Lymphoma Or Not?

[tennisist]

I have had a swollen lymph node on the right side of my neck just below the ear near the jaw since last May. I first noticed it because it when it was  large enough to disrupt chewing. And by last July I was actually experiencing  some dizziness when first arising from a reclining, even sometimes a sitting, position. I consulted my doctor who ordered a CT scan, then did a biopsy when the CT scan showed several swollen nodes and what was described as approximately a 1.5 cm. "lesion" where the lymph node was. The biopsy, which pronounced the lump only had leukocytes, said it was suspicious and indicated further tests were necessary, beginning with an excisional biopsy.

In the meantime, the regular use of an antihistamine and decongestant had begun to work, and when at their peak efficiency, there is no lump that I can feel and there has been no recurrence of any dizziness whatsoever.  Nonetheless frequent allergy treatment is continues to be needed to keep it that way, as the swelling always re-emerges as the effectiveness of the last dose subsides. There are still no other symptoms, no other sites that behave the same, and the lump, when it's there, does not hurt. Do I still need that further biopsy? What is wrong with me...

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Is it just the single node that remains swollen? Other groups of nodes have subsided? If its a single node and since the biopsy has been non contributory, you can wait and watch. But certain infections like tuberculosis can cause an evening rise of temperature, lymph node swelling and increased sweating. This also causes a loss of appetite; as such this is accompanied by weight loss. So, record your temperatures, on a two hourly basis to detect an evening rise of temperature.  Please check with your doctor to rule out this condition. Just cautioning you.

Hope this helped and do keep us posted.

[tennisist]

Hello, Paderla!

As luck would have it, I lived in Chennai for 2 !/2 years (it was then Madras, still!). How is Adyar now? Gosh, I even feel like I know you...

I don't know the status of the other nodes now; the only way I ever knew of their existence was through the CT scan. Possibly the better thing to call them was inflamed? As said, there are no other symptoms such as those you name, just an occasional enlargement overnight when I have been asleep. Is there a drainage problem then? What could cause that?

Also, what could have first been behind the original dizziness that went away? I will still try to take my temperature(s)... I did have histoplasmosis many years ago.

[Paderla Anitha, DNB]

Hi,

You guessed right, I am from chennai and right now its very hot here.

Dizziness that varies with posture could be due to Benign paroxysmal positional vertigo (BPPV), is an entity in which with movement of the head the person is likely to get dizziness. This happens because of a disorder of the labyrinth system in the inner ear. It can get affected due to head injuries, surgeries, nerve inflammations and as a side effect to medications. In a majority of cases the cause is not known. It is diagnosed by a physical examination and sometimes blood tests, a CT and MRI and audiology tests can further help with diagnosis. Therapy is with diazepam and OTC meclizine. Another cause is postural hypotension.

And since the lymph node is persisting an excisional biopsy may help clinch the diagnosis. It is not a drainage problem, lymph nodes swell due to infections or inflammations.

Hope this helped and do keep us posted.