history of cervical lymphadenopathy & complex cysts

[NJMommyof2]

Hi everyone - any help is appreciated.  History:  2005 - FNY of right supraclavicular lymph node (unable to be removed) - went to another doctor, an ENT, for complete work-up and found another on the left - left supraclavicular lymph node removed 2006 - results came back negative. I was to return in 6 months for a CT scan but became pregnant. Time went on and I went back to get the CT scan, but became pregnant again. I never had the CT scan. - most recently, I began suffering joint pains, muscle stiffness and most recently, severe neck pain and headaches with occasional numbness on side of face.  Some nightsweats, but always wrote it off as hormonal from having a baby (7 mos ago).  Went to pcp who gave me predisone and z-pac (5 days) b/c my throat looked a mess - i checked myself for any inflamed lymph nodes and noticed that the front of my neck was swollen.  It doesn't hurt, but it feels like something is stuck in my throat.  Dry coughs (like I have to clear my throat), occassional hoarseness.  My doctor ran ANA tests which came back positive, and negative for lyme, so saw RHE who ordered more blood work and a chest x-ray to rule out sarcoidosis.  All of which was negative.  I just received my CT scan of thyroid which indicates this:

left lobe complex cystic nodule which measures 2.3 x 1.6 x 1.4 cm indentified within the midpole.  there are multiple thickened septations within this nodule.  color flow is noted within the internal septations - upper pole there is a 0.9 x 0.9 cm complex cystic nodule - right is a 4 x 4 x 3 mm simple cystic nodule wihtin the upper pole and a 4 x 4 x 3 mm cystic nodule in the midpole - the isthmus is within normal limits.

both of my recent TSH results were normal, and I am awaiting an apptoinment with my ENT - but for now, I'm wondering if this is more than likely cancerous - I will be going to the doctor, but I'm wondering if my hystory of lymph nodes and now all these sypmtoms are related.  thanks

[Mark Lupo, M.D.]

Sounds like you had a thyroid ultrasound and not CT scan.
This means that the tech did not likely look at the supraclavicular area for additional nodes.
The 2.3cm nodule needs FNA biopsy (assuming the thyroid labs are normal).  Also, a look at the lateral neck for any additional lymph nodes is important.

Not sure if the thyroid is the cause of the other symptoms -- if the thyroid function tests are normal, it's not likely the case.  Would continue to work with the rheumatologist on the positive ANA which is more likely cause of other symptoms.

[NJMommyof2]

Your right, it was an ultrasound, I got confused with all the testing.  I have an appt w/my ENT at Thomas Jefferson on 12/29, but will see my PCP before then and request additional studies for the other lymph nodes.  I appreciate your prompt and courteous response.  

[NJMommyof2]

I forgot to mention - on my blood work, my B12 was low so I was given a shot - I also have had chronic sore throats, and my mentrual periods (although 28 days apart), have lasted anywhere between 7 to 9 days and are extremely heavy since they started a month after having my second child (6 months now).  my "good" cholestorol was also a little low - i'm not sure if any of this is also relevant. thanks so much....