Brief Answer: Chronic infection, investigations required Detailed Answer: Hi XXXX Thanks for writing to HCM. I went through your query and understood your concerns. As in your case previous lymph node study was normal , its a good sign. Not to worry. Enlarged lymph nodes indicates infection which is not adequately treated for long time resulting in chronic infection, repeated infection can result in enlarged lymph nodes. If a patient comes to me with these symptoms first I would like do completely physical examination to check for source of infection: throat infection, any tooth caries, nasal sinus, ear examination. So first I would like rule out source of infection first order including Tuberculosis, HIV as well. As your lymph node biopsy is negative for malignancy, I would still like to order an excisional biopsy by removing the lymph node completely and sending for HPE by pathologist. Your above mentioned symptoms are common in infection or other immune abnormalities. I would like get few test done complete blood count, TSH, ultrasound abdomen, ECG and stress test for heart. Depending on these would like to get hormonal assay as you are mentioned about increased hair growth Once cardiac problems are ruled out common cause for chest pain is gastric acid reflux. Acid reduction medications do help in reducing your symptoms. Head ache if its a recent onset need to get eye refractive test and sinus examination done. Chronic headache common cause is migraine in females. Please take my opinion to your primary physician. Wish you a good health Regards

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