I am here to find some reassurance before my FNA biopsy.
I am a 29 year old caucasian male with. I am generally healthy and active and have had no symptoms of any kind in the last 2 years. I do suffer from kidney stones but I don't think my enquiry is related to it (although I have had minor urinary tract infections - possibly due to stones moving abouts).
About 5 days ago I noticed a small bean shaped lump on the side of my neck (not between the jagular and sternocelidomastoid muslce), but rather on the sternocleidomastoid muscle itself (I think). I consider myself a bit of a hypochondriac so naturally internet search will reveal the worst. All it takes is 1 negative to throw me off balance completely.
I went to my GP and he said I might have lymphedema and sent me off to do a ultrasound of the neck followed by FNA. When I went to radiology in my local area, they misinterpreted it and ment that I do an FNA under the ultrasound. I changed that on the spot and did my ultrasound yesterday. This is what the radiologists report said:
"18mm x 6mm hypoechoic bulky node with no clear benign fatty hilum". Report also states that all other lymph nodes are fine (left and right side of neck) and no other abnormalities are detected. They also suggested that I book an FNA and do the biopsy.
A million things went through my mind - one of them was even profit related for the radiology department as both of the procedures are separate and both cost money - one is $200 the other is $600 - so it is more profitable for them to suggest a FNA. Anyway no disrespect to anybody but you can imagine my mind is racing million miles an hour.
Naturally I went on the internet and checked some of the terms and did not get the best responses. There was a lot of contradictory information and misinformation - some made sence some didnt, some were in favour others weren't.
Now, based on my search hypoechoic mass or node and such don't reflect the u/s waves as good as hyperechoic (At least mine wasn't hypodense) - anyhow... some reports also say that loss of fatty hilum is not a good thing. Again, this is somewhat play on words in my report as "no clear benign ..... " - what does he mean when he says "no clear" - does this mean it is not clear, or it can not be seen at all, or fully absent?
Can nodes be hypoechoic - i read somewhere that they are usually hypoechoic. Can somethimes be absence or no clear indication of benigh fatty hilum?
Can this report conclude anything concrete or are they saying "let's do a biopsy just to make sure it's all good".
I am absolutely petrified and I can not function properly because this is all I am thinking about and there is 4 more days to the FNA procedure.
What are the chances of this being malignant or mastatic? What are the chances of this being nothing?
I've also read ont he internet about CSD (Cat Scratch Disease) - my fiance has a small kitten that I play around with and it bites and scratches me and I read that the symptoms of this are swollen lymph nodes in the neck and armpits.
I have no other symptoms of any kind. Like I tell myself even if god forbid is something bad - have I at least caught it on time to cure it?
Hi, I think you should look at it overall in this way: if there were very strong indications of cancer, then you'd probably be rushed in for an excisional biopsy - i.e.. cutting you open and removing the whole node. But aside from that, things are suspicious enough to warrant further investigation.
A fatty hilum almost always means the node is not cancerous, but lack thereof does not necessarily mean that the cause is cancer.
Some things that tend toward not-cancer: They didn't see extra blood vessels going in. It's not round. No necrosis or calcification. Cancer is rare at your age, etc.
I'd force myself to think the best. It's way too early in the investigation to think that you have cancer, and even so many forms are very treatable..
Make sure you ask for a copy of the pathology report to be mailed to you, if you can get that in AU.
Yes, catch scratch disease can make nodes act very suspiciously.
I'd also spend some time researching whether infections like cat-scratch can cause a hypoechoic image. If you do, please let me know.
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