Should I be worried?

[Mom2four85]

I've read swollen neck lymph nodes in children are a sign of infection etc. and if they aren't a cause of infection or sickness and don't go down after 3 months it could be dangerous?

My 8 yr old daughter fell and hit her head last night so I took her to the ER.  The dr felt her neck and commented and asked if she had been sick - not for over a month, he said to have her pcp check them again BUT if she were 25 he'd have her in the hospital right then - ugh just what I wanted to hear.

My father developed Lymphoma (can't remember what exactly) in his early 60's and passed away within the past couple of months at age 67.

The thing I worry with my daughter is; she's so small - really tall for her age but the weight of a 4 year old, but has a great appetite; so I'm thinking it's just a fluke thing and I don't have to worry...easier said than done for sure.

[Ken_PA]

Well, I'm just somebody trying to answer questions online. Still, I'll say that statement from the ER doc instantly seemed very odd to me. We could talk about the differential diagnosis and how leaping to worry about cancer is unfounded. I don't think that any hematologist/oncologist would even make that statement about an 80 year old with only the same presentation of unexplained adenopathy and no other signs.

But even more so, consider this: who is it that ever gets admitted for an expensive hospital room just for testing? That's even if there were a strong suspicion of malignancy, which there isn't. No, you get tested outpatient, and most likely treated as such also. For goodness sakes, a FISH analysis on a biopsy might itself take several days just to come back from the specialized testing center. So, it seems silly to me to say that she would be admitted, just like that, if she were 25 instead of 8. Alarmist.

But you know, an ER doctor must have a special kind of approach, which is always considering this: what condition might be present, no matter how unlikely, that would be disastrous if missed? I'd suggest to you that approach is necessary in the ER for emergencies, but can lead to being unnecessarily alarmist if applied to a mystery, non-emergency and probably benign condition.

As far as bodyweight, I'd agree that her condition is nothing at all like cachexia, which comes in advanced cancer anyway and not the beginning. Having a good appetite and especially good energy levels is quite the opposite.

Merry Christmas  :)

[Mom2four85]

That's one of the things her dr asked also - no cats and no exposure to cats.

[Ken_PA]

Do you happen to have a cat? The famous cat scratch fever can be a cause of chronically swollen nodes.

[Mom2four85]

Thanks for the reply.  I talked to her new pediatrician about this and she did a routine blood test; I have to get a copy but she said it was ok.

What I find weird is, both dr's felt 5 lymph nodes or nodules; on her right throat/under her chin side which they thought was strange and I know wasn't there 6 months ago at her last checkup.  The new dr said we'll recheck her in 3  months just as a precaution =)

[Ken_PA]

Hi, it is possible but not likely since she's so young. I would find out which type of lymphoma your father had, then you can get some idea of what effect genetics might or might not play in that particular type. It might set your mind at ease.

And yes, lymph nodes sometimes just do not go back down - without being cancer.