Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

173 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

8 years old with lymphadenitis. High WBC count. Need of biopsy and treatment?

Answered by
Dr.
Dr. Das Arindam

General & Family Physician

Practicing since :2008

Answered : 1416 Questions

default
Posted on Wed, 26 Dec 2012 in Cancer
Question: My child is 8 years old and two months back i noticed lymphadenitis - 3 posterior cervical lymph nodes enlarged.. 1 is 1 cm in size and the other 2 less then 1 cm. i took her to the padeatrician and he asked me to do various blood tests and the TB test . in the blood test the wbc count was very high at that time and the TB test was negative. the doctor asked me to XXXXXXX a padietric surgeon and i took my child there. the surgeon asked me to wait for some time before going in for a excision biobsy. i waited for a month and the enlarged node got smaller and is very much less than 1 cm. now the doctor has asked me to consult him after 1 month. i am not giving any medicine to my child right now. i am getting worried.
doctor
Answered by Dr. Das Arindam 1 hour later
Hello,
Thank you for posting a question.

Firstly, some important points should be cleared
1. Did the child had any oral ulcer?
2. Did the child had any other abnormality ?
3. What was the details of differential count of WBC ? Was the neutrophils increased? Did the blood report indicate presence of any atypical cells ? What was the lymphocyte count?

This type of enlarged lymph nodes and presence of high WBC count is seen in infections that may be viral or bacterial, or in leukemic conditions. I think she should be examined thoroughly for any palpable lymph nodes in any other sides, palpable spleen or liver, and any history of bleeding through gum and nose should be noted. All these indicates a possibility of neoplastic conditions.

As the lymph nodes are now became smaller, it denotes a very high possibility of infective conditions. If the neutrophils are increased, it definitely supports, bacterial infection. If lymphocytes are increased that denotes a viral infection. If any abnormal cells are seen that indicates any neoplastic conditions.

One more point is Fine needle aspiration cytology. It replaces the need of urgent excisional biopsy. When the lymph nodes were enlarged, FNAC was a better option for differentiating the neoplastic and infective conditions. It is rapid and effective. Even now, FNAC can be done if the lymph node becomes larger than 1cm again. But before that , infective conditions should be excluded from the complete blood count report.

Right now, no medicine is required. But , one course of antibiotics should be given if infection if infection is detected.

So, consult with a pediatrician or treating doctor to rule out infective conditions and to follow up the complete blood counts again if required.


Hope this information suffices. Let me know, if you have any more question.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,  
Lab Tests
Medical Topics

Recent questions on  Lymphatic system

doctor1 MD

My husband was diagnosed and treated for lymphoma. As the result, he developed a lesion in his thoracic duct which gave need for multiple thoracentesis. His cardiothoracic surgeon corrected this problem with a thoracic ligation however the resulting scar tissue has caused a blockage in the thoracic duct and lymph fluid is backing up into his abdominal cavity. His HPB surgeon placed a Denver shunt to help recycle this fluid but the volume is too much for the shunt to handle. Please tell me is it possble to ligate any of these ducts and if so what type of surgeon whould we seek out? Please help us...Thank you!

doctor1 MD

I am a 22 year old female with chronic swollen lymph nodes only on my left side,which then leads to ear pain and jaw pain. I had my tonsils taken out a little over two years ago because of chronic tonsillitis. I had blood work and the only thing that came up was that my liver enzymes were really high, they were 250. I had tests done on my live and everything came back to normal. Could my liver an lymph nodes be linked?

doctor1 MD

I'm 2 years out of lymphoma. My last ct scan (1month ago) was ok except spleen enlargement 4cm. Doc said not to worry. I had a lymphatic massage shortly after. Since then I've been having pain in original tumor site (media stienum) and tingling sesations all over body, also my spine has been hurting also.

doctor1 MD

Hi. A close male relative has been diagnosed with NHL. General health was very good apart from a fairly minor stroke six months ago and aortic aneurism surgery six years ago. He is 81 years old and symptoms include weight loss, lack of appetite, fever, night sweats, rigors, bladder infection. Has been taking steroids for five days and will continue until strong enough for chemotherapy. Lymph nodes swollen in abdomen, neck, and underarms. Neck node excision confirmed NHL. Any evaluation would be greatly appreciated. Thank you.

doctor1 MD

I have had hard swollen lymphnodes for over 5 years now. I have had them biopsied before and all was negative. i have 4 in my check all 2 cms and one 3.5cms. I also have about 6 on each side of my groin, and a few in my armpits. No doctor knows...

doctor1 MD

I am having a strange issue. First off I am an off and on iv drug user of methamphetamine . And a little background I'm 30 y/o and have no known illnesses except hsv1 and heterozygous factor v Leiden . I take prescribed med clonazepam as needed no...

doctor1 MD

My mother is almost 90. She had surgery on her foot. But, in the last two weeks she gained over twenty pounds of, we think, water, what should we do?