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Will continuous growing lymph nodes in lungs cause lymphoma?

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General & Family Physician
Practicing since : 2012
Answered : 3207 Questions
My son has several enlarged lymph nodes in his chest lungs and he has fat infiltration of his liver with an enlarged spleen his CRP is high and his hct is low. Hey first suspected histoplasmosis but after how testing negative for it and lymph nodes continuin to grow should we be looking at lymphoma? He goes for more scans tomorrow
Posted Thu, 26 Dec 2013 in General Health
Answered by Dr. Shafi Ullah Khan 1 hour later
Brief Answer: Too early to diagnose. Biopsy and scans needed Detailed Answer: Hello there! Thank you for asking. I read your query. You have provided the symptoms and presentation of the 16 years old kid. The odds of lymphoma can not be neglected but it would be too early to call that lymphoma. Low hematocrit, enlarged spleen and liver infiltration and increased CRPs and ESRs are point to this lymphoma though. But as I said it would be too early as many other pathologies like Infectious mono, Cytomegalovirus, Toxoplasmosis, Tuberculosis etc can have similar presentation. So I suggest scans includimg PET scan. And Lymph node biopsy preceded by FNA and bone marrow biopsy would be necessary to see exactly what it is. Also pleural fluid aspirate and CSF needs to be evaluated. A complete blood work up with Cytokine studies like XXXXXXX & 6 and CD25 are required and a good diagnostician. But the odds of the lymphoma are high here. Lets not hush to the diagnosis and wait for the scans and biopsy results. Good Luck and i hope i answered your query. If you have any more queries please feel free to ask other wise kindly close the discussion and rate the answer as per your experience. Take some very good care of your son. Regards S Khan
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Follow-up: Will continuous growing lymph nodes in lungs cause lymphoma? 8 hours later
A small needle biopsy was done and did not grow the histoplasmosis fungus, he has had 4 scans and rachnine show new lymph node masses. One is 3cmx3cm between his heart and airway that being the biggest of them. The rest are in his lungs. He is having an mri and ct scan today. His legs hurt just walking less than 100ft. He has feveres pop up from bo where and i will attach a photo of a rash they recently biopsied but the only thing pathology showed was severe inflammation.
Answered by Dr. Shafi Ullah Khan 1 hour later
Brief Answer: Lets wait for the scans results Detailed Answer: hello again! The histopathology reports for the rash are clear except for inflammation is because these dermatological manifestations are secondary to the disease which involves lungs. And i want you to know that small needle biopsy is not enough to diagnose. though it is started with. Now the next step should be excisional biopsy of an entire lymph node and 2 or 3 minimum lymph nodes and if possible with Video Assisted Thoracoscopes assisted biopsy of Hilar lymph nodes would be more specific for the histopathology. And one should keep in mind the many other etiologies for these manifestations like Infectious mono, toxoplasmosis , Churg strauss, wegeners, Hypertrophic osteoarthropathies or tuberculosis etc but to reach that diagnosis your doctors are active and working doing and all these MR and CT scans are for that purpose and it will need some more work up as i mentioned in above answer so be patient and stay in touch. That leg pains on less than 100 ft walk is explained because of fever and lung involvement. Body is stressed and fatigue. illness does that. No worries this issue will resolve Let the kid rest and wait for the result of the scans. And don't worry these dermatological/ skin manifestations are secondary to the lungs pathology there are many which does that. once that cured skin will regain its texture. May the odds be ever in your favor. Kindly close the discussion if you have no more queries to ask. i was happy to be of some help Take some very good care of your kid. Regards Dr. S Khan
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Follow-up: Will continuous growing lymph nodes in lungs cause lymphoma? 17 minutes later
Thank you for your indepth insight. All the other doseases you have mentioned such as TB, mono etc have all been done and ruled out as well as any and all types of molds. The histoplasmosis is now testing negative yet he continues to have more lymph nodes show up. The dr would not listen to us about testing him for cancer even after him knowig my moms side most of her aunts and uncles died of leukemia,so we went to a new dr. He is the one ordering all the scans and setting us up for a bone marrow biopsy.
Answered by Dr. Shafi Ullah Khan 1 hour later
Brief Answer: Lets hope for the best Detailed Answer: hello again! As you mentioned all the etiologies have been ruled out then I am sure the malignancy odds add up superseded by the family history of blood disorders. And I appreciate your decision to change the doctor and opting for the one who listens to you and cares for you. stay with this doctor, his approach is appreciating and totally trustworthy. Bone marrow biopsy is a good option, Consult him about the excisional biopsy too. Now its all up to histo-pathology and the scans. I am sure you are in safe hands. i personally think it is lymphoma as fever, exaggerating nodes, all excluded differentials, and a typical presentation all points to that. Good Luck. keep asking until you find the inner satisfaction about your kid as he is your family and my patient is mine. Other wise i request you to kindly close the discussion and rate the answer as per your experience. regards S Humble Khan
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