IS IT LYPHOMA OR ANY OTHERS PROB

[ALBATROSS94]

MY 3.5 YEARS OLD GIRL GOT 3 JOINT CERVICAL LYMPH-NODES. SHE IS VERY ACTIVE AND GROWING SMARTLY. SHE HAS NO SPECIFIC SICKNESS. OFTEN SHE GOT RUNNY NOSE. I NOTICED THIS NODES WHEN SHE WAS 18 MONTHS ONLY. THAT TIME IT IS NOT TOO MUCH LARGE LIKE NOW. DOCTOR OVER LOOK IT. 5 DAYS AGO I SAW SOMETHING UP LOOK TO HER NECK. I GO TO DOCTOR THAT TIME, DOCTOR SAID IT IS NOTICEABLE NOW. 1.54 CM 1, ANOTHER 2 IS BELOW 1 CM. THEY ARE NOT PAINFUL. BUT MOVABLE. ONE IS LITTLE HARD BUT TOUCHING SOFT. OTHER TWO SOFT. DOCTOR GIVE SOME TEST TO ME. HER CBC COUNT HB 10.6 LOW FROM THE RANGE, RANGE 11.5, PLAT ELATES 140,000. LOW FROM NORMAL RANGE 150,000.
IRON BINDING IS GOOD BUT IRON IS LOW. HER LYMPHOCYTE 68, RANGE 50, ESR 11. HER TB TEST RATE WILL GIVE TOMORROW. TODAY DOCTOR SEE HER AGAIN, SHE HAS POLYPS IN HER NOSE. MY ONLY ONE DAUGHTER, I CANT THINK ANYTHING, PLS HELP.    

[Ken_PA]

Sometimes scar tissue (fibrosis) forms inside a node and then it doesn't go down in size. But hers are getting a little bigger, so maybe there is an active infection.

You can ask for an ultrasound of the largest node. If the ultrasound report says "reactive" then you can probably relax.

Children tend to get swollen nodes more often than adults. Good luck.

[Ken_PA]

Sometimes scar tissue (fibrosis) forms inside a node and then it doesn't go down in size. But hers are getting a little bigger, so maybe there is an active infection.

You can ask for an ultrasound of the largest node. If the ultrasound report says "reactive" then you can probably relax.

Children tend to get swollen nodes more often than adults. Good luck.

[ALBATROSS94]

Thanks for your reply. yesterday i got some other test results, she has no TB, HB eletrophoresis become normal, Platelets only again 114,000, wbc, rbc, hb all are in the range. but LDH come 685 whether range is 460. Her doctor said don't think about these. it is normal pic for  a child. she gives antibiotics for ten days.Took the measurement of three nodes. yesterday total measurement was 2.5x2 cm, She tell me to follow up the measurement. Doctor saw her nose whole have allergic inflammation. She gives a nasal spray also. I want know, is it the right way for my baby?  

[Ken_PA]

Hi, are you saying that her platelets dropped from 140,000 to 114,000? Or was that a typo? 140,000 is only slightly low and is not a worry. A virus can make platelets go a little low. Danger of bleeding from low platelets comes at around 50,000.

She has no TB. Another (granuloma) disease that can make long term and large nodes in the neck is Cat Scratch Disease.

While LDH can get higher because of lymphoma, it also can get higher because of a nasal inflammation. Her lymphocytes being high points to a virus infection.

Also, I really don't know how large a child's node can get. But 2.5cm is probably around the maximum for a child with an infection. If the node does not get any larger but instead stays the same size or gets smaller, then that is a very good sign that there is no lymphoma. Lymphoma would not typically make a node get very large, very fast but then stop growing.

So the next week will be very stressful for you but my guess is that the end result will be that she does not have lymphoma. Please let me know of any new developments.

[ALBATROSS94]

Thanks for your reply again. doctor gave antibiotics for her. after 3 times take doses.  i feel more soft the nodes now and lower portion of the nodes getting little small. may be its my hallucination. but its my opinion now.  

[Ken_PA]

That's great news, congratulations.

Yes, it is difficult to accurately know the size without any instruments. But as the nodes continue to get smaller and smaller, then the difference should be very visible.

If the nodes get really small, that's a good clue as to what the problem is: not lymphoma and not virus. What is the name of this antibiotic? Some have different effects.

[ALBATROSS94]

The antibiotics name is Cefixime. She suffered for nose allergy now. Little mucus and dry cold also.it makes her breathing little noisy.today i measured again,i thought it is 2.5×2cm. Little bit soft and more movable found. Her body temperature 36.2 in evarage. No symptom occur like bad thing. The antibiotic continue last 2 days. Anything there to her for notice ?

[ALBATROSS94]

Today night i see. Remarkable change of the nodes. It feels my finger now small. Still one is large but not like before. I think these all the nodes become their own size again. Thanks.

[ALBATROSS94]

Today night i see. Remarkable change of the nodes. It feels my finger now small. Still one is large but not like before. I think these all the nodes become their own size again. Thank0Ps.

[ALBATROSS94]

Today 5 days continued the antibiotics. There is 3 nodes together the measurement. 2 is together there. And one coming back small size. But the big two are not come too much small. But they become more soft and more movable. I am still worried. Baby is very fine health. Instead this up grow lymphnodes. What ahould i do pls.

