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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diagnosed With Thyroid Cancer. Had Total Thyroidectomy, Ablation. Having Lumps On Collarbone, Upperchest Which Are Movable, Painless. What Could This Be?

Hi! I m a 38 yr old woman, dx d with papillary thyroid cancer 6/2011, total thyroidectomy followed by I-131 ablation in 10/2011. Clear PET 11/2011. In September, I noticed a small, pea sized lump on my right collarbone. It s movable and rubbery. In a month, it grew to about 1.5-2.0 centimeters. I ve been experiencing low grade fevers in the late afternoon, followed by night sweats (not always drenching, but sometimes), feeling like I have to flu without being sick, odd chest pain that comes and goes, as well as general itchiness all over. Had a CT scan of head/neck (negative), PET scan (negative), blood work (high lymphocytes/Eosinophils; low monocytes/neutrophils) otherwise pretty normal. Head/neck MRI (positive for sub-centimeter nodes in neck). I had a chest xray and chest CT with contrast last night and I see a pulmonologist on Monday. Now, my right collar bone area is puffy. Along with the large lump, there are 2-3 more lumps...however, they are painless, movable and rubbery-ish. There are now 2-3 small, harder lumps on my upper chest near my sternum as well. These new ones just popped up in the last day or two. With everything going on, could this be Lymphoma? I ll find out if either the ENT or the Pumonologist is going to preform an excisional biopsy sometime next week. But, I have no idea when. Any thoughts on what could be wrong? We ve ruled out infectious diseases and viral/bacterial infections. Ruled out Lupus, RA, EBV, etc. Thanks!
Tue, 19 Feb 2013
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  User's Response
Hello,

Based on the history of presence of fever and night sweats followed by lumps in the neck the suspicion of infectious process is the first possibility. Lymphomas can also have features that you are describing that is painless rapidly growing rubbery nodes with fever.

In either case the PET scan or for that matter the CT or MRI should have picked up the disease easily. It is very unlikely to miss a 2-3cm lesion on the imaging.

Your blood tests were also normal.

I have a hunch that these could just be lipomas (benign fat tissue swellings ) that you did not notice prior to this. But they do not grow at the rate you are describing.

The best course would be to take a biopsy and check with the results.

Regards
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Diagnosed With Thyroid Cancer. Had Total Thyroidectomy, Ablation. Having Lumps On Collarbone, Upperchest Which Are Movable, Painless. What Could This Be?

Hello, Based on the history of presence of fever and night sweats followed by lumps in the neck the suspicion of infectious process is the first possibility. Lymphomas can also have features that you are describing that is painless rapidly growing rubbery nodes with fever. In either case the PET scan or for that matter the CT or MRI should have picked up the disease easily. It is very unlikely to miss a 2-3cm lesion on the imaging. Your blood tests were also normal. I have a hunch that these could just be lipomas (benign fat tissue swellings ) that you did not notice prior to this. But they do not grow at the rate you are describing. The best course would be to take a biopsy and check with the results. Regards