Hi. Unfortunately, there is an increased risk for lymphoma after thyroid cancer, That might result from the treatment used earlier, especially radiation. But risk can also be increased from some anti-cancer drugs. Or it can even be because a person has a predisposition, because of their genes or maybe something in their environment.
Here's a paper that talks about the increased risk after thyroid cancer:
It gives the risk for a second cancer as being 1.31 times the risk for people in general. But it doesn't give a number for lymphoma in particular. So that's 31% more likely.
On the other hand, you might consider that some lymphomas are classified as 'indolent', meaning very slow growing. Follicular lymphoma can be that way.
Did a pathologist say that your cells look like lymphoma cells under a microscope? Are you waiting for further testing to be done, such as flow cytometry?
Back in April my endocrinologist said that I no longer have thyroid cancer that it looked like a lymphoma(after a needle biopsy). I had a surgical biopsy removing another lymph node in my neck and they told me that it was a virus. The pathology reports said lymphoid dysplasia, and lymphoid proliferation.
At that point...I was beginning to have trouble with my left hip and thigh. I could feel small nodes where the pain was...but nothing pathological. Now...the nodes on my left side are becoming more troublesome and a little bigger. But still not very big. I just deal with pain from them. I also have a walnut where my thyroid used to be and and swollen lymph node near my carotid artery. I had cancer removed from that area before.
Well, the word 'dysplasia' seems like good news, doesn't it? Plus, I saw your pathology report elsewhere and it says, "No malignancy is present".
Dysplasia means abnormal cells, not cancer. Did it say low grade or high grade? Dysplasia does not necessarily mean it will progress to cancer.
I'd guess the one doc says it was a virus because of the presence of macrophages in the biopsy. Maybe the endocrinologist has been unnecessarily alarming you. One thing that seems to be true is that you do not have a definite diagnosis of lymphoma, but that something unusual is going on.
Also, why do you say that they are nodes on your hip? Did any doctor say that? I could be wrong, but I don't think there would be any actual lymph nodes at that spot.
Btw, I know somebody who had swollen lymph nodes, non-cancer, for longer than 9 months.
A couple of weeks ago. I went to a friend of mine who is an ER doc. He palpated the lumps(very small) that start on the left side of my hip(closest to the hip bone) and periodically go all the way down to the upper left thigh. He said that they felt like lymph nodes and with my history...I shouldn't waist time getting them checked out. So I went to my PCP who said(after feeling the hard lumps on my left side) that we need to rule out lymphoma/leukemia. He did an ultrasound for free cause I don't have insurance. He could see the lymph nodes but said nothing stood out to him. He also did an X-Ray to rule-out the arthritis causing problems(I have arthritis in my spine from crushing discs in my back when I was younger)He said that the X-Ray looked fine. I looked at it also and could not see anything unusual except maybe a small nodule on the top of the left hip. It was too small to really tell.
Because of the hard mass/s in my neck...i'm wondering if this isn't just another reoccurance of the thyroid cancer.
This is good news that you know someone with swollen lymph nodes for longer than 9 months. Starting to wonder if this just isn't gonna be par for the course for me. With all of the surgeries and lymph node removals. I'm bound to have some kind of repercussions from it.
If it weren't for the night sweats and the masses that are causing me pain and discomfort in some areas...not all...I would think this is a virus. But things are gradually getting worse. I think the fact that things are moving slowly is on my side. Just hope that we figure it out sooner rather than later.
Thank you Ken! I appreciate your knowledge on the subject. It makes me feel better knowing that dysplasia doesn't necessarily mean cancer.
>> It makes me feel better knowing that dysplasia doesn't necessarily mean cancer.
It's better than that. They didn't find any cancer at all. Check your pathology report to see if it says 'low grade' dysplasia - which is the type that's known to almost never turn into cancer.
Night sweats? Do you have to change your clothes and bed sheets because they're soaked? That's what is meant. (And an infection can indeed cause night time sweating.)
Okay, by hip I'd thought you'd meant the outer hip bone, the one that you can slam into a wall (the greater trochanter). But yes, the node location that you describe would be included in the inguinal group of nodes, I believe.
Re-occurance of the thyroid cancer? Your pathology report says, "No thyroid parenchyma is present". The parenchyma is the body of the gland. So that seems to me to say that the thyroid hasn't grown back, not in the area where the needle was inserted. Plus, there were no thyroid cancer cells. Instead, the masses in your neck are apparently made of those abnormal lymphoid cells. Your sample B showed a few acinar cells, which might be from a salivary gland. (Acinar means 'many lobed', like for instance a blackberry.) That's the usual structure/shape of those glands. Maybe the needle passed through a salivary gland on its way to the target area.
