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Family Medicine (Expert Forum)
Freaking over swollen lymph nodes x 4 weeks
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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Freaking over swollen lymph nodes x 4 weeks
by nadjjaa, Sep 15, 2005 12:00AM
A few quick details, here.....about 4 weeks ago, I started to feel tired. Then, after a wild party the lymph nodes in my neck swelled up rapidly, painfully, left side only. It was a Sunday, and I started to feel bad. For the next 5-6 days, I felt pretty crappy. I had a fever that would come and go, but never went above 101.8. I didn't really feel like eating when I had the fever, but when I took ibuprofin, I felt better. A node in my left armpit swelled and hurt for about 2 days, but has been gone for almost two weeks. I was very fatigued, achy, etc. I went to the doctor the Monday after I started to feel bad (because my left side nodes were absolutely HUGE and I was alarmed) and at first she was just thinking the usual. But because I was so alarmed she gave me Augmentin. I finished the Augmentin a week later. I felt better, all symptoms were gone EXCEPT the huge, swollen lymph nodes. She gave me 7 days of Levaquin, which I finsihed last week.
I had a CT scan last week. Dr. called with the results, which she said were unremarkable except for the swelling. CBC was all within normal ranges, (except for elevated leukocytes, indicates infection?) mono test was negative. But for some strange reason, she's sent me to the ENT to have a biopsy.
I had a Fine Needle Aspiration last week. Initial results didn't show any malignancy. I called yesterday to get the full report, ENT doc said he didn't find anything but "reactive, inflammed cells", but could not rule anything out. He wants me to come back in 2 weeks, where he will possibly do another FNA, but he assured me that he doesn't think the swelling will go down by that time. He told me that "cancer doesn't hurt, and your neck hurts. Cancer also doesn't pop up overnight, it doesn't respond to ibuprofin." SO why is he wanting another biopsy??
Frustrated, I went to the dentist yesterday to rule out problems in that area. They took a panoramic x-ray and saw two shadows on both sides and was a bit worried, so he took another pano - the shadow moved in the second x-ray, so he didn't think it was anything. But still, he referred me to an oral surgeon. I haven't seen him yet.
I now have two more slightly swollen and painful lymph nodes on the RIGHT side. I had a swollen lymph node in my armpit for about 24 hours. It's been gone for a few weeks, though.
I don't feel sick, really, just a little tired. I am just frustrated because no one can give me answers, they just keep sending me to other docs. Questions: is it likely an infection, even though the docs did a CBC and saw only elevated leukocytes? Docs have mentioned my thyroid, but wouldn't an enlarged thyroid have shown on the neck CT? (I have what clearly looks like a goitre, but negative blood test). I had an HIV test 6 months ago when I got into a new relationship. Is Epstein-Barr a possibility?
I've been a little depressed and anxious about this lately. I've never had swollen LN this long or this swollen. Thx.
I had a CT scan last week. Dr. called with the results, which she said were unremarkable except for the swelling. CBC was all within normal ranges, (except for elevated leukocytes, indicates infection?) mono test was negative. But for some strange reason, she's sent me to the ENT to have a biopsy.
I had a Fine Needle Aspiration last week. Initial results didn't show any malignancy. I called yesterday to get the full report, ENT doc said he didn't find anything but "reactive, inflammed cells", but could not rule anything out. He wants me to come back in 2 weeks, where he will possibly do another FNA, but he assured me that he doesn't think the swelling will go down by that time. He told me that "cancer doesn't hurt, and your neck hurts. Cancer also doesn't pop up overnight, it doesn't respond to ibuprofin." SO why is he wanting another biopsy??
Frustrated, I went to the dentist yesterday to rule out problems in that area. They took a panoramic x-ray and saw two shadows on both sides and was a bit worried, so he took another pano - the shadow moved in the second x-ray, so he didn't think it was anything. But still, he referred me to an oral surgeon. I haven't seen him yet.
I now have two more slightly swollen and painful lymph nodes on the RIGHT side. I had a swollen lymph node in my armpit for about 24 hours. It's been gone for a few weeks, though.
I don't feel sick, really, just a little tired. I am just frustrated because no one can give me answers, they just keep sending me to other docs. Questions: is it likely an infection, even though the docs did a CBC and saw only elevated leukocytes? Docs have mentioned my thyroid, but wouldn't an enlarged thyroid have shown on the neck CT? (I have what clearly looks like a goitre, but negative blood test). I had an HIV test 6 months ago when I got into a new relationship. Is Epstein-Barr a possibility?
I've been a little depressed and anxious about this lately. I've never had swollen LN this long or this swollen. Thx.
Doctor's Answer
by Kevin Pho, MD, Sep 15, 2005 12:00AM
, Sep 15, 2005 12:00AM
To answer you questions:
1) Infection continues to be possible. There may be some infections where the CBC may not be normal. Some viral illnesses may not affect the CBC. The fact that there are elevated leukocytes however, is indicative of infection.
2) Thyroid abnormalities may be seen on the CT scan. However, you may want to consider an ultrasound for further evaluation.
3) Yes, Epstein-Barr is possible. I would obtain blood tests to rule this out. Repeating the HIV test isn't a bad idea.
A single biopsy may not obtain diseased tissue. This is why a repeat one was scheduled to ensure there isn't any more serious problems going on (i.e. cancer).
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.
http://www.straightfromthedoc.com
1) Infection continues to be possible. There may be some infections where the CBC may not be normal. Some viral illnesses may not affect the CBC. The fact that there are elevated leukocytes however, is indicative of infection.
2) Thyroid abnormalities may be seen on the CT scan. However, you may want to consider an ultrasound for further evaluation.
3) Yes, Epstein-Barr is possible. I would obtain blood tests to rule this out. Repeating the HIV test isn't a bad idea.
A single biopsy may not obtain diseased tissue. This is why a repeat one was scheduled to ensure there isn't any more serious problems going on (i.e. cancer).
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.
http://www.straightfromthedoc.com
I just don't want to be sick anymore. This isn't normal for me.
Mandy