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Found swollen lymph gland behind clavicle. Clustered on right side. Report shows old node appears infiltrated. What does it signify?

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One swollen lymph gland discovered behind clavical on right side i.e. neck mass....waited 6 weeks to recheck if it changed size, etc, which was today, and now have two additional lymph glands all clustered in same area fairly good sized. Prelim report from radiologist states old node appears infiltrated and is grossly stable. Two new adjacent hypoc??? are concerning for new infiltrated LNo What do these findings signify and, what is infiltrated?
My doctor has suggested, since we are fairly certain nodes are solid w/no fluid, that biopsy may not be certain definitive....god forbid, this could me a metasis,,.so, we discussed on the phone today and he suggested a Pet Scan...scares me, as I do not want to go on a fishing expedition to look for cancer; however, no way of knowing any info definitive without doing the Pet scan. Also, it is 2:30 a.m. and I must go to bed....I will see answer tomorrow and submit additional info after reading answer.
FYI, the sizes of the lymph nodes are: 1.4 m (original) and two new ones are 1.0 and 1.3.........deeply concerns me, too, that two new nodes developed and grew to the sizes above in just 6 weeks. Is that considered aggressive or norm? Thanks for your good help and medical opinion and I will check back in morning. I live in California.
Posted Tue, 22 Oct 2013 in Medicines and Side Effects
Answered by Dr. Hari Charan Perigela 2 hours later
Brief Answer:
Get an FNAC

Detailed Answer:

The lymphnodes in the neck are enlarged in many conditions like Infection,Tuberculosis,Lymohoma,Cancer .

Correct diagnosis will be made by Pathological examination only.

Initially,FNAC (Fine needle aspiration cytology)is preferred. If it is inconclusive,biopsy has to be done.
Depending in these reports,you can go for PET Scan.

It looks like a simple infective disease.

I start with antibiotic and anti inflammatory medicines to my patients with similar complaints.

Hope i answered your query.

Further questions will be clarified.

Wish you good health

Above answer was peer-reviewed by
Follow-up: Found swollen lymph gland behind clavicle. Clustered on right side. Report shows old node appears infiltrated. What does it signify? 12 hours later
As I understand, a fine needle biopsy is usually used for lymphy nodes that appear to have fluid in them...then usually they are cysts. As I stated in my original questions above, mine are solid masses, FNAC would not be revealing nor the appropriate avenue for testing. I am greatly concerned that the one node, discovered accidentally on 8/13/13 was shocking and following conservative path, doc and radiologist suggested to wait six weeks and re ultrashould...6 weeks was yesterday and two new nodules were discovered with the old one....sizes and location are noted in my original question....common sense tells me this is more than an the growth of two new nodes in 6 weeks common or aggressive and/or what do you think? Could it be a metasis from another part of body? Very frightening...please respond again..thank you
Answered by Dr. Hari Charan Perigela 6 hours later
Brief Answer:
FNAC is the best diagnostic tool

Detailed Answer:

Fine needle aspiration Cytology(FNAC) is a simple needle test which aspirates material from any swelling and give the result.It is helpful in both solid and cystic lesions any where in the body.For example,Cancer in the breast which presents as a hard mass is diagnosed by FNAC only.

Lymphnodes are present in various parts of the body like neck,groin,axilla,abdomen etc.They get enlarged in various conditions.

The role of Ultrasound in the body is to differentiate a swelling ,whether it is Cystic or Solid.It cannot say whether it is due to cancer or not.The confirmatory test is FNAC/Biopsy.

If FNAC is inconclusive,then Biopsy should be done.

Most probably,the infection has spread from one lymphnode to another .

I have seen hundreds of cases of cervical lymphadenopathy.In our area,Tuberculosis is the commonest cause.It will be diagnosed by FNAC only.In cases of Lymphoma,whole lymphnode should be removed and send for Biopsy.But,a good pathologist will diagnose most of the Lymphnode conditions by FNAC.If he has suspicion of Lymphoma,then he will ask for Whole lymph node.

If the pathologist finds it difficult to aspirate directly,he can do FNAC under Ultrasound guidance.

But,i request you to consult a surgeon,get one lymphnode removed and send it for Biopsy.It is simple.

No other test in the world is as accurate as histopathological examination in differentiating Cancer and Noncancerous tissue.

It is common for the lymphnodes to get enlarged as a group .Growth of 2 new nodes is very common.

Nothing to worry.

Biopsy will confirm whether it is cancerous or non cancerous.

If you have any questions,i will answer .

Wish you good health

Above answer was peer-reviewed by
Follow-up: Found swollen lymph gland behind clavicle. Clustered on right side. Report shows old node appears infiltrated. What does it signify? 48 hours later
Last set of questions...received copy of radiological report - it says right supraclavicular lymph node that measures 14x9x11 is essentially stable in size. This tymp node appears to be infiltrative without signifcant fatty hilus remaing and there is a thick cortex (what does thick cortex means and what is the node infiltrative with). Two adjacent hypioechoic nodules of 10mm and 13 mm in maxiumum length are noted with irregular lobular contour & without definite fatty hilus concerning for new infiltrated lymph nodes. The IMPRESSION: In the right supraclavicular area there are now three infiltrated appearing lymph nodes, two of them are new when compared to August 13. Please clinically correlated. Consider further correlation with neck CT with contrast versus PET/CT scan. What does the above mean to you as a surgeon? What is a thick cortex? Please address my questions above...This is my last shot to receive your medical opinion. Before my time clock ends - yesterday I had over a day left, would appreciate the last set of questions, above, to be responded to. Thanks
Answered by Dr. Hari Charan Perigela 24 hours later
Brief Answer:
Cortex is the outer layer of the lymphnode.

Detailed Answer:

At the end of the report,it is written as to correlate clinically.

So,definitive diagnosis will be made by Biopsy only.

Please consult a surgeon and proceed further.

Hope it is a simple non specific lymphadenitis.

Above answer was peer-reviewed by
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