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Had hodgkin's disease. Have enlarged nodes in left groin, mild fever. Blood work done. Looking for suggestion

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Practicing since : 2002
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Had Hodgkins Disease 23 years ago - cheom and radiation - mass was in my chest - node in left clavical - Now enlarged nodes in left groin - 1.9 and 1.7 - not painful - hard - ultrasound said Nodal morphology and echogenicity is consistent with a lymphoproliferative process. So I am going for a biopsy - taking out whole node - could be lymphoma or leukemia---had a low grade fever - highest 99.2 a few nights - last blood work was from hospital 6/21/12 - was there for tachycardia -

WBC 10.9

REC 4.68

HGB 13.7

HCT 41.4

MCV 88.4

RDW 13.7

PLTS 312'MPV 8.5

Seg Neut 76.0

Lymph 16.0

Mono 7.0

Eosin 0.0

Baso 1.0

Neut# 8.3

Lymph # 1.7

Eosin 0.o

Baso # 0.1

From Drs office 6 days eariler

WBC 8.7

RBC 4.49

HGB 13.3

HCT 39.1

Mcv 87.2

PLT 3332

LY% 36.2

MOn% 7.0

Gran# 56.8

LY# 3.1

Mon# 0.6

Gran# 4.9

NA 138

K 4.7

CL 101

CO2 31

Bun 15

calcium 9.9

Phosph 3.2 Total Protein 6.4

Alb 4.1

LDH 167

ALF 67

AST 14

tsh 2.071

Beta 2 microglob 1.63

ALT 17



Direct Bilirubin 0.1

Bilts 0.25

Creat 0.6

Also was in hospital on May 25th for tachycardia and WBC was 17,000 said it was from the stress of the episode of the high heart rate and BP the went to doctors and you see the results went down to 8.7-----so yes I could have Lymphoma or Leukemia---do you have a feeling or though on this with my tests- Ultrasound done today on ovaries uterus spleen pancreas liver and kidneys - all normal except small benign appearing hypoechoic nodules 1 cm and 1.8 cm involving the liver that are unchanged since 5-11-11... some thoughts?? Very nervous and scared Thanks XXXXXXX
Posted Fri, 20 Jul 2012 in Lymphoma
Answered by Dr. Robert Galamaga 1 hour later
hello and thank you for submitting your question.

Your question is a good one and I will work on providing you with some information and recommendations regarding what is going on.

Based on your laboratory studies I do not see any obvious signs that there is lymphoma involved in your bone marrow.

You do have a history of a type of lymphoma which usually responds very well to chemotherapy and radiation. There is a good chance that this can be cured with chemotherapy and radiation but a small percentage of patients may have a relapse

In your case it is very difficult to determine if the symptoms you're having including the swelling of your lymph nodes represents a recurrence of your lymphoma or some type of other process such as a mild infection or mild inflammation.

The only way to adequately find out what is going on would be to perform the biopsy procedure and then have a pathologist analyze the tissue under a microscope.

I want to reassure you know that even if the biopsy result is positive for lymphoma there are still treatment options for you. It would be premature to discuss the treatment right now until a final diagnosis is made.

For now I would worry about maintaining good general health including getting adequate exercise, eating a well-balanced diet and sleeping every day for at least 6 to 8 hours. This type of lifestyle will support your immune system and will enable you to overcome any challenge which comes in your direction.

I thank you again for submitting your question. Again it is impossible to predict what the results of the biopsy procedure will be and as I mentioned earlier there does not appear to be any active lymphoma in your bone marrow. If there was lymphoma in your bone marrow we would see significant changes in your blood counts.
At the same time just does not completely rule out the possibility that there still could be some active lymphoma in your lymph nodes.

Again I thank you for Submitting your question. I hope you found this response to be helpful and informative. If you have additional concerns I would be happy to address them as well.


Dr. Robert
Above answer was peer-reviewed by
Follow-up: Had hodgkin's disease. Have enlarged nodes in left groin, mild fever. Blood work done. Looking for suggestion 16 hours later
Thank you. PLT was 332 sorry I said 3332.... Nervous.......appreciate you answer....yes hodgkins 23 yrs ago and not one problem since till now. Tachycardia ...up to 195...and on and off high bp from treatment.....cardizem and toprol now...toprol making me so achey and awful headache.....forgot to mention a 1.0 node was on other groin to....with other tiny ones.....checked to again a few days later nothing changed....but the tiny ones were not as prominent. If this is not a lymphoma said groin nodes can be from anl cancer rectal ovarian uterus cancer and kidney cancer...correct? I don't want to be so negative but the nodes are large don't hurt and pretty fixed.....hard to be positive....... Lastely was sick beginning of may were severe sore throat and feeling awful.....took awhile to bonce back......but if it w n infection these nodes would be tender.
Answered by Dr. Robert Galamaga 6 hours later
Hello again and thank you for your question.