How's this for a theory: the radiation that you received for the thyroid cancer had the side effect of making the DNA of some of your lymphocytes get out of whack. They are abnormal and are proliferating, but are not cancer. Then, you get some mystery infection. Either it's from a virus, which won't be helped by antibiotics - or else it could be some bacteria that is resistant to all the different antibiotics you've had - or else it could be a fungus or parasite.
Did you go to any foreign countries in the past few years? That might explain a parasite. Did you change where you live? That might have put you into contact with some health threat. Have you been to the Ohio Valley?
Having the inguinal nodes in a chain seems to me to be more likely from infection than lymphoma.
So, you get the mystery infection and that stirs up your immune system. Your immune system reacts strangely because it's got all those abnormal lymphocytes. So the areas in your neck are stimulated chemically and grow somewhat quickly - but are not cancer. Your immune system also can't seem to defeat the infection, because it is weakened. Have you had super stress in the last year? (Okay, that might obviously be a stupid question... sorry :)
It sounds like you've had some very rough years. You must be very brave to have weathered it all. Keep up the good work :)
(A) LEFT LATERAL THYROID, FINE NEEDLE ASPIRATION --
-- ATYPICAL LYMPHOID PROLIFERATION
COMMENT: There is an atypical lymphoid population. The cells are predominately small to intermediate with irregular nuclear membranes and coarse clumped chromatin. Several larger forms are present, a few of which have atypical nuclear features. No thyroid parenchyma is present. Further investigation with excisional biopsy and fresh tissue sent for flow cytomerty is recommended.
(B) LEFT NECK, PERIAURICULAR AREA, FINE NEEDLE ASPIRATION --
--RARE ACINAR CELL GROUP
--NO LYMPH NODE PARENCHYMA PRESENT
COMMENT: There are only a few groups of acinar cells possibly from minor salivary gland. No lymph node parenchyma is present. No malignancy is identified.
(C) LYMPH NODE, LEFT PARACAROTID, FINE NEEDLE ASPIRATION --
--NO LYMPH NODE PARENCHYMA PRESENT
COMMENT: The prepared material has minimal blood only. No lymph node parenchyma is present.
I had an excisional biopsy done on one of the lymph nodes on the left side of my neck. I was not given a copy of the pathology report of that one. Just told that is said lymphoid dysplasia. And that I had a virus. The lab technician did not run the flow cytometry as suggested because I no longer have insurance and she said it cost too much. I was flabbergasted that she thought she had the right to make those kind of decisions.
There are 3 lymph nodes in my neck that have grown since the biopsy. I intend to show the doc when I see him at the end of the month. My family and friends can actually see 2 of them. I can feel the fullness in my neck, but no real pain other than occasional spasm. It's the left hip and upper thigh that is really bothering me.
Hi, it's just a pure guess but I'd think that the lab tech was only following policy. I wonder if you could shop around for the flow cytometry. E.g., I'd bet that you can similarly bargain with PET scan businesses.
If I were you, I'd get a copy of that path report asap. The adjectives might be revealing.
Also, there a pathologist who put up hundreds of videos on youtube, showing specimens while giving descriptions. He also now has a website somewhere. Once you understood everything, I'd try a call to the pathologist who did your report.
Are you familiar with why flow cytometry would be done? (the antibodies, etc)
As far as the hip/thigh nodes, I guess they are simply reactive (i.e., doing their immunity job).. Have you had thrush? Burning eyes? Do you get a bad reaction a day or so after consuming sugar? Have you taken yogurt as an anti-candida measure?
As for your C) needle quoted above, I don't quite follow - since it says it was ostensibly taken from a node yet only blood was in the sample. Even so there is no mention of deranged/abnormal shaped lymphocytes.
Thanks! I will ask for a copy of the pathology report when I see my pcp at the end of the month.
The lymph nodes on my left side are growing slowly and are still very painful. It is getting more difficult to walk or lean over. There are also now 2 lumps in my neck the size of walnuts. They are hard to the touch and don't cause me any pain other the a fullness and sometimes a little discomfort when swallowing. One of them is where the thyroid once was the other is below kind of sitting to the left of the trachea(hope i'm saying that right).Like I said they really don't cause any pain to speak of...but I sure can feel that they are there. They started growing about 6/7 months ago. Just thought it was more of the same...lymphadenopathy.
I appreciate all of your help. The way you have explained things helps me keep hope that this could very well be some kind of virus that I am fighting and not cancer.
