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Avatar universal

Swollen Gland in Groin

In late early July 2013 i was diagnosed with Epididymitis.  I te4sted negative for major bacterial causes.  The doctor suspects a viral infection of some sort.  I was told to wait it out.  I went to walk in clinic three weeks later as i began getting a pain in my goin on the right side.  It seemed to stick out a little more than the left.  The doctor said it could be hernia or a swollen lymph node which would make more sense with a genital infection present.  He sent me for an ultrasound to confirm the lump.  It was  confirmed a swollen lymph node:  "mildly enlarged right goin lymph node corresponding to the area of tenderness with mostly benign features likely reactive and of questionable significance."  it measure 19.3mm x 11.1mm x 5.7mm.  My issue is that it is a month past that that diagnosis.  I can't tell if the lump is any bigger, but i do know the pain has not gone away and slightly increased.  Pain spreads to my upper right thiigh, right buttock, right lower back and kidney area.  In early july i had my annual physical and my blood work came back clean.  nothing unusual our outstanding.  My concern is lymphoma.  Can anyone please comment.  I have an appointment with my doctor tomorrow to review the pain i have in my groin and thigh.
47 Responses
1081992 tn?1389907237
COMMUNITY LEADER
Hi, lymphoma in a node is almost always not painful. The pain comes when immune cells multiply to fight an infection, and push outward on the node's surrounding capsule. But cancer grows right through the outer covering and so doesn't cause pressure/pain.

That plus the good sono means you shouldn't worry about lymphoma. Maybe your infection is still active. Do you have weakened immunity?

I'd want another CBC, to rule out a kidney infection. Do you have fever? Or maybe it's just referred pain.
Avatar universal
Thank you for your response.  To my knowledge, i do not have weakened immunity.  I'm fairly healthy most of the time.  average weight and height.  My cholesterol is a little high, but nothing else really.  I have no fever.  This all started in June.  I had testicle pain.  my initial fears were testicular cancer and than when that was ruled out, i feared STD's.  During that time was very scared and depreseed.  I did not eat or sleep much at all.  I lost over ten pounds in a month from the nervousness.  I have gained a lot of that weight back now.  I never had night sweats or anything like that.  just rear and anxiety.  The weight loss was very rapid.  my doctor thinks it was the anxiety.
1081992 tn?1389907237
COMMUNITY LEADER
Well, if STD tests are all negative then there is probably still some infection - but you also possibly have an immune system which is not average (and might be overactive rather than suppressed).

Histamine is an immune system chemical which is also a neurotransmitter and can be involved in anxiety. The antihistamine Benedryl was actually the precursor in development to Prozac. That's something to keep in mind.

Does your kidney hurt when you press on it?
Avatar universal
There is no Kidney pain.  Just an occassional sharp pain once in a while that seems to stem from my groin.  At times it actually feels like someone tied a tight rubber band around my leg where my abdomen and groin meet.  tightness and pressure, especially in the front if the thigh/groin.
1081992 tn?1389907237
COMMUNITY LEADER
That's good then, Since you'd originally mentioned kidney, it's important to rule out a kidney infection which can be very serious.

So you might have "referred pain". Just guessing. That occurs when the nervous system is not experienced/educated in pain from an unusual area and so can't quite pin down the location.

