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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Lymphoma Be Ruled Out?

My daughter has a low white blood cell count of 3.5 as of January 2014. In Sept. 2013, it registered at 3.6. In March of 2013 it was 5. It's gone down. In March of 2013 she suddenly became ill and hospitilzed because of extreme reaction to Mono (fever, enlarged spleen, elevated liver enzymes). At the same time, bladder infection and idiopathic (non herpes, she is non sexual) vaginal ulcers. Her face was extremely swollen. She continues to have a swollen face (11 months later), just not so obnoxious, she has a round face now. Her sides hurt indicating the kidneys. Cracked lips to no avail. Itchy face and eyes and itchy body. Burning hands and feet. Tired - very tired. slightly anemic. Flutters in her chest. Swelling in one ankle from time to time. Her neck swells from time to time. No obvious nodules but can't they be deep inside as well? This all sounds to me that she should be checked for Lymphoma in which a hemotologist blew me off.. argued with me that her face is not swollen?? Very dismissive about everything. He ran CBC, the only thing I was told is that her white count is now 5 (which is not acceptable for a 16 year old girl and I find their lab to be faulty as they misdiagnosed a bladder infection and other bloodwork before which had to be repeated) Also.. she wa 3.5 two weeks prior to his lab results through another caregiver). His lab has been faulty in the past. Even so, I don't think I should get dismissed. Am I overreacting or should I pursue another hematologist to ask for an MRI and Cat scan? I'm awaiting results about automiune disease as well for Lupus, but would like to still outrule Lymphoba. Her liver seems fine but no one has rechecked her spleen or kidneys. This seems very neglectful and we were told our daughter was healthy and he didn't see a reason to run anything else. Shocked.
Fri, 5 Jan 2018
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Oncologist,  's  Response
Hi

Lymphoma, a kind of cancer, tends to present in the same fashion as
the flu or a bad cold or mono. Patients show the following symptoms:

-- Chills
-- Fever
-- Night sweats
-- Swelling of the lymph nodes
-- Itching
-- Fatigue

Most people who present with these symptoms do, in fact, have the flu
or a stubborn cold, or mono. Still, it's important to have a thorough
physical examination, just to be sure.

Your physician will look for several things in the course of your examination:

"If you have symptoms suggesting lymphoma, a complete physical
examination will be performed. During this examination, the doctor
will look for swollen lymph nodes under the chin, in the neck and
tonsil area, on the shoulders and elbows, under the arms, and in the
groin. The doctor will also examine other parts of the body to see
whether there is swelling or fluid in your chest or abdomen that could
be caused by swollen lymph nodes. You will be asked about pain and
examined for any weakness or paralysis that could by an enlarged lymph
node against nerves or the spinal cord. Your abdomen will be examined
to see whether any internal organs are enlarged, especially the
spleen.

If the doctor suspects after reviewing your symptoms and performing a
physical examination, he or she may order other tests help confirm the
diagnosis. These tests should include a biopsy, and may include blood
tests, x-rays and other imaging tests, scans, bone marrow evaluation,
and perhaps an examination of the cerebrospinal fluid.
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How Can Lymphoma Be Ruled Out?

Hi Lymphoma, a kind of cancer, tends to present in the same fashion as the flu or a bad cold or mono. Patients show the following symptoms: -- Chills -- Fever -- Night sweats -- Swelling of the lymph nodes -- Itching -- Fatigue Most people who present with these symptoms do, in fact, have the flu or a stubborn cold, or mono. Still, it s important to have a thorough physical examination, just to be sure. Your physician will look for several things in the course of your examination: If you have symptoms suggesting lymphoma, a complete physical examination will be performed. During this examination, the doctor will look for swollen lymph nodes under the chin, in the neck and tonsil area, on the shoulders and elbows, under the arms, and in the groin. The doctor will also examine other parts of the body to see whether there is swelling or fluid in your chest or abdomen that could be caused by swollen lymph nodes. You will be asked about pain and examined for any weakness or paralysis that could by an enlarged lymph node against nerves or the spinal cord. Your abdomen will be examined to see whether any internal organs are enlarged, especially the spleen. If the doctor suspects after reviewing your symptoms and performing a physical examination, he or she may order other tests help confirm the diagnosis. These tests should include a biopsy, and may include blood tests, x-rays and other imaging tests, scans, bone marrow evaluation, and perhaps an examination of the cerebrospinal fluid.