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What are the bumps on my neck?

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Practicing since : 2007
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I am sorry I have asked this once before but I am not connecting it together. .. so putting it in one question. First - I have lupus and Postural orthostatic tachycardia syndrome . ( just so you have my history ) and I question the lupus diagnosis because I do not have antibodies - but I have a positive ANA with many symptoms so the rheumatologist has me on plaquenil- I take it. for the past 6 months I have noticed that my left tonsil is swollen. probably 50% bigger than my right one. and it has HUGE crypts in it . one of the crypts makes the tonsil look kind of funny it almost looks like there is a cyst on the top part of my tonsil but the crypt looks like its so deep that it kind of folds in. the one on the left looks kinda heart shaped (like the top of a drawn heart or the back of a number 3 ) this is starting to concern me because I have SO Much fatigue all the time. I have had blood work in the past and this is what it shows CBC is normal - but my hemoglobin/hematocrit is always low Ferriton - 4.6 (low) normal 9.0-150 TIBC- 437 High - normal is 210-415 Iron 27 (low ) normal is 30-140 Transferrin Saturation was 6 (low) normal is 11-46 Not only do I have the large tonsil on my left (again about 50% ) bigger than my right I am also SO so tired all the time. BUT and this is what I found new and concerning - right around each of my carotid arteries if I push down a few centemeters (and I have a thin neck I would say) I can feel this "flap" like bump on EACH side of my neck. the top of it moves and I can flap it back and forth (left to right ) but not up and down. its longated not round really . more like an oval . it doesn't hurt - on the OHTER sie of my neck in basically the same place I can feel another one . about the same size too (maybe a centimeter) I am starting to really get worried about having lymphoma. I don't have really many low grade fevers (I do sometimes but maybe that's my lupus) But I do not have night sweats. I get flu like SOMETIMES but when that happens all my joints hurt too. SO could I have lymphoma in the past I have had other blood work such as this ESR- 29 CPK 0.1 ANA 1:80 speckled then 1:360 speckled then 1:160 speckled I have whats called Polycolonal gammapathy with slightly elevated IgG levels (not sure what that even means) I have had negative chest xrays , negative CT of my abdomen and pelvis and negative CT of my sinus's this past year. im very scared to have cancer. I am a 27 year old non smoking or tobacco user female.the flaps on my neck feel like their attached to the neck tendons?
Posted Thu, 6 Mar 2014 in Lupus
 
 
Answered by Dr. Jorge Brenes-Salazar 2 hours later
Brief Answer: Define what the lumps in the neck are Detailed Answer: Dear XXXXXXX Thanks for the query. The first thing that needs to be done is define what are the lumps in the neck. Is it a lymph node? Is it a cyst? Is it a vascular structure? A physician by means of physical examination can have an idea. If it is a lymph node, then usually in young people unless there are worrisome features such as ulcerations, rapid growth, non-mobile, large (eg more than 2cm) rubbery lymph nodes, observation is the way to go. A neck ultrasound may help. In 6 to 8 weeks, it they have not subsided, and are the same size or larger, a small needle biopsy can be considered. Hope that helps, wish you the best, Dr Brenes-Salazar MD Mayo Clinic MN
Above answer was peer-reviewed by
 
Follow-up: What are the bumps on my neck? 2 minutes later
did you see my original post ? if not here it is below - I don't know what the lumps are they have been there for a year with no change my original post mostly has to do with my tonsnil here is the original posting am sorry I have asked this once before but I am not connecting it together. .. so putting it in one question. First - I have lupus and Postural orthostatic tachycardia syndrome . ( just so you have my history ) and I question the lupus diagnosis because I do not have antibodies - but I have a positive ANA with many symptoms so the rheumatologist has me on plaquenil- I take it. for the past 6 months I have noticed that my left tonsil is swollen. probably 50% bigger than my right one. and it has HUGE crypts in it . one of the crypts makes the tonsil look kind of funny it almost looks like there is a cyst on the top part of my tonsil but the crypt looks like its so deep that it kind of folds in. the one on the left looks kinda heart shaped (like the top of a drawn heart or the back of a number 3 ) this is starting to concern me because I have SO Much fatigue all the time. I have had blood work in the past and this is what it shows CBC is normal - but my hemoglobin/hematocrit is always low Ferriton - 4.6 (low) normal 9.0-150 TIBC- 437 High - normal is 210-415 Iron 27 (low ) normal is 30-140 Transferrin Saturation was 6 (low) normal is 11-46 Not only do I have the large tonsil on my left (again about 50% ) bigger than my right I am also SO so tired all the time. BUT and this is what I found new and concerning - right around each of my carotid arteries if I push down a few centemeters (and I have a thin neck I would say) I can feel this "flap" like bump on EACH side of my neck. the top of it moves and I can flap it back and forth (left to right ) but not up and down. its longated not round really . more like an oval . it doesn't hurt - on the OHTER sie of my neck in basically the same place I can feel another one . about the same size too (maybe a centimeter) I am starting to really get worried about having lymphoma. I don't have really many low grade fevers (I do sometimes but maybe that's my lupus) But I do not have night sweats. I get flu like SOMETIMES but when that happens all my joints hurt too. SO could I have lymphoma
 
 
Answered by Dr. Jorge Brenes-Salazar 5 minutes later
Brief Answer: Query tonsillar lymphoma Detailed Answer: Tonsillar lymphomas typically present as you are saying with a big disparity in the size of tonsils, or asymmetry, but there are usually symptoms associated including changes in the voice, difficulty swalowing, weight loss, night sweats, fevers, the so called B symptoms of lymphoma. You do not mention any of those. The shape of tonsills can be quite bizarre, particularly if you have had repeated sore throats in the past, so although they look strange, they might just be cryptic tonsills with hypertrophy. An ENT can take a closer look inside and determine if the appearance is pathologic or benign
Above answer was peer-reviewed by
 
Follow-up: What are the bumps on my neck? 7 minutes later
thanks - I am going to go see the ENT next wed. and see what he has to say just trying to stay hopeful
 
 
Answered by Dr. Jorge Brenes-Salazar 24 hours later
Brief Answer: God speed Detailed Answer: Very good XXXXXXX it is best to have an optimistic attitude; by worrying until then, you won't accomplish any additional benefit. Best of luck, wish you the best
Above answer was peer-reviewed by
 
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