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Query about lymphoma - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Lymphoma
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1722 Questions
User :   Hello. I have been to 3 doctors about my lymph nodes, including an ENT. The one on the left side of my neck is a little bigger, always has been, does not continue to grow but is just bigger than the right. All 3 docs do not seem concerned and I have no other symptoms. They say it is bigger permanantly because I have chronic sinus issues and have had mono in the past. Because of this, however, I have poked around the rest of my body and can find lymph nodes. I can even feel pea-sized lumps in my abdomen area on each side. My primary care doc says it is because I am so skinny. It just doesn't seem normal to be able to feel nodes everywhere.
Doctor :   let me read ur query
User :   Thank you
Doctor :   ok
Doctor :   can u mention your age, weight, height and ur prior medical issues ?
User :   Sure I am 27, about 115 and 5'3. No other medical issues other than chronic sinus issues. I do suffer from I don't know if this is related or not. I just had a baby 5 months ago and obviously have been losing weight because of that, but I am still about 5 lbs above what I was pre-pregnancy
Doctor :   ok
Doctor :   How long have u had this enlarged node ?
User :   years and it has not grown. it has been this same size for a long time
User :   it is moveable and rubbery
User :   the ENT said I could have it removed but he did not recommend it
Doctor :   have u had any biopsy or any blood tests before ?
User :   i did have a full cbc with differential and a blood smear. all came back normal
User :   no biopsy
Doctor :   any scans or any other investigations done ?
User :   i have had a ct and mri of my neck about 2 years ago because i hurt my neck and that came back fine as well
User :   also had an xray of my chest about a month ago and they said it came back great. i had a bad cough
Doctor :   ok
Doctor :   In such cases , this is a very uncommon case, of persistant lymphadenopathy without cause
Doctor :   have u done any tests to check for Immunoglobulin levels, and plasam protein electrophoresis ?
User :   no i haven't
Doctor :   these tests can given an idea, if there is any excess antibody that is being secreted due to such increased size of lymph nodes
Doctor :   in case the tests are done and they come normal, then you dont have to be worried at all
User :   what does that look for? lymphoma?
User :   have you ever heard of anyone being able to feel lymph nodes in lower abdomen because they are skinny?
Doctor :   yes a beningn form of lymphoma, called lymphadenopathy of unknown significance
Doctor :   yes, this is very common in people with a BMI less than 22
User :   if those tests come back elevated, what is the next step
User :   ok that makes me feel better. they aren't big, but i can feel them if i poke around. which i know i am not supposed to do!
Doctor :   in that case, you have Paraprotienemia, and condition called MGUS, monoclonal gammopathy of unknown significance, etc
User :   sounds scary
User :   haha
Doctor :   i understand
Doctor :   but the name is a benign and does not sound serious medically
User :   well that is good :)
Doctor :   its just a variant of the normal body function
User :   yea because i can feel tiny nodes everywhere...elbow, etc. i need to stop looking for them
User :   but like i said, i am tiny
User :   no night sweats, etc
Doctor :   absence of any signs, indicate that, this is just a normal variant without any pathologic significance
User :   that makes me calm down a bit. thank you. i have been too anxious over this lately
Doctor :   i understand
Doctor :   I hope i have solved your anxiety
User :   is every little lump in your abdomen a lymph node or is it also fat, etc
User :   sorry i know we are running out of time
Doctor :   sometimes a at calcification can appear as a enlargeed ln as well
Doctor :   fat calcification i mean
User :   what is the cause of that
Doctor :   hardening of fatr deposits can be seen as such
User :   interesting
Doctor :   it could be due to insignificant trauma etc
User :   i did just have a baby :)
Doctor :   or abnormal fat deposits due to hormonal isssues as well
Doctor :   pregnancy can also sometimes cause such a lumpy palpable lumps
Doctor :   hello
Doctor :   are u back ?
User :   yes i am :-/
Doctor :   ok
Doctor :   So did u have any other query ?
