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What do enlarged lymph nodes above the collar bone indicate?

DOCTOR OF THE MONTH - Jun 2015
Jun 2015
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General & Family Physician
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i have lymph node infection on right collar bone. i have gone through tests like FNAC, NO TUBERCULOSIS INFECTION,BUT PUS FORMATION IS THERE.
Posted Wed, 19 Feb 2014 in Medicines and Side Effects
 
 
Answered by Dr. Polash Sannigrahi 1 hour later
Brief Answer: Send pus for culture-sensitivity,start antibiotics Detailed Answer: Hello XXXXXXX Thanks for your query. Enlarged lymph nodes above the collar bone is known as Supraclavicular lymphadenopathy. It is suggestive of: 1. Infections: like Lung infection, Tuberculosis, Sarcoidosis, etc. 2. Cancer: like Lymphoma, cancer of Lung, Breast or distant metastasis from Gastrointestinal tract. Kindly let us know about the following: 1. Are there similar lymph node enlargement/infection in other parts of the body? 2. Any positive family history of cancer of breast, lung, colon, etc.? 3. Habit of smoking or drinking alcohol? 4. Any associated symptoms like fever, night sweats, joint pains, cough, breathlessness, irregular bowel habits- constipation/diarrhea, nausea, vomiting? 5. Did you notice any significant loss of weight or apetite? If your answers to the above mentioned questions are NO, then the lymph node swelling can be attributed to local infection. Kindly consult your General Physician & get a proper clinical examination done to detect the source of infection. As you have already undergone FNAC, which has ruled out Tuberculosis & has revealed the presence of pus formation. So, the pus can be sent for culture and sensitivity reports. Based on the results obtained, specific antibiotics can be started to tackle the infection causing agent. There is no need to worry, you will be fine. Please let me know if I need to clarify further. Take care.
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Follow-up: What do enlarged lymph nodes above the collar bone indicate? 10 hours later
i dont have fever,weight loss,night sweats, joint pains. ultra sound scanning was done on abdominal region, no lymph node infections x-ray was taken on chest region, lungs are clear culture was given, there is no infection like fungi, acid fast bacilli
 
 
Answered by Dr. Polash Sannigrahi 2 days later
Brief Answer: Kindly view the details Detailed Answer: Hello XXXXXXX Thanks for your follow up query. Given the fact that you do not have any associated clinical symptoms, the investigations like X ray & Ultrasound scan reveals a Normal study and the pus culture does not show any fungi or acid fast bacilli, the pus formation in the lymph node can be attributed to lymph node abscess secondary to a local infection which has now subsided. So, kindly consult your Doctor & get a proper clinical examination done. If it does not subside with antibiotics, then the pus needs to be drained or the lymph node can be removed surgically. There is no need to worry. Wishing you a good health. Take care.
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Follow-up: What do enlarged lymph nodes above the collar bone indicate? 8 hours later
thank you sir before i told the repot of bacterial sensitivity and culture. This was the result of FNAC FNAC report : smears show predominantly necroinflammatory exudate comprising of dense neutrophils and necrosis and also seen epiheloid cell granulomas and histiocytes.ZN stain for AFB shows scattered beaded pink bacilli.
 
 
Answered by Dr. Polash Sannigrahi 2 days later
Brief Answer: Lymph node Tuberculosis-start ATT Detailed Answer: Hello XXXXXXX Thanks for your follow up query. Necro-inflammatory exudates along with presence of epitheloid cell granulomas and histiocytes is indicative of Granulomatous inflammation. The scattered beaded pink bacilli seen in ZN stain are the Mycobacterium (TB bacilli). Based on the FNAC report, the lymph node swelling can be attributed to Lymph node Tuberculosis. According to W.H.O guidelines, Lymph node Tuberculosis is managed with 2 months of Isoniazid, Rifampicin, Pyrizinamide & Ethambutol + 4 months of Isoniazid and Rifampicin. The doses need to be adjusted based on your body weight. So, it will be advisable to discuss with your Doctor & start Anti Tubercular Therapy. There is no need to worry, you will be fine. Wishing you a good health. Take care.
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