[ALBATROSS94]

Thanks for your valuable reply. Yesterday i went to doctor. She said, my daughter is improve very fine. And she also guess, nodes are coming small. I am also see that all nodes are going separated. So no doubt abot the nodes to come small. Doctor give also another type of mesicines after current course. Montelukast 4mg and penvic syrup for 4 month. She has no yeast infection yet. But her tonsils are little large but no infection seen. Her nasal passage are conjusted for allergy. Nasal spray and ketotifen syrup also give along with antibiotics.

[ALBATROSS94]

I observed that my daughters one nodes actually feeling two nodes in one place. They are still little large 1.7×1.5. Some side they feel soft. Other side feel hard and big. I cant understand whats going on. Some time i feel too much scared. Still runnig her antibiotic doses. Doctor said it is going to be normal. Pls say somthing about my fear. Other nodes go out allready which mates with that big one. Only this node is the remarks to me. I again say her health is very quite. No sick history.

[Ken_PA]

It is reasonable to believe that all of the swollen nodes got that way from a single cause. Since the antibiotic is working, then that tells us that the cause is an infection, not lymphoma.

While nodes usually get enlarged because the immune system cells needed to fight infection are multiplying a lot, sometimes the infection gets right inside a node. When that happens, scar tissue can build up inside the node and the node does not go down. That's the most likely cause.

If you have a family history of unusual immune reactions, such as being overactive, then that can also contribute.

If that double-node gets bigger, you can ask for a sonogram. But you probably won't need to get that. I wish more good luck to both of you, things are going well so far.

[ALBATROSS94]

Thanks again. As you and my doctor  i am relieved from the fear of lymphoma. I really see every day improvement. And nodes are now allmost separated. Large one is maybe 1.2 ×1 cm and its with some fleshy lean soft part.  But the improvement really slow, maybe it is very first improve on a doctor eye. So i can out of the fear of lymphoma?

[ALBATROSS94]

One thing i forget to tell that i had thyredectomy 7 years ago. I take thyroxin tab. But doctor said, thyroid have no connect with this. And i am really good health.

[Ken_PA]

No, Albatross, I don't see any reason to worry about lymphoma. If there is internal scarring, that can take a long time to go away.

What I would wonder about is the connection between her nasal inflammation and her enlarged nodes. Ketotifen is a "mast cell stabilizer". Mast cells are powerful immune cells that control lots of things. So if in her future years she has other mysterious problems, remember the mast cells. Hers might be overactive. E.g., with a very bad reaction to bee stings or certain foods or with having many allergies. Some foods can also be "mast cell stabilizers", and spices like turmeric and ginger.

Please keep me updated.

[ALBATROSS94]

Thanks for regular attention to my post.today is the 1oth day of antibiotic course. Nodes are not gone. Still 2 nodes join together and one separated from them. Some times its feel big then before. Some times its feel so hard. Some time feels so soft. But it is true when she sleep,nodes become more softer and smaller than she wakeup. I am really confused. And i again say, she is really fine. No problem with her health yet. No weight loss, no fever, no extra night sweat.i am really scared too much about the nodes. One thing her ldh level was high than range. 685 out of 460 ul. And platelates count was little low than range.after that her pedestrian not think it is too bad.doctor said it will become small. And give another 3 months antibiotic course.

[Ken_PA]

Nodes can change somewhat because of the inflammation inside them. The change can be quick. In the immune system, there are lots of biochemicals that cause inflammation to go up and down.

3 months of antibiotics? That's a lot. So I'd really use the yogurt and maybe kefir, too.

Does the doctor sat what type in infection is probably there? Some rare bacteria?

[ALBATROSS94]

Doctor said, there is simple bacterial problem. and also said these type of infection common in child. I just mentally released, when i saw antibiotic work. In the night time it become more small when she sleep. i try to follow your suggestion, give her yogurt. I also see you ignored LDH, so i am aslo pleased about this. i will tell what type of medicine give her today. and i am surely out the danger of lymphoma. thank you very much.  

[Ken_PA]

Now you can relax a little :) Have a peaceful day.

[ALBATROSS94]

Thanks for advise me. Dear she is still no problem. Lymphnodes become small. But one is still not too much small 1.3×1.1. But i really scared when platelates count low then normal. And her ldh level high then range. Platelates was 140000 and 114000 and ldh is 685. These twos are symptoms of lymphoma. so she has 3 things1.swallow lymphnodes 2. Low platelates count 3. Ldh level high.

[ALBATROSS94]

She has given for 4 months phenoxymethyl penicillin 125 mg. And montilucast 4mg.

[Ken_PA]

Well, 114000 is getting lower than expected. I'd want frequent CBCs now. Every week, just to be sure they aren't dropping very badly very fast.

It's possible for some drugs to reduce platelets number. E.g., "Demonstration of an immune-mediated mechanism of penicillin-induced neutropenia and thrombocytopenia."
http://www.ncbi.nlm.nih.gov/pubmed/6882683
But that would be rare.

You can ask for a sonogram of the big node. Only a biopsy tells for sure; but even so, a sonogram can still tell a lot of things.

[ALBATROSS94]

All nodes getting small. Only that node. That node also getting small but slowly.other nodes become 0.5 cm, today when she sleep i take the biv ones measurement, big one is 1.2×0.7 cm. After that i go for a cbc test today. I thought about pplatelates now. Otherwise antibiotic done the job well. Yrsterday i see her doctor. She said contunue meds, and she also said nothing there for specific lymph problem. It is gradually down. My child's weight, temperature, active everything normal.let you know todays cbc results. Thanks.