lymphadenopathy

I recently had an ultrasound for enlarged left axillary lymph nodes.  The results showed:  a circumscribed heterogeneously hypoechoic nodular focus measuring 2.6cm and another measuring 1.3cm.  I just got back from the surgeon who was not overly impressed by these findings and is not even sure if a biopsy is warranted.  She's going to talk to her radiologist first.  I'm very uncomfortable with not doing anything about them and felt my questions weren't answered today.  Anyone have any suggestions on what this report means and what can be causing these enlarged nodes.    

[Dennis MD]

Hi.
Just have some clarifications.  How old are you?  What are your signs and symptoms?  Can you feel any lumps in the breast or in other location?
Your ultrasound showed 2 nodular masses in the left axilla.  Though the result is non specific, there is a need to investigate the cause.  Infection can result in enlargement of lymph nodes in the axilla.  Other causes of enlarged lymph nodes include lymphomas and metastatic carcinomas.  You may have the lymph node biopsied for a definite diagnosis.
Good luck.

[sweetgrl]

Thank you for your response.  To answer your questions I am 29 years old and otherwise symptom free of anything.  I have a palpable axillary mass but my breasts are fine as per my GYN.  I do have a strong history of lymphoma in my family and I guess thats what scares me the most.  As most of the people on this board probably know the fear of the unknown is the worst part of illness.

[Teezie]

Hello, how right you are. I am in the same boat as you and the main part of my journey ( when they started testing ) began in November 2007. The not knowing what is what is unbearable, i think i would deal with the diagnosis of lymphoma better than " The fear of the unknown ". I will find out next week if haem will do me the honour of taking away the 3 lymph nodes that have grown in my groin, as they are all about 1 - 1 1/4 inch now. I hope you find your answers soon x

[Dennis MD]

Hi.
What you can do now is to have the axillary mass biopsied (either aspiration biopsy or excision biopsy) for a more definite diagnosis.  A diagnosis of lymphoma rests on symptoms and biopsy result confirmation.  
Good luck to you.

[sweetgrl]

I have a quick question:  Which is a better option for proper diagnosis - needle biopsy or excisional biopsy.  I've had different people tell me different things.  

[Dennis MD]

Hi.
An excision biopsy may provide a better diagnosis since there will be more tissue specimen to work on.  The specimen can be processed with a special stain in order to be more definite of the diagnosis.
A core needle biopsy is more preferred than a fine needle aspiration biopsy.  It also involves more specimen (though not as much as an excision biopsy specimen) for the pathologist to work on.  

[sweetgrl]

I ended up having a fine needle aspiration by a radiologist.  The results were benign...thank God...but I still don't seem to have a peace of mind.  I still don't know why these lyph nodes are enlarged and therefor don't know what to do about them.  Should I go for the excisional biopsy...if anything to relieve the pressure in the axilla?  Do you have any more suggestions?  Thank you in advance.

[Dennis MD]

Hi.
Thanks for the update.
It’s good to know that the result of your fine needle aspiration biopsy turned out to be benign.
How are you doing now?
Many normal persons have slight enlargement of the lymph nodes in the axilla as a result of previous infection.  And this can be permanent.  Since there is still persistence of the lymph nodes in your axilla, and you are experiencing some pressure on the area, you may need to go back to your doctor.  I believe there is still a need to investigate further to determine the cause.  Have you had a chest x-ray done?  A chronic lung infection like tuberculosis should be ruled-out.  

[Shamroxy]

Hi,

For the past year I was being monitored for breast density.  Changed medical coverage and new physician requested a mammo and an untrasound and radiologist found some suspicious lymphnodes under left armpit.  I'm scheduled for a core boipsy next week.  What's the % it could be cancer? I'm 45 and father died of lymphoma at age 81.