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Sore, swollen lymph nodes in arms, taking insulin for diabetes, enlargement of xiphoid process. What specialist do I need to see?

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Internal Medicine Specialist
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I have noticed sore and somewhat swollen lymph nodes in the bicep region of both arms over the past several weeks. I was diagnosed with diabetes approximately 5 months ago and am on insulin and Byetta. Since then my labs are all good, but soreness in mid back and under the rib area on left side and these lymph nodes in my arms. No other noticeable lymph nodes, although the soreness in the back may involve lymph nodes. I also have noticed an enlargement of th xiphoid process, visible when undressed. What could this mean, and what kind of specialist do I need to see? My family doctor said "not to worry" but I am worring. No hx of cancer in family, but concerned.
Posted Tue, 17 Jul 2012 in General Health
Answered by Dr. Sudhir 10 hours later

Thanks for the query.

1. Enlarged nodes are commonly due to infection, inflammation or rarely due to cancer. Routine blood tests can be normal in such cases. Possibility of cancer seems less likely, as there would have been associated cancer symptoms by now. If you are concerned getting it checked with an ultrasound scan / fine needle biopsy will reveal the true nature of this lump.

2. Since you have pain in the rib and mid back region, I think possibility of chest infection should be considered as first possibility. A detailed chest examination and chest X-ray needs to be done to evaluate this.

3. Enlarged xiphoid process without any symptoms does not concern me. It is also not related to the nodes in your arm.

4. In my opinion you need to consult a general physician / chest physician. The doctor can tailor investigations for you after clinical evaluation.

Hope that answers your question. Let me know if you have any other concerns.

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