enlarged lymph nodes in arm

[Bananie22]

I'm really getting concerned now.  I have Hashi's, scheduled for a thyroidectomy in mid May.  I went for a routine mammogram and they found the lymph nodes under my arm are enlarged and want me to come in for an ultra sound.  I've also been having a numbish tingly feeling in that arm.  I have a large nodule on my left side of my thyroid (visible to the naked eye) and that's also the arm with the enlarged lymph nodes.  My thyroid is also very large with a thick neck.  Here's my question, does the discovery of these enlarged lymph nodes under my arm make it more likely that this is lymphoma?  Should I push up my surgery?  My FNA showed high lymphocytes but was "inconclusive" (no flow cytometry was done), I want my thyroid OUT anyway, but the fear is growing fast about this not just being Hashi's because of the axillary lymph nodes being enlarged. Thank you.

[Mark Lupo, M.D.]

The lymph nodes are concerning but can also be seen in Hashimotos.  Procede with the ultrasound recommended to follow-up the under-arm (axillary) lymhph node -- it is not common to see axillary nodes with hashimotos.  If the lymph node is significantly enlarged, then excision may be necessary.  Typically when I have indeterminate FNA results I try to have patients undergo surgery within 4-6 weeks.  Procede with axillary node eval first.

[Bananie22]

Thanks for responding...I can't actually feel the lumps at all.  They found them during a mammogram.  My armpit doesn't hurt or feel different...just my arm going numb and tingly a lot, almost always actually.  My TSH was sorta close to normal last time and my hypo symptoms have vanished (even managed to drop ten pounds with much exercise and dieting).  So would I still be likely to have enlarged lymph nodes if all my hypo symptoms are gone and my TSH is almost normal (it might even be normal because he upped my medicine to 175 mcg after my last TSH reading of 4.2 about a month ago)  I know Hashi's is an autoimmune disease and it can make your lymph nodes enlarge, but under my arms?  I'm waiting to hear from the surgeon and the endo still.  Every time my phone rings I jump a mile...only to have it be a friend or someone trying to sell me something...grrr!  I had accepted my thyroidectomy...was doing ok...then the call from the Breast Care Center came and BOOM...back to being a mess.  Thanks for listening.  =)

[Bananie22]

I've heard a lot of different "norms" with this issue.  He had said that he wanted to get it lower than 4.2 so he upped my medicine.  I'm due for another blood test the first week in April.  I'm really curious what it's down to because I've felt so NORMAL lately...it's been a year since I've felt this good...now I get these stupid lymph nodes scaring the heck out of me.    
Do you know if swollen lymph nodes cause arm numbness and tingling?  Why does it take so long to hear back from doctors??!!!

[Bananie22]

I mean MY doctors...not the doctor here!  =)

[Bananie22]

They scheduled me for a CT scan tomorrow (neck and chest)...not quite sure what they are looking for.  I guess I still have to go for the ultra sound too?

[wonderme]

Good morning.  I saw this and thought I'd share my experience with this issue...

I have had numerous hypo symptoms for years -- since my second child was born.  I have had several inadequate thyroid tests -- TSH only, TSH and T3 Uptake...

I finally got my doctor to listen and she sent me for full thyroid -- TSH, Free T4, Total T3 (was supposed to be Free T3 and I'm trying to work this out), thyroid antibodies and adrenal testing -- cortisol, ACTH, DHEA, prolactin, testosterone, estrogen...  Just went yesterday so I should hear in about a week or so (fingers crossed they'll provide some answers).

Now as for the enlarged lymph node.  About 3-3 1/2 years ago I had a pain in my lower neck that felt like it was burning and a strong ache behind my shoulder blade (left side). I ignored it until a few days into it, I woke up in the middle of the night with pain in my left arm and my fingers numb and tingly.  In addition, the discomfort had wrapped around the front of my chest.

I called my doctor because I know this is a symptom of a heart attack (left side, etc.).  I was only 34...

Went in and they took x-rays, found nothing...sent me for a mammogram and ultrasound.  The mammogram came out clear, but the ultrasound revealed an enlarged gland (no injury/infection/illness)under my left arm(pit) and what they believed was a fibroid adenoma at about 2 o'clock.  

While they didn't suspect anything sinister, they told me to come back in 4-6 months to monitor that nothing had changed.  When 5-6 months passed, I called my doc for the paperwork to go back for the ultrasound.  She told me instead to go to a breast specialist and see what their thoughts were.

Did that -- he thought there was nothing wrong.  Maybe it was my shampoo causing the enlarged lymph node (six months later?).

Still had pain, etc. coming and going.  Went for physical therapy and helped for a short time, but the pain/ache always returned.

The following year I went to my yearly ob/gyn exam and my doc asked about the lymph node.  Told her it was still there.  She also noticed a couple in my groin.  Told me she was going to send me to a breast specialist for a second opinion.

Went to yet another doc, breast specialist.  She didn't think it was anything, but was "mad" I hadn't gone back for the follow up ultrasound.  So, she sent me.

Went again.  Buffoons!  The sonographer told me that it was hard to tell b/c they hadn't taken any measurements the first time.  I told her that they had.  She said no.  Also, she had someone else's name and info on the ultrasound screen -- I asked her about it and she said oops, need to change to you! But, the old films were mine!?