User :   i was looking at my labwork after pregnancy (they checked me for clotting issues because i delivered at 31 weeks)
User :   they tested me for igm anticardio something?
User :   anyways, i didn't know if that was what you mentioned being tested for...the only thing that popped up on my labwork was that i have mthfr c677t
Doctor :   no the tests they dd was not for MGUS or for anything else
User :   my vitamin b and folate was low so i am now on a rx of neurpath-b everyday
Doctor :   the tests they did was to rule out antiphospholipid antibody syndrome, which can cause such antibodies causing clotting issues
Doctor :   those supplements arefine and those ahve no bearing on the nodes that are enlarged now
User :   do you think the ones in my abdomen are enlarged? they feel the same on each side and less than a pea
User :   i just didnt think it was normal to feel them at all...ugh i hate worrying about this
Doctor :   some times post pregancy you can feel such small nodes just in the lower part of the belly
Doctor :   this could be a skin fat deposition or it could be a node enlargement
User :   i can feel the armpit ones too but i have to dig. all of them besides the neck ones i have to dig for
Doctor :   this can definitively ruled out by an physical examination done by your treating doctor
User :   i have had 2 docs check the nodes in the jaw, neck, collar bone, armpit and groin
Doctor :   the nodes in the armpit an the neck could be real lymph nodes
Doctor :   what was the info given to u then ?
User :   that they felt moveable and fine. the ent said this as well. did not check the ones in the abdomen. my pcp said the one in my neck that i feel is a grape she said it feels like a raisen to her
Doctor :   In that case there is no need to worry at all
Doctor :   just relax ad everything will be just fine
User :   thanks. :) so you don't think i have lymphoma because i can feel every freakin node? lol
Doctor :   i dont think u will have any major issues
Doctor :   no his is no lymphoma
Doctor :   this is not lymphoma
User :   yay
User :   ugh i think my anxiety has taken issues i think
User :   everything i have googled (yes i need to stop) says you are not supposed to palpate lymph nodes in the stomach area. i think that is why i am like ok well why can i feel mine
Doctor :   i understand
Doctor :   but there is no real reason to be worried at all
Doctor :   u can stop worry now and take rest and relax and enjoy your motherhood
User :   thanks. :) i was going to say that the lymphocytes were 18 on the differential cbc i had done not too long ago but wbc and rbc were normal range
User :   is that of any significance
Doctor :   both are within normal range
User :   ok good. the range for lymphocytes showed that 18 was low but i guess it varies for different labs
Doctor :   yes
Doctor :   its a cause to be worried only if they are very high
Doctor :   a low DLC could be due to elevated other cells due to associated infections, etc
User :   all my labs have always been normal but low normal. such as the rbc and hemoglobin and the lymphocytes this time
User :   but not lymphoma or leukemia
User :   sorry you are probably thinking i know way too much about this...i work in a doc office
Doctor :   thats completly normal
User :   ok
Doctor :   that is fine
Doctor :   people should have knowledge about such stuff
Doctor :   it seems that since you see a lot of patients, you are extra cautious as well
User :   i agree. one more question...if the nodes that i feel everywhere (stomach, under arms etc) feel the same on each side, does that probably mean no cancer or problem with the nodes? and let's say if i did have lymphoma, would the nodes grow quickly or over a long period of time
Doctor :   in such case of lymphoma, u dont have superfical nodes '
User :   yes i think that is why i am turning into a nervous ninny...because i work in the medical field
Doctor :   you will ahve enlarged nodes within the chest as well as the deep pelvic and abdominal nodes as well
Doctor :   these nodes will be evident in the chest X ray and CT scan if done
User :   but i am ok because i can feel mine? i just hate that i can feel them!
Doctor :   lymphoma DOES not present with superficial node enlargement
Doctor :   if u feel too worried then u can consult a surgeon and can have them removed surgiallly
Doctor :   i hope i have solved ur quries
Doctor :   bye for now
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