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Forum Name: Lymphoma

Question: lymphadenopathy with thyroid nodules


 nikkidb77 - Thu Mar 26, 2009 2:06 pm

A lymphnode in my neck had been enlarged for about a year. About three months ago I discovered another lymph was enlarged, but i was not sick and they were very hard with no tenderness. I went to the doc and she ordered tests: Blood work, x-ray, and CT of neck and chest, as well as an appointment with ENT (Apr.1,2009)for possible FNA. Blood and x-ray were fine, but CT came back with the discovery of nodules on my thyroid and other enlarged cervical lymph non-palpable. I have been doing research with only negative discoveries. What are these symptoms really indicative of? Do the lymph nodes have anything to do with the thyroid nodules?
 Dr. Tamer Fouad - Sat Mar 28, 2009 6:00 am

User avatar Hello,

Thank you for your question. Nodules in the thyroid as seen by CT scan can be malignant or benign there really is no way of telling for sure without more investigations. The Gold Standard is obtaining a histology. Another option is a FNA from the nodules after excluding thyrotoxicosis as that seems to get confused with follicular carcinoma (false positive). A cold nodule on thyroid scan is also more concerning.

Obviously you are concerned about the presence of lymph nodes in the neck and whether they indicate a spread from a possible malignancy in the thyroid. That is always a legitimate concern depending on the nature of the presentation and examination.

Many things come into play here - the longer duration of onset of these lymph nodes favors a more benign condition. The size of these nodes is also important (>1cm) and whether or not they continue to enlarge or not.

Another important thing is the location of the lymph nodes. The first station of spread of a thyroid cancer would be the lymph glands in its immediate vicinity (prelaryngeal, pretracheal, paratracheal). Lymph nodes in the lateral compartment of the neck (internal jugular) can also happen.

Please keep us updated.
 nikkidb77 - Sat Mar 28, 2009 5:11 pm

I had an ultarsound of the thyroid and the sonographer said she couldnt find the nodules. She asked at what facility the cat scan was performed to compare the two. Then she said the determination wasn't hers to make but all she can see is grey areas????? I didn't ask her any questions (she just offered this information) as I know she is no radiologist or MD. So I am still awaiting my visit with the ENT(Apr.1) for further investigation into these lymph nodes and the "non-existant" nodules. I have no idea which exam is more efficient in the determination of nodules but I assume it would be the Ultrasound.
 Mmoney33 - Wed Apr 01, 2009 8:29 pm

Im freaking out, I have a swollen lymph node on the right side of my groin. It was painless and soft. I went to my gyno and she said it felt funny. She did a pap and discovered I had a bacterial infection. She gave me an antiboitic for it, but she still ordered a blood test. The blood test was a CDC diff ESR. I did the blood test on Modnay, but Im totally freaking out. Why did she want to do a blood test. I know your glands can become swollen if you have an infection which I did. I started searching the internet and its scared the crap out of me. Swollen lymph nodes is a symptom of HIV/Aids, cancer, Im freaking out thinking I have something like that. Its now Wednesday and the lymph node feels smaller, less mobile.

Could I have something serious, or could the bacterial infection been the cause of the one lymph node to enlarge.

Please help I wont have my results from my blood work for 2 weeks, Im very scared.
 nikkidb77 - Wed Apr 01, 2009 10:50 pm

I went for my appointment with the ENT today and he said that I do have a thyroid nondule 3mm on the left side of my neck. The enlarged lymphnodes are also on the left side, but the largest lymph node ( the most recently discovered) is only 8mm. He said he sees thyroid nodules in a lot of people "no big deal "and we should wait and see if the lymphnode gets bigger to go back to my doctor in a year. I am sure he is a good doc and all but should I wait to see if my lymph nodes get bigger????? Or should I go and find out why I have enlarged lymph nodes all over the left side of my neck??? If they are chrhonic reactive lymph nodes what are they reacting against???? Or do reactive lymph nodes just stay enlarged for no reason???
 Dr. Tamer Fouad - Sat Apr 04, 2009 1:53 pm

User avatar Hello,

To answer your question, yes many times lymph nodes remain felt and slightly enlarged after an infection. The whole purpose of lymph glands is to react against infection hence these are called reactive lymph nodes. When they are less than 1cm in size they are also called shotty lymph nodes.

There's a whole article that I wrote on this website about lymph node enlargement that you may find useful.

Best regards,
 Tommy57 - Mon Apr 06, 2009 3:18 pm

I just completed a routine blood test and was told my thyroid level was high (11.42).

I have no ill effects, what does this mean, I'm I sick
 Dr. Tamer Fouad - Tue Apr 07, 2009 5:40 am

User avatar Hello,

Please provide the exact name of the test and its normal range. Usually several tests are done together when evaluating the thyroid so please provide those as well.
 Tommy57 - Tue Apr 07, 2009 9:45 am

I am seeing my doctor today, hopefully more tests or more information will be made available so I better understand what is happening to me.
 nikkidb77 - Tue Apr 07, 2009 11:35 am

The problem with my lymphadenopathy is I have not been sick in almost a year (besides fatigue and weight loss -40 pounds in 2 months). My Personal Provider did blood work to find an infection but there were no signs of infection. I do however have cervical cancer (high risk HPV)that has not been maintained and I fear perhaps this lymphadenopathy(neck) has to do with that.
When I went to my gynecologist the last time she wanted to do exploratory surgery on my female parts and I refused, she ultimately divorced me. That was in Apr. of 07. Then my father fell ill and I had to take care of him so I neglected to find another gynecologist. After my father passed in nov of 08 I made an appointment with new gyne but could not get in until this month (april 20, 2009). I fear my female problems have affected my body. Now I have unexplained (persistant) lymphadenopathy in my neck and also a thyroid nodule...I don't believe my personal provider is taking all of my med history into consideration. Is it possible to have female problems that take a toll on the rest of your body??...
 Nursegirl264 - Thu Apr 09, 2009 2:28 pm

I have had a Right solid dominate Thyroid nodule since 1999. Initial testing then showed a "hot"nodule, all thyroid levels were normal and have remained so. At that time I had a ultrasound guided FNA which was inconclusive. In 2003, I followed up again, the nodule was bigger and a FNA in the doctors office {not ultrasound guided} was performed and it was negative. In 2005, I moved to AZ and obtained new docs. I had the uptake scan and my previously "hot" nodule had now become "cold", the US showed it had grown, not substantially, but it had and the thyroid levels remained normal. In 2008, I once again had a US and ultrasound guided FNA, which came back ok. About three months ago, I noticed that the lymph nodes lateral to my thyroid nodule were swollen, I have not been sick and it is only in that area, all others are non-palpable. My neck appears full upon inspection and the nodes in that area are palpable. Last year my nodule measure 2.7 cm by 1.2 cm, upon palpation I can feel a lump beyond my thyroid as well, not overly firm, but definitely noticeable and only on my right side. My question is... can a previously "hot" nodule become cold and turn malignant. Would the lypmh nodes be swollen in the absence of infection and what are the odds it's malignant? I see the doctor next week, but am very concerned. My father did have Adrenocortical Carcinoma, although I don't think this is Medullary Cancer. What are your feelings on this?

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