I completely understand that you're dealing with a high degree of anxiety related to what is going on. I would discourage you from speculating regarding what things could be going on until we have a real answer.

You are correct that usually tender lymph nodes are related to infection. this is not always the case however. I am not trying to ignore the concern regarding some type of malignancy or some type of lymphoma going on but I preferred that you remain optimistic. Maintaining a good positive state of mind will serve you very well both psychologically and physically.

Again if this happens to be lymphoma there are many possible treatment options. You are a very healthy person and I want you to really focus again on maintaining and preserving your health right now while your physicians do the best that they can to accurately characterize and diagnose what is going on.

I will await additional information if you can provide it related to results from a possible biopsy. We can then discuss what is going on and possible treatment if indeed any treatment is indicated.

I thank you again for submitting your question. I am sorry you're dealing with this degree of stress and anxiety. I am optimistic that in the future things will be better for you.


Dr. Robert.
Above answer was peer-reviewed by
Follow-up: Had hodgkin's disease. Have enlarged nodes in left groin, mild fever. Blood work done. Looking for suggestion 11 minutes later
Thank you....I will be back after biopsy......what has me down is what I said the ultrasound report's there they see an abnormal can that be wrong?? It's like I already know the end result....the node appeared black with just alittle specks of white popping thru.....sorry to be so negitive.....
Answered by Dr. Robert Galamaga 21 hours later
Hello and thank you for your follow-up question.

The radiologist commented that the lymph node appeared abnormal. This is not a conclusive statement which indicates the presence of malignancy. It does however provide us with a reason to investigate this further with the biopsy. Again even in the worst case scenario there will be treatment options. In a best case scenario this is a benign enlargement of lymph nodes. I know this provide you with hardly any degree of comfort right now but I am trying to help you beat both realistic and somewhat optimistic at the same time.

I again remain available for discussion of the upcoming results.

Dr. Galamaga
Above answer was peer-reviewed by
Follow-up: Had hodgkin's disease. Have enlarged nodes in left groin, mild fever. Blood work done. Looking for suggestion 3 hours later
Thank you ... you have helped a lot. Today I called my oncologist cause I feel like I have some swelling in upper thigh...node pressing on something?? I can't believe he didn't Call me. I was nervous all day......he's been great over the 23 yrs but when I complain about things now he just says live life and enjoy....I do! But if I don't feel good I have to tell him....frustrating.....I feel he has abandon me. But I will worry about that later. I understand what you are saying about the node but I did see was ugly......very black no white....just a few tiny dots of white here and can an ultrasound lie??? Sorry I am dome and gloom but I feel the proof is's not like it's's round and black and hard and fixed.....if you can tell me anything on this awful node please do.

Thanks again......
Answered by Dr. Robert Galamaga 12 hours later
Thanks again for your question.

The swelling could possibly be related to swelling of the lymphatic system but I suspect that also your senses are heightened and you are likley very sensitive to even slight symptoms. It is a fine choice to ask the oncologist for advice. If he is not able to respond, maybe one of his nurses might be available to help you.

Only a radiologist can interpret the lymph node. An ultrasound of a node can look very irregular under ultrasound. Again - patience is important here. Nothing more to add until a biopsy is obtained.

Thanks again,


Dr. Galamaga
Above answer was peer-reviewed by
Follow-up: Had hodgkin's disease. Have enlarged nodes in left groin, mild fever. Blood work done. Looking for suggestion 47 hours later
Thanks again. Biopsy Monday. So nervous.....did another CBC....

Esr was 11 in march is now 14

Nodes checked again yesterday....Same size

WBC 7.1
Rbc. 4.30
Hgb 12.8
Hct 42.1
Mcv 98......?
Mch 29.8
Mchc 30.4
PLT 313.0
Ly% 34.2
Mon% 5.3
Gran % 60.5...??
Ly# 2.4
Mon# 0.4
Gran# 4.3....??

Any input on blood work....
I know blood work can be norml and still have lymphoma

Esr tell anything in this case....

Again I am assuming cancer....maybe will get a surprise.....but radiologist said its a sick looking node....

Thanks again XXXXXXX

Answered by Dr. Robert Galamaga 20 hours later
Hello again and thank you for your follow up with additional information.

Again as you know it is difficult to assume anything from your CBC. The numbers all look fine. Regarding the sedimentation rate I would regard this result as essentially the same as the last one.

You are correct that we cannot assume anything at this point but again I don't want you to focus on the negative prospects. Again even if there is evidence of lymphoma this is extremely extremely treatable.

Please let me know the schedule of your follow-up appointments and any additional questions you might have.


Dr. Robert

PS I see you are from the great state of Rhode Island. That is where I spent the first 18 years of my life. It's a beautiful state!

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