4 year old daughter

[WorriedMom6229]

Hello,

I need some advice from another doctor. About three months ago I noticed my daughter had a lump in her neck. It seemed larger than an swollen lympth node, and it is painless. During these three months, I noticed her appetite decreased, and very fatigue. Then, my husband and I agreed that it got a little larger and took her in to the doctor. He said to give it another month and see if the lymph node swelling decreases, if not then come back. We returned to the doctors a month later and he put her on an antibiotic to see if she was fighting some type of infection. He said after the antiobiotic was finished (2 weeks) to return if stayed the same size or got bigger. The lump was still there, and she developed two more around the same area, but not as big. My doctor then suggested to get some blood work done, and chest x-rays. When he feels her lump he said it feels benign to him, but he wants to research it more, and so did we. We decided to do the tests, and the x-rays came back normal. The blood work he said was normal, but showed that she is fighting some type of viral infection, but noting extreme. The doctor also tested her for mono, and that was negative. He left it up to us if we wanted to get in biopsy, or wait a few months to see if the lymph node decreases in size. We felt that was the right move, because cancer in four year olds in very uncommon, and the test results were fine. She still is fatigue, seems pale, but her appetite is coming back. At this point, my husband and I are wonder if we are doing the right thing. Her five year appt. is in May, and the doctor said if it is still there then he might take the next step, which I assumed that meant biopsy. I check her lump once a week, and since the test results a couple of weeks ago, my husband and I think the lump is a little bigger. Again, her lump is painless and moveable. What would you suggest? Thank you for your guidance.

Worried Mom

[Dennis MD]

Hi.
Only a biopsy of the lymph node will confirm the diagnosis of lymphoma.  Usually, lymphomas are associated with symptoms like unexplained fever, weight loss, fatigue, sweating.  However, there are also asymptomatic cases.
Laboratory examinations will aid in the diagnosis.
X-rays cannot diagnose one as having lymphoma.  

[WorriedMom6229]

Thank you for your prompt reply. I forgot to ask you one other question. If her blood results and x-rays came back normal, could there still be a possibility of lymphoma?

Worried Mom

[Dennis MD]

Hi.
There are times when the lymph nodes do not go back to its original size or do not resolve after treatment of infection.  An ongoing infection could make the previously enlarged lymph node to get bigger.
A biopsy would give the diagnosis, whether the lymph nodes are secondary to the infection or to other condition like lymphoma.
It would be best to regularly consult her doctor and report anything you notice.
Stay positive always.
Good luck.