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Date of last update: 8/21/2017.

Forum Name: Rheumatology Topics

Question: WBC differential/swollen lymph nodes

 Debra Van Ness RN - Tue Feb 17, 2009 8:33 pm

Question for the group. I have chronically swollen lymph nodes in my neck. I read somewhere that this can be typical of FM. Therefore I never mentioned it to my doctor. They have been swollen for a few years now and seem to be getting a little larger. I will ask the doc with the next visit. Just wanted some input here.

As for a WBC differential, what might you see with a suspicion of some type of cancer or autoimmune disease?

I don't run fever that I know of. Of course I am exhausted all the time. In pain 97% of the time just about everywhere.

Thanks for input,
Debra Van Ness RN
 Tom Plamondon PA-C - Wed Feb 18, 2009 12:47 pm

User avatar Hello,

Thanks for writing in.

If I am suspecting lymphoma, I may expect anemia, low platelet count, high WBC count with reduced lymphocytes however CBC can vary and normal does not rule out lymphoma.

Of note will be other clinical data:
*night sweats, fever, weight loss,
*size (node larger than 1cm shoud be biopsied), character (benign appearing nodes are soft and freely for immobile, hard, painless, or firm rubbery nodes.), number, and location of lymph nodes (e.g. supraclavicular lymphadenopathy raises a large red flag for malignancy)
*family history
*history of RA or SLE which may associate with lymphoma
*other risk factors: hx of Crohn's disease, chronic H.pylori + gastritis, celiac disease

Also consider any history of skin cancer on the face.

Lupus can cause generalized lymphadenopathy especially in the cervical area. Node size and tenderness may vary depending on the state of the lupus.

I'll send a copy of note to oncology for any thoughts about screening for malignacy.

Take care.
 Dr yasmin taha MD - Wed Feb 25, 2009 3:56 am

Hello Tom,

In order to diagnose lymphoma we need CBC with blood film and also a biopsy from the lymph nodes.
 Dr. Tamer Fouad - Wed Feb 25, 2009 4:52 am

User avatar Hello,

Many times chronically swollen lymph nodes are just post-infectious consequences. After a viral / bacterial infection some nodes remain larger than normal. These are usually in the range of 1 cm, 2 cms at the most.

If however, you are absolutely sure some of these nodes are growing in size then you must report to the doctor immediately.

Lymphoma tends to be broken up according to its degree of aggressiveness into an indolent and an aggressive type. Indolent types grow over the course of years and have a milder disease course.

As Dr. Yasmin mentioned if on clinical exam the doctor feels there is suspicion of lymphoma the only way would be to biopsy one of the lymph nodes.

Good luck and keep us updated!

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