I called the second breast specialist and told her I was concerned that they hadn't been looking at my old films b/c I knew they had taken measurements (I have two kids and have had several ultrasounds and know when they're taking a measurement).  She went to the hospital and reviewed.  Yes, they had taken measurements, but she felt that everything was okay.

I then just went to my primary care doctor to look at my new groin lymph nodes.  Did bloodwork to rule out any lyme disease,lymphoma, etc.  All came back normal...

Went to an orthopedist who sent me for an MRI.  Saw a bulge in one of my discs that presses slightly on a nerve.  Pretty much just told me to live with it.

All this time later I still have on and off discomfort in my neck and shoulder.  My enlarged lymph node is still with me and has been joined by about three in my neck that are just hanging out.  My doctor doesn't know why, but they're there.  The tingling and numbness have pretty much abated.

I hope you don't have this much trouble.

I hope it turns out to be nothing for you.  I am learning to demand attention when I know something is not right.

I wish you much luck.

[Bananie22]

Wow!  What a nightmare!  I am so sorry you have to go through that and live with the discomfort...it doesn't sit right with me at all.  Didn't they want to aspirate any of the nodes to see what they were up to?  
As far as me...well I have this weird tingle in my left arm only (the one with the lymph nodes) numbish...just annoying really, not pain...like it's constantly falling asleep.  I'm concerned it's thyroid lymphoma that has spread (because of the lymph nodes being enlarged).  I'm having a ct scan today and an ultrasound Friday.  I'm hoping I get more answers than they gave you.  I'm just completely shocked that they didn't want to investigate it more.  Maybe you could push for an FNA on it?  I don't know..this is all very new to me.

[wonderme]

Honestly,  I have the shoulder discomfort to some degree everyday.  The lymph nodes don't cause me any pain or discomfort and they are not huge, just palpable (1/4 to 1/2 inch) opposed to my others which I cannot even find if I wanted to.  Since they haven't changed in 3 years and all my bloodwork appears normal, they don't see a need to investigate any further.

Without being a doctor, it is extremely hard to know when enough testing has been done. I've had a lot of follow up and no one seems concerned -- so I guess until something changes, this is where I am.

I am curious to see how my thyroid panel turns out now that I've had additional tests done.

I feel a bit like a hypochondriac but I know something's wrong, just don't know what.  I worry that if I'm this tired and foggy at 37, where will I be when I'm 60? 70? 80?

Anyway, best of luck with your situation.  Let us know how it turns out.

Best regards.

[Bananie22]

I wish you the best of luck too.  I hate tests and hate waiting for the results even more.  The only reason I brought up FNA is, my original endo didn't seem to think it was needed on my nodule as it showed up ok on the ultrasound and hadn't grown in size, my newer endo ordered an FNA right away and it came back a little iffy, which has prompted more tests, which is where I'm at today.  IF this actually turns out to be lymphoma, I will be so very grateful that my new endo actually stuck a needle in my neck to check it out so I could get treatment ASAP.  I have no doubt you're not a hypochondriac...you know your body and you know when something isn't quite right.  I've had other medical "scares" that I went with my gut feeling on (over a doctor's advice) and ended up saving myself a total hysterectomy.  Trust your gut and don't give up trying to find the answers...as much as it stinks to have to switch doctors and go through the whole dance all over again.  I'll let you know what the results are of my ct scan etc...you do the same!

Oh yeah...one other question...do you have Hashi's or any other autoimmune disease that you're aware of?  I ask because of the lymph nodes...what about Fibromyalgia (sp?) is there a test for that?  My friend has it and feels so lethargic and has some swollen lymph nodes.  I'm curious about your blood work too, I know over the last two weeks this is the best I have felt in a year!  It's amazing just to feel normal again.  I hope they find the cause and you can feel it again as well.  
Ok...good luck to you and keep us posted!

[Bananie22]

CT scan came back good.  Had scan of neck and chest.  Still have the ultrasound on lymph nodes tomorrow, but feeling good about the CT results.

[hadituptohere]

Wow - Wonderme sounds very much like what I've been going through for over a year now.  I am only 34 & started feeling lousy in November 2004, probably sooner than that but I'm not one to run to the doctors office for every little thing.  I have been desperately trying to have my condition identified.  Last Dec. the endo felt a slight enlargement on the left side of my thyroid so he referred me for an ultrasound which I finally had in Feb., it confirmed that I have a small node on the left side but found a larger on the right that he hadn't dectected.

I'm scheduled for a biopsy but that isn't until May.  The endo says he's not concerned but I've had consistent waves of feeling crappy for so long now.  I went to my primary care doctor this past Friday because I've been in constant pain along my shoulder blades, spine and soft tissue in my breasts and chest for over a month.  He literally said he didn't know that was going on and couldn't help me. I said that wasn't accaptable, I keep complaining of the same areas over and over and no one has recommended a CT scan.  He relunctantly made a referral but doesn't think anything will be discovered.

My throid levels were checked once a year ago and at that time they were normal.  I've so had it knowing something just isn't right and not getting any answers/relief.  You do begin feeling like a crazy hypochondriac (sp) when no one can help or put their finger on it and they want to put you on antidepressants or say something crazy like eating too many carrot can cause heart palpations.  What the?!?

I am a level headed woman and this had been the absolutely most frustrating experience in my life!!  Good luck to all those in the same boat...