I too hope your appointment went well.
Chelle, here is the original journal article with the info that your source quoted from:
http://www.aafp.org/afp/1998/1015/p1313.html
Lymphadenopathy: Differential Diagnosis and Evaluation
ROBERT FERRER, M.D., M.P.H., University of Texas Health Sciences Center at San Antonio, San Antonio, Texas
Am Fam Physician. 1998
How did your appointment go?
Hi, the thing to consider is that there are some indications that there might be a malignancy, but they are still only indications at this point. The only way to be sure is with a biopsy - so it is premature to assume it is cancer now. Besides that, cancer at your age is more rare than at older ages.
The part that stands out for both enlarged nodes is 'highly vascular". When a cancer is growing, it stimulates the growth of new blood vessels (angiogenesis) to allow it to keep growing - establishing supply lines for oxygen and nutrients, etc.
So that is probably enough reason to have a biopsy. They might do the MRI first because that involves no risk from cutting.
If there is a "fatty hilum" seen on sonogram or MRI, that'd be a a pretty good sign there is no malignancy. But the loss of the hilum is not mentioned on your report, nor other signs of cancer such as being hyperchoic.
"well circumscribed" means there are no signs of a cancer invading the tissue outside the node - it has a defined boundary instead. While most lymphomas will eventually invade surrounding tissue, Hodgkin's Lymphoma typically does not. And btw, HL is also the one to think about for your age group.
All else is normal, including SMGs = submandibular glands (salivary).
wrt to the blood test: on its face that could suggest a virus infection which is killing off neutrophils. Lymphocytes get activated to fight virus infections. But those reactive lymphocytes are also seen in the most common type of HL. However, lymphoma wouldn't cause lowered neutrophil count except if it gets inside the bone marrow and crowds out the cells that produce neutrophils.
I'd want soon the MRI and/or a visit with an oncologist/hematologist. I'd also read up on Hodgkin Lymphoma before a visit, so as to be factually prepared for whatever might be discussed on a visit - then you don't waste time with basic questions... such as on any Reed-Sternberg cells which would be seen with a microscope on any biopsy involving HL.
HL does have a good cure rate.
But keep in mind that no one can know until a biopsy is done - and an MRI before that might rule out malignancy. Good luck.
I'm going through a similar thing....
Hi,
I went to the doctors as there was a noticeable lump under my neck (to the left) - been there for about 5 weeks now and got bigger. He claimed it was a cyst that needed to be removed. I went for an ultrasound and they were able to completely rule out a cyst and in actual fact ended up discovering an enlarged lymph node.
Can anybody please help explain the ultrasound results (below):
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There is a well circumscribed highly vascular rounded mass just to the left of midline within the sublingual area measuring 11 x 8mm.
Both SMG appear normal.
At the base of the left neck at the anterior chain is an enlarged lymph node measuring 27 x 12mm which is highly vascular.
No other unusual masses seen within the neck or supra clavicular fossa.
In light of these findings Malignancy must be considered.
Impression:
Suggest urgent follow up imaging such as MRI to assess extent and nature of mass and Lymph nodes.
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I am now waiting for an MRI date but have since had a physical from the doctor who found another lump under my left arm. After discovering this he sent me straight for blood tests.
The blood test results have come back with the below comments:
''Neutropenia.
Reactive lymphocytes seen suggest check virology. If symptoms persists consider lymphonode biopsy''
I have an ENT appointment Friday at 10:15am.
SCARED
Welcome to our forum Michelle. I tried to open the link in your post but for some reason it wouldn't. Maybe the website is down. Anyway, what I can tell you is that most cancerous lumps are not painful. Because you haven't had this lump for very long, it's possible that you have some sort of infection brewing and your lymph node is reacting to that. I can also tell you that night sweats associated with lymphoma are usually pretty severe...like having to change your clothes and sheets severe.
The only way to know for sure if a lump is lymphoma is with a biopsy. However, my guess is your GP won't want to do one just yet since you just discovered it. He may have you wait a while to see if it goes down on its own.
Please don't feel bad about being anxious. Just the thought of possibly having cancer is pretty scary to most people. Please keep us posted on how your appointment goes.
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