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CT scan showed lymphoid tissue in throat behind tongue, sleep apnea, lump in neck. Why is my doctor not doing biopsy?

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Practicing since : 2003
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I had ct scan which showed excess lymphoid tissue in throat behind tongue that pushes on glottis and narrows my airway. They said this is what causes my sleep apnea. I was referred to this surgeon to rule out lymphoma because in addition to this i also have a lump on the side of my neck that is not a cyst or fat deposit. He used endoscope and confirmed what ct scan had shown but said it is nothing to worry about, that it was abnormal but normal for me. Why would he not do the biopsy i was referred for and why would this be something i should not worry about?
Posted Wed, 18 Apr 2012 in Ear, Nose and Throat Problems
Answered by Dr. Gyanshankar Mishra 8 hours later

Thanks for posting your query.

After going through your query, I would like to comment the following:

1.     Increased neck circumference is a risk factor for sleep apnea.

2.     Since there are no other features on CT (Computerized Tomography) suggestive of lymphoma and the local characteristics on endoscopic inspection would not have revealed any suspicious elements, hence your surgeon was confident in ruling out the possibility of lymphoma.

3.     I also suggest here that you get your lymph nodes clinically examined by your physician and if found to be enlarged, an FNAC (Fine Needle Aspiration Cytology) would be an ideal investigation.

4.     For sleep apnea, I am sure you must have evaluated yourself and would be currently on treatment for the same, e.g. CPAP (Continuous positive airway pressure) therapy.

5.     Hypothyroidism being a risk factor for sleep apnea should also be under optimum treatment.

6.     Coming back to the throat swelling, I would like to inform you that carrying out biopsies of throat swelling has a significant risk of aspiration & bleeding post biopsy. However an FNAC can be done from the swelling, if there is any suspicion of an alternative etiology.

7.     Also you need to do a regular follow up with your Physician for at least 2 years to monitor the swelling clinically.

I hope I have answered your query. I will be glad to answer any follow up queries.

Please accept my answer if you have no follow up queries.

Regards and take care.

Dr. Gyanshankar Mishra
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