Is it allergies, irritation, or cancer?

Hi everyone,

I'm 22 years old and a former light smoker (1-2 packs/week for 4 years). I've also used marijuana quite frequently for the past few years.

Over the last few months I've developed some symptoms that concern me. I've suffer from season allergies pretty bad since as long as I can remember. Usually I take Claritin OTC and that takes care of most of my problems, so when I started spitting up blood about 8 weeks ago you can understand my concern. I'm 99% sure that the blood is coming from either my sinuses or the oropharyngeal area, as I do not cough up blood, but rather just spit it out when I'm brushing my teeth for example. I've also had a post-nasal drip for some time, frequent earaches, and the lymph node under my chin is swollen. It is also possible that a lymph node on the back of my neck may be swollen, but it's difficult to tell. I also have occasional pains in my neck around the swollen lymph node.

I've been to the doctor twice. At first they thought it was a sinus infection, so I took a Z pack for 5 days and saw no improvement. I've also been doing a sinus wash a couple times per day, but strangely the wash is almost always clear (i.e. no blood). I also do not typically see blood when I blow my nose.

I'm really concerned that I may have some type of pharyngeal cancer, since the symptoms seem to be all there and my doctor is just missing it. I should also add that sometimes I spit little or no blood for a few hours, only to have it start back up again. I'd appreciate any help!  I have another appointment scheduled soon, but I'm starting to drive myself crazy about this.

Thank you!

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

Hi,
Blood in your sputum and swollen lymph nodes are symptom that need to be investigated in detail.
A normal blood report is insufficient to rule out lymphoma. Do you have a tendency to bruise easily? Have you ever had an FNAC of your swollen lymph nodes? If not, then maybe you could discuss with your doctor about getting one done.
You may also like to get an imaging done (like CT scan of the paranasal sinus and neck).
All the best, and God Bless!

[klipschpt01]

OOPS, forgot to say that I've also had multiple complete blood tests and everything looks perfect, including white blood cell count, platelet counts, etc., which my doctor said likely rules out lymphoma?