Cancer?

[iapesd]

Hi,
I am 27 years old, male and very active these days.
2 months ago I got shingles. I got the rush and my right armpit lymph node was enlarge. I did not took any medicine and the rush went away after 2-3 weeks but my lymph node stayed enlarge. Then a few days ago an cyst (or an enlarge lymphnode?) just right to the upper part of my larynx appeared. I was having a discomfort feeling in this area so I check it with my hand and I felt it. The discomfort went away after half a day but the cyst (?) stayed. I have also occasionally these days low fever which do not exceeds 36.9 Celsius. Also for a long time now, I have sometimes a weird pain or discomfort in the abandomen.In the right side usually. Its not sharp or severe just a discomfort. I said weird because sometimes seems to be moving for example from the upper part behing my chest to the lower part (near my kideneys) in a couple of hours or vanished for days or appear to the left side. I do not have any other symptom as far as I know.
In my family I have a history of pancreatic cancer as my grand father and my uncle died from that.
I am extremelly worry from all the above. I am in foreign country, working hard and I am worry if I am very sick. What do you think? Should I be worry?

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
The test results are all normal.
You have two tiny nodes, unlikely to be lymphoma.
So just relax!
Good Luck!

[iapesd]

Hi,
I got my results back and I thought to post it for a second opinion. My pathologist told me that I am fine and I should be worry any more for the lumps.
So my results are:
Chest X-ray:No pathological evidences
Ultrasound:Liver, Kidneys, Gallbladder,Pancreas, Prostate and Spleen normal. Two lymph node 7.7mm and 7.2mm on the right bubonic area.
Blood results: (I put the ranges in the right as it is on the results. I heard that for some of them like the LDH differs from laboratory to an another. Is this right?)

Red: 5.2 (4.7-6.0)
Ηemoglobin: 15.9 (13.5-18)
Whites: 5.9 (4-10.5)
Basophils:0 (0-1)
Eosinophils:4 (1-5)
Lymphocytes:29 (20-45)
Neutrophils: 58 (40-75)
MCV: 93.1 (78-100)
MCH: 30.6 (27-31)
MCHC: 32.9 (32-36)
RDW: 13.2 (11.5-14)

Blood Urea: 26 (10-50)
SGOT,AST: 15 (5-38)
SGPT,ALT: 9 (5-43)
gama-GT:11 (8-50)
ALP: 51 (40-129)
LDH: 263 (Less than 460)
hsCRP: 0.22 (Less than 3)

She told me not to worry any more and if I had something bad at least one of the above will be giving a clue. Do you share that view based on the above?

Thanks for all your help

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
From your description, it is unlikely (in my view) that the tiny lymph nodes and the abdominal sounds (borborygmi) represent lymphoma.
Good luck for the results!

[iapesd]

I did the exams. Waiting the results on Monday afternoon. On the ultrasound he check for some reason only my right vuvonic area and he told me that he found two 0.71 and 0,78 cms nodes. I have to wait for Monday for the rest of the results

[iapesd]

Hi,
First thanks for your help. I am really grateful.
Unfortunatelly my nodes are too small for needle biopsy. My pathologist told me that it is normal to have small nodes like mine and I should be worry. Even though in my groin there are two nodes one very small and one around 0.6 cm as she said.
However, as I was extremelly worry for these lumphs and the constant stomach noises that I have these days she was kind enough to write that I have enlarged nodes (for my insurance) and order blood tests again, chest x-ray and lower and upper ultrasound in my abdomen.Do you feel that these tests will be conclusive if or not have lymphoma? My main problem is that in one month I go for my miltary service and for the next 9 months I will have very bad health care if something bad happens

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Keep me posted!
Good Luck!

[iapesd]

Hi,
I would ask for a biopsy as soon as I see my doctor. Hope he does not ignore me again by saying my lump is too small

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Lymphoma may not show up on the blood and urine tests.
Small lymph nodes are usually non-specific. This is likely in your case.
However, to reliably rule out the possibility of lymphoma, an FNAC is needed.
Good Luck!