At least, I think, you can not get bogged down with needless worry about lymphoma. Good luck with your appt tomorrow.
Avatar universal
Ken, thanks for the support and your input. I will update the posting when I get more feedback from the doctor.
Avatar universal
had my meeting with my doctro.  he reviewed my ultrasound results.  He does not feel the enlarged node is of any concern.  He feels it is an inguinal hernia.  The hernia is pushing on my femoral nerve and maybe others causing the referred pain in other close by areas.  Although the node is enlarged, it is not of concern.  If the pain or lump in your groin is of concern, please go see your doctor.  The stress can turn your life upside down until you know what the problem is for sure.
1081992 tn?1389907237
COMMUNITY LEADER
Thanks for being considerate and posting back with the end result. It's funny that various docs can examine a bump and disagree on whether it is a node or not. but that happens. I'm glad that things worked out well for you :)
Avatar universal
Ken,
I hope all is well.  its been a few days since my last post.  Since then, my situation is a bit different.  the pain that was extending to my thigh is pretty much gone.  the groin lump/discomfort remains steady.  I am now experiencing quite the amount of discomfort in my right flank.  I have a fullness feeling between the top of the hip and the bottom of the rib cage.  If i press on the top of the hip bone, it feels bruised.  Also, if i press around the right flank between the hip and rib i feel pain.  i do the same on the left and there is no pain.  I still worry because there is an enlarged not in groin (almost 2cm).  So i started feeling around my neck.  on the right side i can feel one node for sure.  it is very small and very firm on back of neck near hair line.  I think i feel a second on the right about one inch below my ear lobe and one inch back.  it seems to be attached to a muscle so i can distinguish if it is a stiff muscle with a knot or a lymph node.  I guess pushing on it does not help.  I worry myself sick.  I keep going back to my doctor and he keeps saying its no big deal.  totally disregarded the enlarged node in the groin.  This is making things hard for me.  all i do is feel for lumps.  i barely sleep at all.  I got about three hours in last night.  it's making my life hell.  Does anything in the symptoms above set off any alarms or triggers for you?
1081992 tn?1389907237
COMMUNITY LEADER
Hi, again. Although it is true that the new appearance of enlarged nodes at a site away from the original node can point to lymphoma, nothing else about you points to lymphoma. You also don't know at this point if the neck bumps are nodes, either.

Plus, you had a good sono of the inguinal node. Think of how a tomato has an internal structure, with ribs and seeds and chambers. That's similar to the internal architecture of a lymph node. Now think of a potato: it's all the same inside. That's how a cancerous node becomes, as the normal tomato-ish internal architecture gets effaced by endlessly dividing copies of the same monotonous cancer cell. Your sono didn't show that.

Does your sono mention fatty hilum, btw? That's almost always associated with not-cancer.

Have you possibly pressed on the areas of the neck bumps so much and so often that you might have irritated them and possibly caused cysts.

If not, do you feel anything wrong with your scalp or right ear?

Or, I suppose offhand that some fungus might be causing granulomatous lymphadenitis. Or maybe you have now got some self-sustaining autoinflammatory condition, without any infectious agent present.

My amateur guess is that you never had a hernia. But then, that same doc seems unlikely to now order a Fine Needle Aspiration biopsy, which might tell why the inguinal node hasn't gone down.

The node alone might be causing the neural effects that he says are caused by a hernia, I suppose. You don't experience anything else in those extended areas, do you? Like heat, swelling, redness.


Avatar universal
Ken. The tiny node on bak of neck is hard. The one on the side is firms bit bigger I think. I have been touching it a lot an pressing a lot.  That muscle now seems stiff. My right flank is tight as well.  I feel no redness or swelling in the xtendes areas. No heat either.  The ultrasound report said swollen node with benign features, likely reactive of questionable significance.  That lead my doctor to disregard it entirely.  
Avatar universal
Ken, thanks for helping out when you can.  Your comments and advice goes a long way in helping my mental state during these difficult times.  Can lymphoma be a cause of pain in the right flank?  I have a doctors appointment this coming thursday and we will review all concerns at that time.  however, I want to know what I'm looking out for.  Basically if you type "lymphoma" followed by any body part in google, something will come up.  I know paranoia is setting in with me, but i can't help.  I don't know what is wrong but i do know something is not right.  My right side is tender to the touch, the muscles feel tight.  All indications point to a kidney issue, but i dont' know about that either.  All i know is the pain is getting worse daily.  Does lymphoma cause such symptoms and do they progress that quickly?
1081992 tn?1389907237
COMMUNITY LEADER
Hi, I see you've asked on the kidney group. I hope you get an answer there soon, because your saying "worse every day" is troubling. You need to check your temperature. If you have a fever I'd guess that qualifies as a medical urgency. An unchecked kidney infection can, AFAIK, require IV antibiotics and  possibly lead to loss of the kidney. Does your doc know about "worse every day"? You should call there. If you have fever (but I think you would have mentioned that), you can consider a walkin clinic or the ER.

