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Dear Dr., 10 Years Ago I Noticed That One Of

Posted on Thu, 31 Jan 2019

Question: Dear Dr., 10 years ago I noticed that one of my lymph nodes on my neck (I think it is called cervical) became bigger. I went with it to the doctor, who sent me to MRI, which said there is a 1,2 cm lymph node but no tumor to see. This was in 2008. I went to control the lymph node in 2015 it was still measured with sonography 0,85x0,9cm, the doctor said it is normal to have enlarged lymphnodes for a longer period of time. Now in December 2018 the weather was very cold, I got sore throat, my whole neck was swollen and quite painful, I noticed more lymph nodes increased in size. Also the one I had for a long time. I went to the doctor, it measured around 1,9x1,2x3,2cm the size of the lymph node I have for 10 years. Now this doctor started to worry, and want to let it remove at the hospital, because this might be lymphoma, which makes me terribly worried. Not even that I have cancer, but the fact that they want to operate me just for the diagnosis. I went to another doctor who said with sonography that there is fat in it and bean formed so I should not worry. I will do next week an MRI, maybe that gives more information. Here my questions: - Is it possible, after 10 years, I have lymphoma? I have absolutely no other sickness sympthoms, no weight loss, night sweet, itching, ... Can a lymphoma develop so long without any other sympthoms? - Can an MRI provide more information that makes sure it is not a lymphoma? - Is there any other high-tech method to diagnose this? On blood test everything was OK, they only did sonography, and MRI comes next. Doctors said the only way to see clearly when they cut out, what I want to avoid. Which diagnosis steps would help to decide if it is something terrible or not? - Which kind of doctor would be the most appropriate to diagnose this? I see there are a lot of parameters on sonography picture which should be considered (fat, size, form, echo..).Which doctor is the most appropriate to consider all these parameters? Onkology? ENT doctor? I really want to avoid that they operate they lymph node out from my neck, as I had an operation (bowel) some months ago, and I am really afraid to repeat all those struggle. Thank you for you help.

Answered by Dr. Anders Mark Christensen (36 minutes later)

Brief Answer:
Sounds benign, ENT next

Detailed Answer:
Hi Mail,

I am sorry to hear about your troubles. First of all, lymphoma developing over 10 years is extremely unlikely. To me, it sounds like the lymph node gets enlarged when you have an infection, which is normal.

An MRI is a possible next step, and a PET CT scan would also make sense if there is a suspicion of malignancy. I suggest you see an ENT doctor next, and in my view, lymphoma is very unlikely, but a definitive diagnosis requires surgery.

Please let me know if you have further questions.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Anders Mark Christensen (21 hours later)

Is biopsy (just using a needle to get some sample from the lymphnode) enough to have a more precise diagnosis? Why is always the complete removal suggested?
How big operation is such a complete removal? Can it be done ambulant, or is this a full narcosis operation with several days hospital stay?

Answered by Dr. Anders Mark Christensen (1 hour later)

Brief Answer:
Excision is a small procedure

Detailed Answer:
Hi Mail

A complete excision is to be preferred because it allows for a better microscopic evaluation of the lymph node. The excision is done under general anesthesia (usually) but it is day case surgery so you will be discharged same day.

Hope this helps.

Note: For further inquiries on surgery procedure and its risks or complications book an appointment now

Above answer was peer-reviewed by : Dr. Raju A.T