easy when someone pokes my arm or even just touches me. My legs and the back of my neck are constantly itchy which drives me crazy because I keep scratching until the area is raw and I have also noticed on the back of my left leg I have a hard spot that gets really itchy and does not ever heal I leave it alone and it doesn't change I showed the doctor and she didn't know what to make of it so she has also sent a referral to a skin specialist. When she took my temp yesterday it was 40.1 she has also noticed a lymph node in my armpit has grown in size since my last visit and has mentioned a needle aspiration(sp) to do a biopsy. She hasn't said too much or explained much to me so I am still kind of in limbo. It just worries me as my father had NHL and passed away at the age of 21. When I was in the doctors office yesterday and while she was talking to me my nose started bleeding for no apparent reason and she had a hard time stopping it finally it did but thought I would have to go to hospital to have it cauterized(sp) I just feel like I am falling to pieces. I am now waiting for the hospital to call me for my date for the PET scan. Will the PET scan show in datail what is going on inside me and view my lymph nodes as well?

Sorry about going on but I am very concerned at this point.
Irisheyes

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