Swollen lymph nodes and fatigue. Please could someone give me some insight?

[igrace12]

Hello.

I just thought i'd post on here to see if anyone could help me with some questions I have.
I'll give you a quick overview, promise i'll keep it short.

I am a 21 year old female, generally good health, weight, non-smoker etc. About 3 months ago I noticed a swollen lymph node under my left ear, near the end of my jaw. It is about an inch across and 1.5cm in length. It does not hurt at all, unable to move it, and can see it under my skin. I think it is a bit bigger than when i first noticed it. The other day I noticed that the lymph node on the other side of my neck is becoming swollen too, though not as big.

For months I have had extreme tiredness, no amount of sleep seems to cure it. No other symptoms, no sign of an infection etc.

I have had blood work done, general CBC and HIV tests, all negative. Also, a chest x-ray was performed, which was clear. My doctor has referred me to have a biopsy.

My questions are, is it possible to have lymphoma without feeling like anything is wrong with you? Also, surely my doctor would have tested me for other infections such as mono etc, if he thought it was an infection? Does the fact that he has sent me for a biopsy rather than more tests for infections something to be concerned about?

I don't want to sound like a hypochondriac, but i'm curious and a little worried. A second opinion is always needed.

If anyone could help me, that'd be great. Thank you

[Mochadelicious]

I completely agree with Ken.  There is absolutely nothing to be feel foolish for by getting it checked out again.  You have to be your own advocate or nobody else will be.  I basically had the same experience but mine lasted for 3 years before anyone looked at lymphoma as a possible diagnosis.  Infection was always first on thier minds.  If you feel as though your previous doctor did not take you seriously, maybe a new doctor would be a good idea?  

By the way, other than having lumps, I did not have any other indicator that I had cancer.  I felt completely fine.  I wasn't tired, didn't have night sweats, fever or weight loss.  Blood tests were normal too.  I would request a biopsy on the lymph node, as this is really the only definitive way to know for sure what you're dealing with.  If your doctor doesn't want to go that route, atleast request a PET scan.  Pet scans are not definative, but if you have lymphoma in that lymph node (or any other node), it should show up on the scan.

Good luck and please keep us posted.

[Ken_PA]

Hi, there's nothing foolish about you being concerned, because:

- it has lasted so long

- you say it's hard, not soft

- it increases in size, which wouldn't be expected from a node reacting to infection

Also, you can't be sure it's a lymph node at this point.

Regarding the pain, there is thread below to look carefully through. While I haven't seen any alternate medical reason for pain after alcohol, it's also true that some have the pain without having Hodgkin Disease.

OTOH, if your tiredness is gone, that's a good sign that it's not HD. HD is more common at your age than NHL.

Some reasons why a node might be long-term enlarged: a chronic infection, or scar tissue (fibrosis) has formed inside (which might explain the hard-not-soft feel).

I recall a study that went like this: out of every 100 people who go to a doc because of a chronically enlarged lymph node, 5 get a biopsy and 2 have a malignancy.

Btw, a lipoma (benign fatty tumor) can grow and grow, but you'd expect that to be soft.

If it were me, I'd go back and ask for a biopsy or at least an ultrasound.

[igrace12]

Hello,

I thought I would write on here again to give an update.

Last year I went to see a consultant regarding my swollen lymph node and he pretty much dismissed me straight away saying it was nothing to worry about. So fot eh last 14 months I've ignored my lymph node, and they just put it down to just being nothing. They weren't able to offer me an explanation for it, they just viewed it as 'one of those things'.

Anyway, a year has passed and my lymph node has definitely increased in size. My parents and boyfriend can now see it underneath my skin by just looking at me, and I would probably say it's doubled, maybe nearly tripled in size... It is still painless and hard. Now this has obviously got me worried. I have also noticed that after a heavy night of drinking (which isn't very often!) the next day my lymph node can be quite tender, and sort of aches. It's not a shooting pain, but it's definitely more sensitive. Whereas usually it doesn't hurt at all. I am in perfect health otherwise, I rarely get ill.

Would you recommend going back to the doctors and insisting on more tests? Or just ignore that it has increased in size. They made me feel a little bit foolish last time I went and it has put me off going back about the same problem.

If this has happened to anyone else please could you tell me, and what the outcome was?

Any advice or comment would be helpful. Thanks :)

[Ken_PA]

> Wouldn't a hidden infection have shown itself by now?

not necessarily. E.g., it might be very difficult to determine if a person currently has Lyme disease, and that's a bacteria. Viruses are much harder, look at how long it took to  discover AIDS.

One way is by testing for antibodies to the infection. But you'd have to do those individually, there isn't one test for all.

Also, there is increasing use of PET scanning to try and detect occult infection.

> a lot of people think they produce a lot of false negatives

yes, correct - because it gets such a small sample, you might miss any abnormal cells that are located in a spot that wasn't sampled.

Good luck, Grace.

[igrace12]

Thank you so much for your reply, it was very helpful.

I will definitely ring the doctors and gather all my results.
I'm sure most likely it'll be an infection, and nothing more sinister, but you can't help but wonder. Wouldn't a hidden infection have shown itself by now?

I can't wait to get my biopsy done and then I can relax. I've read up on the needle biopsies, and a lot of people think they produce a lot of false negatives. Do you have any thoughts on this?

I hope your father is doing well and he's in complete remission :)

[Ken_PA]

> is it possible to have lymphoma without feeling like anything is wrong

absolutely true. But it's also more *likely* to have some other condition, such as a hidden infection, that causes the signs/symptoms

> do you think it is worth asking him for [results]?

always :)   keep a stack. I'd even get a copy of any CBCs right when they're done - just ask the nurse to print out a copy for you

> biopsy

a biopsy is the only way to be sure, one way or the other. Maybe yours will give you some peace of mind.

btw, I'd also say that CBC results aren't necessarily indicative. They apparently were in  Yamahaulin's case. But my father had NHL, and his leukocytes never were out of range because of the NHL.

[igrace12]

Thank you so much for your reply.

My doctor never gave me all the breakdown of my results..do you think it is worth asking him for them? He just said everything seemed normal.

I hope your doing well and your treatment has worked or is working for you.

[Yamahaulin]

If you have lymphoma it would probably show up in your CBC results particularly in your white blood cell counts as abnormal, or if caught early as a high or low in the acceptable range depending on the type of white blood cell.  Look closely at your CBC for NE and LY levels.  NE below 45 and LY above 45 could point to many things one of which is lymphoma.

I have NHL and you're describing pretty much what I felt but I never had any glandular swelling just the unusual white blood cell counts.  A clear CT/Pet scan but they found cancer in my bone marrow so that makes me stage four.  I've been taking Rituxan treatment for the past 8 weeks and my blood counts are back to where they should be.  See a good oncologist and get it check out.