I had an enlarged lymph node in my left neck. I complained for a long time about it. I first brought it up around 2011 but made a big deal about it this year as it had grown and was not shrinking. it hurt when i swallowed. I wont go into the entire backlog but i will start with earlier this year. i had a full hysterectomy including ovaries in april. Advanced Stage 4 endometriosis was found but the complex masses on ovaries and in uterus were "benign". that surgery triggered a bunch of stuff in this order. an allergic sinus infection that swelled up my tongue and upper left jaw that triggered a large absess with an out of control tooth infection in an upper molar that had a previous root canal, autonomic dysfunction with cardiac involvement presenting with high blood pressure and tachycardia. i had about 6 visits to the er with the combined symptoms and lots of cardiac tests. i should probably add that just prior to the surgery, during a vascular screening, the ultrasound tech picked up a "questionable lymph node" and two masses below the thyroid. that turned out to be 2 thick walled cysts in the cartilage of my thyroid. i finally got the tooth out but none of the drs i was seeing would address the infection that had eroded jaw bone and moved into my sinus cavity. I had been told by the ent oncologist i went to originally about the recurring left mouth ulcer that if the lymph node was still enlarged after the tooth was gone, (because an infection is the obvious reason for an enlarged lymph node) that he would have it excisionally biopsied. i was also trying to get my deviated septum and swollen turbinates repaired so in september i was handed off to a different surgeon who surgically biopsied the mouth ulcer again, fixed the septum and turbinates, and removed and biopsied the lymph node. I was told it and the pathology reads as normal for non hodgkin lymphoma.
Well the thing is that since this surgery, my heart rate and blood pressure improved some, and some of my symptoms have lessened. However, I have also learned that I have an atypical hemangioma in the c4 vertebrae of the spine in my neck. it is at the same level as where the lymph node was. The lymph node was between that and the thick walled cysts in the thyroid cartilage. I have also learned that the cysts have changed. One has grown and has started forming calcification. the other has not grown or started to calcify, but now has an irregular border. I have another complex cystic mass in my left breast that has slightly grown since 2013. the report is confusing because it says that it doesn't enhance with contrast, but at the bottom in the impression it says that it does enhance. Again I was told this was benign so no big deal. Oh and did I mention I also had complex cysts in I believe both ovaries, a uterine fibroid that was growing, a small pituitary tumor, a splenule and an accessory spleen, and a calcification in an artery near my right kidney? I have been trying to be seen by a genetic dr because of family history of neuroendocrine tumors, both benign and cancerous. I have a whole bunch of risk factors, including for Multiple Myeloma and myeloproliferative neoplasms.
I did see a hematologist about this because I also have a mutation in the VHL gene that is linked to chuvash polycythemia. During the period between the hysterectomy and the sinus/lymph surgery, there were more then one instance of elevated cbc labs, a periods of metabolic acidosis with respiratory alkilosis, and my alk phos has been high and rising. last test it was 157. it was in the mid 70s a couple years ago.
So I decided to try to understand the lymphnode biopsy pathology to see if they were only looking for non hodgkins lymphoma or if they were considering any other possible reason for the enlarged lymph node. Well, duh, but I cant figure it out. Can you help me understand how to read this thing? I am getting hung up on the Miscellaneous markers section. Thank you in advance.
Flow Cytometry Lymphoma Panel
B Cell Associated Markers (% Positive Cells): CD19 = 22; CD20 = 22; CD23 = 14; Kappa = 12; Lambda = 9; Kappa:Lambda ratio = 1.3
T Cell Associated Markers (% Positive Cells): CD2 = 75; CD3 = 75; CD4 = 56; CD5 = 75; C D7 = 72; CD8 = 18 CD4:CD8 ratio = 3.3
Miscellaneous Markers (% Positive Cells): CD10 = 0; CD34 = 0; CD38 = 73; CD45 = 100; CD56 = 0; FMC7 = 7; CD200 = 29
Cell Viability (%): 97 Number of Cells Analyzed: 10000 Total Number of Markers: 23 Summary of Marker Combinations: Kappa/Lambda/5/10/19/45/38/20; FMC7/23/5/34/200/45/19; 2/7/5/3/4/45/56/8