Brief Answer: Considerations Detailed Answer: Hello and thank you for sending the question. I can understand why you have some concerns about the laboratory findings. Honestly, many individuals will have these types of findings in the setting of a normal blood count. What you are seeing are very subtle abnormalities and by abnormal it just means that they are slightly outside the calculated laboratory range. I understand you are having some symptoms with itchy legs, night sweats and diarrhea. A single swollen lymph node is something to watch but does not necessarily reflect cancer. I see no convincing evidence of active cancer based on this single complete blood count. Regarding the AST, a low AST does not indicate a disease process or cancer. Again the AST will fluctuate from time to time and in many individuals it will be slightly high or slightly low as it is in your case. Regarding the osmolality it is possible this might reflect some type of fluid imbalance although this is something which should be reviewed by your primary care doctor and possibly with correlation to your Comprehensive metabolic panel. A comprehensive metabolic panel evaluate your electrolytes as well as kidney function. If this has been done this would include your sodium, potassium, chloride as well as creatinine which is a function of kidney function. You might also see a measure of glomerular filtration rate. This is an estimated of how well the kidney is filtering fluid and producing adequate urine. If you are concerned about the lymph node and the fact that it has been present for months you might ask your doctor for a referral for some imaging including an ultrasound. If the ultrasound reveals a lymph node which is within a size range of concern that he might recommend a biopsy from a surgeon. Again I do not see any convincing signs of cancer. I understand you have some symptoms which are not explained fully and I encourage you to continue to talk your doctor about this. In the meantime it is also critical that you maintain a very healthy and active lifestyle. This includes eating adequate well-balanced diet and exercising at least 4 days per week with adequate sleep at least 6 hours per night. All of these lifestyle habits will help promote your immune system and healing which your body has a natural tendency toward. Sincerely, Dr. Galamaga

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