Chronic swollen lymph node... many tests with little explanation of strange symptoms

[mhomerjr]

I have had some weird things happening in a year. I have seen a ton of doctors...  About a year and a half ago, I experienced something similar with a node on the right preocciptal side of neck. I began experiencing the fevers, sweats, weight loss, tinnitus, and floaters. I was in the ER three times and admitted twice with ZERO outcome of a diagnosis other than unknown. They ran a variety of various bloodwork for autoimmune and viral tests like Epstein-Barr, Julien-Barait, lupus, Lyme, Brucellosis, etc. all were negative. It was a CT of my neck that revealed the thyroid nodules. Things seemed to calm down for a slight period, but then the summer hit and a cervical lymph node on my left side has slowly become reactive. My CBC bloodwork has supposedly come back normal but my WBC counts have come back somewhat low.

The level 5 neck node (posterior triangle node) that is reactive now is painless, except I have been experiencing a feeling of dysphagia or tightness around my throat and where the lymph node is located... I haven't been losing a ton of weight this time, but I have been more tired. Further, I am concerned because I believe this chain drains my thyroid, and I have been concerned about developing thyroid cancer due to the numerous nodules I have in my thyroid. The dysphagia has been very unsettling and is a constant feeling. My doctor has told me that it is idiopathic (termed "globus") and stress related and has prescribed Xanax, but it doesn't help. The node measures 1.1x0.4x0.6 cm, and appeared to have normal flow in October when it was ultrasounded. Since then, the node feel that it has gotten larger and my doctor feels that it is still no concern and scheduled another ultrasound to look tomorrow. He did offer to excise the node with full anesthesia, but refuses FNA despite it being just under the skin surface.

Should I be concerned for lymphoma? Can the cervical lymph nodes be that large and normal in the neck despite the cutoff size of 0.7cm^3? I am really concerned because this thing has been swollen for a long time, and my doctors have been pretty condescending.

[Ken_PA]

Well, Mike, the opinion from the onc is no surprise. But that doesn't address what the real cause of all your symptoms is - which I think is some non-malignant immune thing.

I'd suggest that if/when symptoms flare up, you should immediately assess and record what had been different in the preceding period. That might be exposure to foods or chemicals or heat/cold, etc.

But with luck, you won't have any flareups and can take a break. Good luck, my friend.

(A permanently enlarged node can be from fibrosis which occurred during some previous immune battle within the node.)

[mhomerjr]

Ken,

Sorry it has taken such a long time to reply. My ENT felt I should see an oncologist, so instead of any biopsies, the doctor just referred me to the cancer center in town. When I went to my appointment, the doctor looked at my records, felt the lymph node and said that my nodes aren't cancerous. He was a bit flippant, but told me that the reason I was referred was to reassure me that nothing was wrong with me. He said the nodes are just big, and that having a permanently larger node is normal. Since then, I have tried to block it out of my mind, and i am trying to take the doctor's word.

I have also since relocated to a new city for work, and my wife and daughter are stuck behind until her teaching contract is done. I am going to keep an eye on the nodes, but for now I am going to try my best to block it out of my mind. I hope all is well, and I again appreciate your insight.

[mhomerjr]

Merry Christmas, Ken!

You are right about having the option of the 1st ENT. I am trying to keep my mind out of the worrying state, and I have been just trying to keep busy with family. I went for a long run , and it felt great... it was the longest I have run in months! I am certainly considering the immunologist. I was told by my doctors office that I may hear from him by Friday or the beginning of next week. I will certainly keep you posted.

As far as the Armour Thyroid, I have been on it for two days now, and so far so good!

I hope you had a wonderful holiday! I will be in touch once I hear from my doc.

[mhomerjr]

I am sorry to hear that you are in similar shoes at the moment. Also, great job on kicking cancer's a**.  To answer your question about imaging, I had a Neck CT in May 2012 when the first preocciptal node went haywire. During that CT, they found the thyroid "hypodensities." I was still experiencing neck pain, headaches, fever, and floaters, so the hospital admitted me twice and they performed a spinal tap to check for meningitis, and they ran a neck MRI with contrast that did not show any abnormalities. Last January (2013), I had another followup MRI of my neck which was also normal. In May 2013, my left cervical node became inflammed and has been that way since. Since then, the only imaging I have had completed has been ultrasounds.

I am hoping to here from my doctor in the next couple of days to see what the oncologist has told him. I appreciate your input, and I hope everything yields a good result with you as well. The uncertainty is scary, but this forum has been an excellent resource for me and been very informative.

[summerluvr]

I have some swollen nodes in my left side neck, and was diagnosed with a thyroid condition as a result of the ultrasound to look at those (it found my thyroid enlarged and scared, and blood tests confirmed high  antiboides from Hashimoto thryoiditis)

I just had a 6 month follow up ultrasound (lymphnode is still there) mine is stone hard and fixed.  They feel the size is borderline (1.5 cm) as it is a jugulodiagastric (sp?) node.  Since I am a cancer survivor with a history of severe infectiosn (sinue, ear etc) as a result of my immune dysfuntion from treatment and my cancer they are not that worried and fell it is likely just a a scared node.  But, my hematologists has asked for copies of the ultrasound results and will consult with a head and neck oncologist.  They might do a ct scan with contrast or a FNA in january. Right now they are not that worried about it, but I probably worry more!

If I was in your shoes (i kind of am?) I would not want to jump into a major neck disection surgery just yet. Have you had a CT scan or MRI with contrast? If you are going to have the node removed and there is a chance it is cancer, I think having the oncologist involved is definately the way to go.

[Ken_PA]

As you probably know, lots of people who are hyopT love Armour. Just be aware of any possible allergic reactions, like hives.