That's the worst scenario, but I don't want to be overly alarming. Maybe the worry and pressing is causing the symptoms. But the original swelling in the inguinal node came by itself, not from pressing. That makes me think infection.

Can lymphoma cause pain like that? The answer is not really... only in certain circumstances AFAIK. One example: if a tumor gets big enough to press on something internally (but reactive nodes can do that, too, and is much more likely). Having diffuse pain, such as through the flank region? Not that I've heard of. That sounds like inflammation. But only a personal check by a doc can see what is really happening. Without swelling or fever or redness, I don't know.

OTOH, if you've been pressing a lot on the inguinal node, that might account for the symptoms, via referred sensations.

You could say that any cancer can produce almost any feelings anywhere. But you have hit on the main counterpoint to that: it wouldn't progress to that so quickly.

What you need from your doc IMO is to find some physical manifestation, something besides the feelings.

Let me know how things turn out, okay?

Avatar universal
Thank you Ken.  I will definitely update the forum when i get back from my doctors appointment.  Just clarification, i am continually pressing on the node in my neck (or what i think is a node).  its at the top of the sternocleidomastoid (SCM) muscle, about an inche below the ear.  When looking for other swollen nodes i found my self pressing this area quite often.  now the muscle is tight and the top feels bruised.  it is larger than the left side where i feel nothing, however i did press the area quite often for the past few days.
1081992 tn?1389907237
COMMUNITY LEADER
I think there might be a thread here from years ago, where someone also had a bump right on the SCM. I remember thinking that a node probably wouldn't be on top of a muscle like that, but are generally in more recessed, protected spaces.

I forget how that ended up.

As far as pressing, if you re not now often pressing on the inguinal node and yet it still is getting worse, that's important.


