lymph nodes stuck together

[Maggie88]

My husband had a lymph node dissection today. They removed four nodes from under his armpit. I am a medical professional and have search reliable sources to find information on lymph nodes that are stuck together.  They all seem to point towards more advanced cancers.  It is unlikely that they are benign given they are stuck together?

[Life_life]

Dear Maggie.  I know that this is a very very old post but my sister is going through this exact scenario. Cluster of lymph nodes in lung and near her spine. Enlarged node at collar bone and in the neck. All results are negative; cancer, tb, autoimmune, viral. All bloods normal. They haven't a clue what it is and she's just having follow ups at the moment. I'm wondering if you ever received a diagnosis for your husband in the end?

Many thanks.  

[HeinrikMD]

Glad to hear that.
The biopsies on nodes in the armpit tend to collect a good amount of tissue. Even if no specific test for TB or sarcoid had been requested - I think the pathologist would be able to say if these alternative diagnoses are likely. Some doctors would not perform diagnostic tests in parallel but in series, one test leads to another. In some ways this makes sense as it would lessen the number of tests by having a more directed search and by stopping early if a conclusive results comes early - I do emphatize with the waiting that this approach can produce if several tests in series are done.

[Maggie88]

Thank you for your response.  I am not interested in doctor shopping.  It is what it is, but what I won't accept is a non-malignant pathology with no good follow up questions to ask, such as, "can we test for TB and sarcoidosis?"  The MD made it sound as if malignancy is the only concern.  We aren't afraid of the answer.  We are afraid of NO answer.

Thanks!

[HeinrikMD]

Hi,

The final verdict would of course be the pathology report. The nodal appearance is more a function of how much is the burden that these filters would require to handle. Hence, the nodes tend to coalesce and become matted when there is severe infection, malignancy, or immune-related diseases.

Perhaps the better term to consider is "aggressive" more than "advanced". Aggressiveness generally refers to the speed by which the disease progresses - and hence the nodes may fail to contain the disease properly and form matted nodes... when the term advanced is used - it would generally refer to disseminated disease, in which there is evidence of disease elsewhere. A biopsy of a single nodal group does not automatically imply that there is disease elsewhere and hence using the word "advanced" automatically may be less appropriate. Other tests, usually imaging tools would be required to ascribe an advanced stage.

There generally is a focus of infection if we were to consider this as the primary cause of the nodes. You would be looking at wounds on the arm. It is known however that some infections like tuberculosis - which generally involves lung can present with disease outside the lung and hence produce nodes.

Immune-related disorders also usually come with a constellation of symptoms from arthritis to abnormal fluid accumulations around the intestines, lungs, and heart.

At this point, it would good for you to keep exploring what the disease could be - but should the pathology report come out as malignancy- some people persist on looking for other diagnosis and shop for other doctors- I hope this is not the course which you would take if it happens.