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Question regarding lymph nodes and chest x-ray
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Question regarding lymph nodes and chest x-ray

I saw my family doc last week and am concerned over his response to some swollen lymph nodes. I am female and 57 years old. A few months ago I noticed an obvious lump in my abdomen. I was not overly concerned as it is directly behind some incisions I had for a surgery back in 2003. In fact, I thought it was scar tissue building up. It is dead center in mid abdomen. Then I began getting headaches and while rubbing the back of my neck from headache and also stiff neck I found a large lump on the left side on the back of my neck. It is almost directly on hairline and seems it is right at the area where head ends and neck begins. I thought it was in the muscle and my headache was a tension type.Not so. I had Doc check it and he says it is large swollen lymph node as is lump in stomach.

He called this a "lymphadenopathy" and ordered a chest x-ray. I will have that done tomorrow. But, my chest is not on my neck, nor in my stomach, so I am now wondering about why this is his choice of tests? It is the only test he ordered. I could understand a test being done where these nodes actually are but what is his reasoning for a chest x-ray? We were discussing that and other things and it did not even occur to me how odd this seemed until long after I had left his office.

Can you please explain to me what he could be looking for by ordering a chest x-ray for these symptoms? I do not have an obvious cough although when I lay down I get some what of a cough. But we did not even discuss a cough or s.o.b. or anything to do with my chest.

Any information is very appreciated.
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The direct approach would be to give you a diagnostic exam (i.e CT scan, PET scan or MRI) that would check you from the neck down to the groin area, which would cover the swollen lymph areas that you mentioned ... plus, everything else in between. But, a lot of times, one's insurance coverage dictates what tests are justified... and in what order those tests are given. Chest x-rays and Ultrasounds are less costly; so, those would be the first types of tests to administer.
Usually, if those exams return with inconclusive results; then, a different, more expansive (and more expensive) test, like a CT scan, PET scan or MRI would be in order. It's just a guess, but I think that your doctor is following the guidelines of the insurance company when it comes to the tests that he's ordering. It's possible that he'll have to order more tests... and, the chest x-ray may be the first of other tests to follow.

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