[iapesd]

Hi,
Sorry to bother you again. I am on holidays and I had a weird pain and noise in my stomach. I also found a lump on the right of my groin, just where the leg meets the body. I also had bad diareea yestrerday and a mild one today and my stomach makes noises all the time. The lump is very small, at least the part I can feel (less or at most 1 cm) but it is there. So now I have small lumps in my neck and groin and a very very small in my armpit.
Should I be worry? Can this be lymphoma which it did not show in the blood and urine exams and does not enalrge my lymph nodes so bad? Can affect so distant places so fast and only one lymph per area (as the rest in my neck was less than 1 cm in the ultrasound and seemed normal)? Can the shingles that I had 2 months ago messed up my lymph system?
I worried again. It seems that this thing will ruin my holidays but I think anyone will be worried if he was on my shoes. Sorry again to bother you

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Great to hear!
Enjoy Yourself!

[iapesd]

Hi,
The ultrasound found that the lymph has 1cm diameter and the rest in the neck are fine. She told me that below 1.5 cm is normal and this area of lypmh nodes is highly sensitive to cold and flu. Something that I migh got when I found it, as these days I had also a pain in my throat and a collegue which I was flying with was sick. She also told me that it can take weeks to become smaller but it is not something concern. As the ENT also reassured me I think I can relax now and I can enjoy my holidays.
Thanks for your replies and your help!
Take care and thanks again!

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Good to know that the blood test report was normal.
If the ultrasound and ENT check turns out normal, then you can relax and ignore the stickiness/mucus etc and enjoy your holidays!!
Good Luck with the hospital visit!

[iapesd]

Hi again,
I got blood tests and seen by a pathologist and an ent dotor. The blood test was a blood count+ something else to see if I have an infection. Everything was normal and I have no signs of infection. So tomorrow I will have an ultrasound in my throat and an another visit to the ENT. Still I am worried as I also have a tickling sensation in my throat today. I am also having an urine test tomorrow but not for that. I am going anyway to the hospital have not done one for ages, and the tests are paid from the insurance so why not check that also?
Sorry to bother you with this unlimited questions but all the doctors say that I should not worry but the lump is still in my throat and still I have a mucus feeling there. Its 4 weeks now so I a just want them to leave and enjoy my holidays.

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
You are not a hypochondriac imagining diseases when none exist. You do have signs and symptoms, enlarged nodes, and throat infection.
You may like to follow this doctors advise and see her again after a week. Meanwhile antiseptic gargles and mouthwashes will help tackle the residual infection.
All the best, and let me know how it goes.

[iapesd]

Hi,
I finally saw a doctor. She told me that the lump in my neck (around a cm in the right of my upper larynx) is in an unusual place and that probably is a small lyph node but she was not really sure! She also told me that they do not normally examine these part of the neck for swelling and if I did not tell her she would have miss it. In any case she concluded that because my neck is red and that my lump is small that I had an infection and see her in one week if it grows or does not get small. She did not prescribe me anything and told me that even a blood test is not necessary!
So I am just  hypochondriac or a small (around 1 cm at least the part that I can feel with my hand in the neck) and ligt feeling of mucus in the throat is something that need attention and therefore find a another doctor?

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Good to hear that your symptoms are better.
Good luck!

[iapesd]

Hi again,
I finally found some primary health care here. It had only nurses. It seems that my lump near my throat is not a lymph node. And that the other lymph nodes in my neck are not swollen (at least the one that can be felt by hand), Also that my fever is on the normal range and that the pain in the abdonimal is weird and maybe asymptomatic as it is moving and is not constant. So hopefully everything will be ok. Ofcourse I will go to a doctor when I go back home for a better opinion.

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
That is good; in the meantime, warm saline gargles a few times every day will sooth the tonsils and throat.
Good Luck!

[iapesd]

Hi,
THanks for the reply. I will follow your advice. Both lumps are around 1.5cm in diameter and moving if I press them. I also feel a slight discomort on my tonsils and pharynx area and like I have phlegm in my thorat.
I will have already gone to a pahtologist but I am in ofreign country where I do not speak the language and I do not know anyone. I am waiting in 10 days to go back home and check all this.

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Your symptoms seem to be infective in origin. There is no specific reason to suspect cancer, although it is of course a theoretical possiblity.
You have fever and palpable lymph nodes in the axilla and neck following a viral infection. If these do not resolve quickly, please consult an internist and perhaps get an FNAC test done to clinch the diagnosis.
You may want to take some time off from your hard work in order to recuperate your health and regain strength.
All the best, and God Bless!