Maybe one of these:
http://www.medhelp.org/forums/search/139?utf8=%26%23x2713%3B&query=sternocleidomastoid
Avatar universal
Ken, I hope all is well.  I went to my doctor today.  After review of scans again and physical examination we have concluded that the enlarged node is not lymphoma.  I had a viral infection in my testicles that caused the node to swell.  The testicle pain is has been gone for about 10 days now and the node can remain swollen for some time afterwards.  He does not seem worried, the radiologist was not worried, the doctor at the walk in clinic was not worried.  I think i can put that to bed for now.  However, after going over my right flank pain, the doctor is concerned with possible damage to my iliac crest or a muscular issue.  I don't like jumping to conclusions and the doctor says that cancer is the farthest thing from his mind at this time, but I am aware that cancer can be in the bone and cause  pain in the bone.  My pain is the rim of iliac crest on the right side.  I just did an x ray of the hip/pelvis.  What can an x ray show besides a cracked or broken bone?  Sorry, i'm not too familiar with different imaging techniques.
Avatar universal
Ken, I hope you're doing well.  I don't like diagnosing myself but can't help it.  after seeing my doctor, he is insistent this is not lymphoma.  The node is swollen due to infection and even after infection is gone (i have felt better in the last two weeks or so in testicle area) the node can remain swollen for some time.  the ultrasound did not point to cancer.  my concern is that since the node is still swollen, it is pressing on nerves that can be causing pain in other area's? if so, as the pain is getting worse could that indicate the node is still growing and pressing harder on the nerve?  if the infection caused the node to swell, it shouldn't still grow?  I apologize for all the questions but my doctor listens but all he keeps saying is don't worry, you don't have cancer.  can one be so sure if the symptom is a single swollen node for two months with a sono scan and referred pain???
Avatar universal
Ken, sorry for multiple messages. I know my anxiety is taking over but I have an additional question.  With the thought of lymphoma on my mind, I began palpating other areas of my body looking for additional enlargements.  Checked beck an arm pits and both groins.  I did find a hard lump in the neck. It's smaller than my finger tip however it is very firm. Cervical lymph node.  I felt it over a week ago an thought nothing of it. Although small, is it normal to be able to palpate a lymph node if it is not swollen.  It's pretty firm and the only one I can feel.
1081992 tn?1389907237
COMMUNITY LEADER
Yes, the enlarged node can still cause symptoms like pain as is presses on things. And you can make other nodes get inflamed by pressing on them. I hope you can find a way to not obsess so much, I know it's not easy and you can't simply stop just like that. Good luck to you.
Avatar universal
Thank you ken. I am doing my best. I suppose when doctors tell you enough times its not cancer, I gotta listen eventually.  I will work with my doctor to figure what's going on here.  Thanks again.  It makes me feel better to share my concerns.  This is something I'm not sharing with my daily.
Avatar universal
Hello all.  I'm just keeping the thread going.  I'm not saying I have lymphoma for sure or I don't, but I want to keep this updated so if anyone is ever having the same issues as me, they may come across it and point them in certain directions for the right answers.  Here I am, one month after an ultrasound diagnosed my enlarged node as mostly benign and likely reactive.  It still hurts a very small amount, the bulge in my groin is still visible, and the referred pain in the groin, thigh, buttock, and right flank is still there.  sometimes weaker, sometimes stronger.  I'm going to see my doctor tomorrow.  I called him and explained the lump in the back of my neck.  He wants to see it and than figure out if it warrants and ultrasound or not.  The tip of my finger can cover it.  Its very firm and fixed in place,  it is located in the top of the Posterior triangle in the right side of the neck.  from my researching, if this is a lymph node it would be a posterior cervical node.  it does not stick out through the skin.  you have to press firmly between the two muscles to feel it.  I have had friends feel to prove there is something there.  again, not saying its a node but there is something there.  I will let you know what the doctor thinks tomorrow.  I have also asked that he and i talk about ways to cope with stress, fear, and anxiety.  not sure if anyone else is in my shoes but I am having trouble.  i can't eat or sleep and am always tired from not eating and sleeping.
Avatar universal
Hello all.  Keeping this post going.  Went to the doctor to inspect the lump in my neck.  by physical examination he thought it was max 5mm and would not consider even an ultrasound of it.  He thinks it all in my head and I truly want to agree.  My concern is, I still have the bulge in my groin, right side.  Now, I had an ultrasound done almost two months ago where the node was declared benign and reactive.  Reactive to what?  we have no idea.  Anyway, the node is still there.  It's bothersome.  it hurts at times.  as it sits in the inguinal region, walking or sitting in awkward positions puts pressure on it and irritates it even more.  I still feel referred pain in the thigh, flank, hip, and buttock.  It changes daily.  today is more in the flank and abdomen as opposed to the thigh.  yesterday was the thigh.  I guess my question is what can cause a node to swell for this period of time?  i noticed it at the start of july.  it's still there.  the node itself hurts more now.  I cannot palpate the node.  Is that normal?  I have a bulge, but cannot single out the node.  In any event, my doctor thinks nothing is wrong but i know what i feel.  anyone ever feel the same thing as me?
1081992 tn?1389907237
COMMUNITY LEADER
It could have internal scar tissue, from an immunity-vs-infection battle that took place right inside the node. Or there is less chance that it might be a granulomatous condition where immune cells can't kill the infection so they wall it off.
Avatar universal
Thank you Ken for coming along with me through my journey.  it's a good feeling knowing someone is listening.  it's hard to talk to family and friends about this.  I will continue to see if there is any improvement and/or change in my condition.  It's the unknown that is the worst.  More and more people I talk to about this issue i'm having all seem to be steering me away form lymphoma.  I will ask my doctor about the possibilities you suggested and see if there is any way to verify.

Thank you again.
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