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Family Medicine (Expert Forum)
Enlarged Lymph Node
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
Enlarged Lymph Node
by cars, Apr 14, 2005 12:00AM
Hello,I went in for a ultrasound on a enlarged lymph node on the right side groin area one node is 2.5 by 1.6 cm's all others are normal.
Blood work as follow's (I will only put the elevated or abnormal numbers)
Creatinine - range 0.5-1.4 mine is 1.5
HDL Cholesterol range >40 mine is 35L
RBC range 4.20-5.50 mine is 5.90
Hematocrit is 37.5-50.7 mine is 51.3
Everything else is perfectly normal.
I am having back pain on my left side over kidney area back side,also some headache and lower ab discomfort above pubic area,I have had lots of tests in the past with no conclusive answers (ct scans etc.),my health seems spotty some days feel good others like today don't feel so hot,my doc called with the results of the ultrasound and said we now have a bench mark to go off from as far as the measurements and we could monitor it or talk to a surgeon and have it removed and tested,he really doesnt mention just having it biopsied,he is talking removal of the one big one only,he also went on to say something about a reaction or active after removal?don't understand that?
Obviuosly I am very concerned and not sure if I want to remove it or what to do?could a kidney infection cause something like this?
what are some reccomendations from you at this point? any advice helpfull not sure what to do or if I should go and get another opionion from more doctors?
I am 42 white male 215 pds.
Thank you for your reply.
Blood work as follow's (I will only put the elevated or abnormal numbers)
Creatinine - range 0.5-1.4 mine is 1.5
HDL Cholesterol range >40 mine is 35L
RBC range 4.20-5.50 mine is 5.90
Hematocrit is 37.5-50.7 mine is 51.3
Everything else is perfectly normal.
I am having back pain on my left side over kidney area back side,also some headache and lower ab discomfort above pubic area,I have had lots of tests in the past with no conclusive answers (ct scans etc.),my health seems spotty some days feel good others like today don't feel so hot,my doc called with the results of the ultrasound and said we now have a bench mark to go off from as far as the measurements and we could monitor it or talk to a surgeon and have it removed and tested,he really doesnt mention just having it biopsied,he is talking removal of the one big one only,he also went on to say something about a reaction or active after removal?don't understand that?
Obviuosly I am very concerned and not sure if I want to remove it or what to do?could a kidney infection cause something like this?
what are some reccomendations from you at this point? any advice helpfull not sure what to do or if I should go and get another opionion from more doctors?
I am 42 white male 215 pds.
Thank you for your reply.
Doctor's Answer
by Kevin Pho, MD, Apr 16, 2005 12:00AM
, Apr 16, 2005 12:00AM
If you are not comfortable with the current course of treatment, I would always recommend a second opinion.
Infection is the most common cause of an enlarged groin lymph node. I would check a urinalysis as well as consider a prostate exam to exclude GU infections. If the tests are non-revealing, you can consider removing the node or biopsying it.
Regarding the lab values, the creatinine is slightly high. This can indicate some kind of kidney disease. In connection with the elevated HCT level, I would consider a erythropoetin level to further evaluate this - some kidney diseases (i.e. a mass) can raise the HCT level. A kidney ultrasound can be considered to evaluate for any mass.
Regarding the low HDL ("good cholesterol") - lifestyle changes such as increasing exercise and losing weight will help. You can consider a referral to a dietician to further evaluate this.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Infection is the most common cause of an enlarged groin lymph node. I would check a urinalysis as well as consider a prostate exam to exclude GU infections. If the tests are non-revealing, you can consider removing the node or biopsying it.
Regarding the lab values, the creatinine is slightly high. This can indicate some kind of kidney disease. In connection with the elevated HCT level, I would consider a erythropoetin level to further evaluate this - some kidney diseases (i.e. a mass) can raise the HCT level. A kidney ultrasound can be considered to evaluate for any mass.
Regarding the low HDL ("good cholesterol") - lifestyle changes such as increasing exercise and losing weight will help. You can consider a referral to a dietician to further evaluate this.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
My 19 year old son has a large lump under his arm. It is about 4 inches long and 2 inches wide... A few years ago I took him to the doctors and they said there was nothing wrong that it was a swallon lymph node.. They said that it will go away, well it didn't I kinda didn't think anything of it until the other day when he took a shower he came out and lifted his arm to scratch his back. I saw the lump and he said it has always been there and that it doe's not hurt at all. I make an appointment but wont be seen until next week. Any idea's what it could be? Everywhere I look online is bringing me to cancer sites... Any info would be greatly appreciated
I am a 28 years old man that have been having trouble with repeated swollen lymph nodes (especially the ones on the neck), throat inflammation (severe in 3 ocassions), have had 3 infections on the throat (Streptoccocus aureus, Serratia marcesens, and another Streptoccocus bacteria infection -- all these happened in a period of 2 months and has been 4 months since then... no problem right now but the first symptoms described earlier). I have been seen by 3 ENT doctors (2 in Costa Rica and 1 in Houston) and an internal medicine doctor. So far, I have had the following tests: Brain MRI, Head and Neck CAT-SCAN, GI test (result OK), Thyroid ultrasound, other major organs ultrasounds like liver-kidney-colon, Blood Tests (toxoplasmosis, ANA test, CMV, Brucellosis, HIV, CBC (slightly off when throat infections.. but other moments OK - including platelets), tuberculosis). All blood test came OK. Everything seems to be OK.. however, I still have swollen lymph nodes and swollen throat (usually red). Just recently I have been taken anti-allergy & anti-histamine and it dimisnishes symptoms for about 60-70%. I used to live in Houston for 10 years and just moved to Costa Rica and have been here for a year. I did not have this problems in Houston. The only problem that I had in Houston and I currently have is IBS. However, these new symptoms (swollen lymph nodes and muscle pain) were not present until now.
Any pointers and suggestions will be greatly appreciated. As you could possibly imagine, I'm very frustrated and worried about my situation since this has been going for about 11 months now.