I won't lie...I have moments when I'm convinced it's back. But after talking with more people and asking a lot of questions...I am extremely hopeful! Thank you :)
Glad to have been of some help, Therese. Is the pain only in the nodes themselves? Or also in deeper and/or surrounding areas? I ask because of this: nodes experiencing pain are known to almost always be the result of infection. The nodes fill with lots and lots more immune cells that are fighting the infection. That powerful stretching from within, along with the inflammatory chemicals being released, is what causes the pain in the node.
What result do you get when you take an anti-inflammatory like ibuprofen? Is the pain any better?
The inflammation is a necessary part of fighting the infection, but in your case the process seems to be going too far. It's possible that your nodes themselves are infected. In that case, the nodes are also overfilling with suppuration. (Maybe also there are what's called 'granulomas' present, like in cat scratch fever. But that's not too relevant for now.)
My guess about those inguinal nodes is not a virus, but a yeast/fungus - because you've had so many antibiotics. Use of antibiotics is known to allow a yeast to proliferate. That's because the antibiotics kill off the normal, friendly bacteria in the body and so the yeast has no competition and it takes over.
Let me know if any of that was not clear :)
I'd also strongly suggest that you call and have them mail the biopsy report to you. That way, you can get familiar with it beforehand, even post the results here. Then your limited time with the doc won't be wasted on basic questions. You might choose not to even open the envelope until after Christmas. I'd think about doing that my own self.
Thanks! That's really good info.
The lymph nodes themselves do not hurt. It's when one gets pressed on by leaning over or lifting my leg. Underwear, jeans, anything that applies pressure is a problem. It doesn't seem like they themselves hurt it's almost like they are somehow pressing on nerves.
I like the idea of waiting until after Christmas to deal with this. I have asked for my pathology report and hopefully I'll get it before my appt on the 29th. I would like to see what you think.
An infection might explain the night sweats. I'm not drenching everything. I just get really hot and sweat in the upper torso and head and neck area.
Anyhow...I'll keep you posted. Thanks again. Getting a logical look at things really helps. My mind tends to jump to the worse right now with everything I've been through and I know it's not the healthiest thing for me to do. Your words are encouraging!
Yep, so there is that pressure thing at work causing the pain. That should actually be a relief to know. Still, the way you describe the feeling as "pressing on nerves"? I don't know about that, having never experienced it.
Yes, I'd think it's wise to wait and then go full guns on Monday. The way your thoughts can go negatively are completely normal and natural and understandable, given your past experiences. I've seen it happen in others more than once. BUT, negative doesn't seem to be that accurate this time around. Merry Christmas to you and yours, Therese :)
Over the last few days...I have felt tenderness in my left breast. Every time my left arm would touch my breast...it would feel like I hit my breast and there is a bruise there. In the shower this morning I found a bee bee sized lump in my left breast and another one to the left of my breast. There are also more little ones (superficial) on the top of my left thigh and around the hip bone. The bone itself really aches. It's kinda dull but it aches. Especially if there is any pressure placed on that area like I explained before.
There is something else I forgot to mention before. I thought about it this morning. Back in 2003 when the thyroid cancer metastasized to my lymph nodes...I was having pain in my left hip. I never felt any swollen lymph nodes. But there were times when I had to use a cane to walk around. I haven't used a cane since 2004. Do you think I should tell my pcp about this? I'm always afraid of overwhelming my doc with info. I need him to focus on what's wrong so I can get better.
Thanks again for responding! Merry Christmas to you and yours also!!! :) Therese
LOL! You're right about me being complicated. The doctors I worked with up north said that I am a case for the AMA journals. lol!
Anyway...the hip pain I experienced before seem to stem from the joints and areas where there are lymph nodes, but there were no palpable lymph nodes back then. Now..there are palpable lymph nodes accompanied with bone pain from my left hip where the bone protrudes and my right collar bone in the medial end. It also feels like it is being pushed out. I've had that sensation for at least 2 years.
Yes I worked in the medical field and hope to again someday. I was an ER Tech, Lab Tech,MA. Was going to school in the RN program when I got sick. This last year when I was in remission...I was working for PPH as a lab tech. Then I started getting sick again and my husband thought it was best that I not work and focus on my health so I could go back to school. Just finished nutrition and looks like I'm gonna have to retake some of my science classes as they don't quite line up from the last college I went to. Oh well, I really liked A & P anyway.
I have been tested for MRSA,hep series,ana,.lupus - all negative. Although I do have a chronic cough. Get pneumonia at least once a year. (Ever since I got thyroid cancer)
My mother reminded me today that I had Mono when I was a sophomore in high school. I was bed ridden for a month. She thought that I should let my doctor know this as some cancers have been linked to mono. Have you heard of this?
