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What are the chances it is just a virus and not cancer???

Hi, my 22 year old son had ultrasound for an enlarged inguinal gland. The results showed several rounded enlarged glands, largest being 18x16x17mm. Loss of normal fatty hilum. Low level vascularity and says nodes are not typically reactive. His doctor and sent him urgent referal to both surgeon for biopsy and haematologist/oncologist. I understand that no one can know for certain what it is until biopsy, I just would like to know, based on these results what is the likely hood that it is cancer and not just a virus???
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1081992 tn?1389903637
Hi, there is still some chance that it's not cancer. There are even some rare possibilities wherein it's not an infection, such as 'inflammatory pseudotumor' or Rosai-Dorfman disease. Inflammation can sometimes wipe out the fatty hilum and result in some new blood vessels.

Hopefully you can speak to the surgeon immediately after the biopsy to ask if he saw any signs one way or the other.

If it is lymphoma, then it's more likely because of his age to be Hodgkins Lymphoma, which has a better outlook than non-Hodgkins Lymphoma. At his age there is also a very high chance of successful treatment and, in fact, the worry might be more about what will be twenty years in the future - rather than what's in store for 3-5 years from now.

Did the nodes all pop up very suddenly and then stop growing and multiplying? That could tend toward infection. You'd want to consider if there was exposure to a pathogen.

You'd also want to consider if there is a family history of unusual immune conditions.

The node that he notice (big one) came up a while ago but suddenly grew larger. That one was painful (which I believe can be a good sign?) We have a very strong family history of ankylosing spondylitis. He has a great Aunt and second cousin (her son) who were both diagnosed with lymphoma withinn weeks of each other last year.
His doctor did full blood and urine testing and has shown no signs of infection (any odvious ones) or abnormalities in his blood
1081992 tn?1389903637
I would definitely look into As as a possible alternative cause. I just had a couple of minutes for right now and found two case reports.

Am J Med. 1986 May;80(5):951-3.
Diffuse lymphadenopathy as a manifestation of ankylosing spondylitis.

Clin Rheumatol. 1998;17(5):412-5.
Lymphadenopathy in an oriental with ankylosing spondylitis.

Not recent though.

Have you ever looked into the association of As with Klebsiella bacteria?
...should be AS above (for ankylosing spondylitis)
Thank you so much for your responses so far Ken, If for no other reason it's helpful to feel like I'm doing something (researching) during this waiting period. I hope it turns out to be an infection or due to AS. The part that worries me in regards to these is the fact that the nodes are labelled as not typically reactive. Usually in normal immune response they are reactive. He had his CT scan yesterday so now just wait for results from that.
1081992 tn?1389903637
There are ways besides cancer that nodal architecture can be effaced, as mentioned above. Granulomatous disease is another one and TB is known for that. Some types of Klebsiella do that, too. Nothing is an exact match, but if your son has something other than a cancer, it's likely rare and somewhat unexpected, but can be similar to conditions like TB or Granuloma annulare while also being different in some ways from them.

That's something to hope for, anyway. But a scan probably won't differentiate.

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