possible lymphoma??

I am a 35 female. About 2 wks ago found a dime size moveable lump right below the groin area on the bone that connects the pelvis to the thigh.  My doctor said lymphoma would be more in the inguinal region and felt the lump and said he was not worried about it and did blood work- normal.  I have not felt well and have had constant back pain for 2 months (feels like possible nerve pain).  My hip bones also ache.  I have had a bout with UTI's and was on cipro twice and macrobid twice.  Then got weird bowel movement and GI did a stool sample and came back C Diff so I took Flagyl for 7 days..seems to be getting better. My doctor said the C. Diff was the pesky form not the serious form. I also get constant heart palpitations upon exertion and have had a full cardiac work up which was normal.  My back pain was so bad I went to the ER and they did a CT scan of abdomen and pelvis, x-ray of spine and all checked out and no kidney stones. My blood count came back normal, but my WBC count was 8.6 and RBC was 4.07 & Diff count was normal hemoglobin 13.1 and hematocrit 38.8.  My last WBC count was 4.7 and 6.2.  I know 8.6 is within normal limits but would this be indicative of leukemia or lymphoma being that my WBC count is usually lower?  What number would be something to worry about for an abnormal WBC count?  Also would the CT have shown anything pointing to lymphma or leukemia.  I also have lost about 12 pound over the last four months. Have not noticed any fevers (usually my temp is 98.0-98.6 on my oral therm. but my husband is always low at 96.0)  Last year I did have an ANA of 1:160 and an RA factor of 37..sed rate 14 and neg. lupus panel. Then this year my ANA came back at 1:40 with RA of 20 and neg lupus panel and thyroid normal.  I am getting so frustrated..is there any other test that should be ran.  My achiness is starting to make everyday life very hard.

[Kevin Pho, MD]

The WBC is within normal limits, and may not be suggestive of lymphoma.  If this is suspected, a peripheral smear can be done as well as biopsy of the lymph node.  

Any number that is outside the normal range should be investigated.  

I would also consider a thyroid test to evaluate the weight loss.  The negative CT scan would also make lymphoma less likely as well.  Of course, age-appropriate cancer screening, like a PAP smear and a mammogram (if high risk) should be done.

These options should be discussed with your personal physician.  A biopsy of the lump would be the most conclusive way to diagnose the lesion.

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.
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