I'll let you know how the pcp appt goes. Hopefully we can figure some things out. Trying to stay positive in the interim has not bee easy for me. But I realize...I have no choice.
Quick question, sort of out of the blue: was there any doubt about the diagnosis of thyroid cancer? IOW did anybody think it might not be malignant, that it just seemed to be close to malignancy but was really just an odd node there?
Yes, there is an association of EBV to cancers, but I don't know the probability figures. E.g., if you buy TWO lottery tickets, you have doubled your chances ... but the chances are still only 2 out of a billion :)
Yes...the pathology reports stated that in 2003 both the thyroid and isthmus had papillary carcinoma with a follicular variant(thyroid). Then, a year later...in 3 lymph nodes out of 16...showed thyroid metastasis.
Stopped by the pcp's office to pick up the path report and they didn't have it. I did however pick up the cbc that was done on 11/30. Just had another one done today. Will see my pcp on wednesday.
Since that last visit on 11/30. I now have a small lump just to the left of my breast that is not painful...I just feel it when my left arm touches or brushes it in a certain way. The left breast also has a small mass that we have been watching for 2 years. Will be getting another mamo in a month.
To tell you the truth I'm really getting tired of all this. Seems like everyday...there is something new. A swollen lymph node, mass, or some kind of crap like that. Sorry for bitchin...just getting really tired of it all.
Here's the cbc values if you're interested: (giving the values that are off only)
neu 42 L
lym 46 H
eos 4 H
m/seg% 38 L
m/lym% 46 H
m/eos% 6 H
ANISO A 1+
I know I should remember what all of these values mean...but I don't. To me it looks like I'm fighting a infection. But after 6 courses of antibiotics...hmmmm. Could just be some kind of resistant virus...who knows.
Thanks again for your help! Greatly appreciated! Therese
Just wanted to say thank you for all of your help! Saw my pcp yesterday. He has ordered a PET scan and referred me to oncology. The doctor he has referred me to has a really good reputation. I initially asked to be sent to UCDavis. He said that I would be given to interns and they would do all kinds of tests before I even saw an oncologist and that is not what I need.
I asked him outright what he thought. I asked if it could be some kind of virus. His reply again was...it's been too long.
I'll be seeing the oncologist next week. Try to keep yah posted. They really don't have a clue as to what kind it is. It feels a little like dejavu.
Well, I don't quite know what to say about that. If you already know that masses are growing quickly, then the PET will tell you that masses are there which are growing quickly. It will also show up any that you're not currently aware of, such as deep inside the chest or abdomen,
Both of the actual path reports might have given valuable info.
You can find a candida group and ask them if a yeast/fungus can last for two years. I bet they'll tell you it can last a lifetime.
I must not of communicated the growth patterns very well. They are moving slowly...this has been going on for months...almost a year. It's just that some of them are hardening and causing pain.
You probably explained this before. How could I have a yeast infection in my lymph nodes. I don't have thrush. Never have(don't know about infancy). I don't have a vaginal infection. Haven't had any problems since my husband and I first started having sex. I don't do baths...always shower. I have had atinea versicolor from the night sweats when the thyroid cancer metastasized to my lymph nodes. I still get occasional out breaks from the night sweats. Is there something that is making think it's a yeast/fungus? I would like to bring this up with my doc next week.
Saw the oncologist. Because of my financial situation we decided to just watch my progress every 30 days. He said the 2 tests I need are flow cytometry and a PET scan. They come up to almost $6,000.00. He said that it appears to be a low grade lymphoma in which case there is not cure for. That I will be around a very long time because it does move so slow.
He did also state that my neck is very abnormal and I should consider at least a cat scan on that which would be around $500.00. I am saving up for that one.
Of course he didn't come out and say it's cancer. But he did say with confidence that it's not an infection or virus. (Oh, yeah...just finished another bout of antibiotics for bronchitis).
He could feel the lymph nodes and didn't appear to be too concerned because nothing is really pathologically enlarged except for my neck.
I think I'm ok with our plan. There really isn't much else I can do. So no point in letting it get to me.
Sorry that you didn't get the resolution you were hoping for. So you're still in the same boat.
The flow cytometry would be to tell exactly what the cells are (by looking at what's on the surface of the cells). The PET would be see if there are other active areas inside that you don't know about. The CT of the neck would likely be to see the internal structure of what's there to try and get a clue.
Btw, lots of times with an "indolent" (slow growing) cancer such as follicular lymphoma the advice is just to watch-and-wait anyway - even with a firm diagnosis. Ironically the slowest growing ones are not generally curable while the fastest growing ones are more likely to be curable.
Thanks for the detailed update -- and "being around for a long time" sounds like good news when all is said and done.
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