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Had left supraclavicular swelling. Biopsy showed H.Pylori. Feel tightness and pinching around chest area. What is causing this?

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I am 50 F have had issues with left supraclavicular swelling for 2 years now. It comes with malaise. I feel tightness and sometimes a pinching in surrounding chest area. Nothing shows up on ct scan or ultrasound. Have RA. Had chronic mono for over 2 years (an active case in my late 20 - 30s). Upper endoscopy showed erosive nodular gastritis w fold thickening. Biopsy showed no H. Pylori present. Lower endoscopy not well done due to incomplete cleanout but seemed okay. It may be important also to state that I do not run fevers anymore. I stopped after my long bout with mono (My blood pressure did drop to 50 over something, going into shock once, apparantly due to some unseen infection - so I was told). My bloodwork doesn't appear to show inflammation even when I obviosly do.

My General Practitioner ordered an ultrasound of the area and a visit to an ENT specialist who ordered a thoracic CT scan. Nothing showed so my GP said it is likely not a problem since I've had the problem for so long and nothing showed up on the scan. I would like to find out what is causing this. I would like some direction other than "we could run hundreds of tests and not find out what it is". I think it must be from some infection (abdominal?), chronic inflammation, possible cancer in gut somewhere?
Posted Sun, 11 Aug 2013 in Lung and Chest disorders
Answered by Dr. Basheer Ahamed 1 hour later

Thanks for your query.

Left Supraclavicular swelling may be very significant based on what is causing it.

If it is a lymph nodal swelling then it is called as signal lymph nodes.
This may be the sign of underlying cancer of the GI tract(Gastric Carcinoma) or lung carcinoma.

But all your CT scan, endoscopies and Biopsies are normal.

Considering the duration of more then 2 years cancerous conditions may be ruled out unless it is a very slow growing tumour.

In my view it may be an Inflammatory Adenitis due to the chronic Inflammatory(RA) and infectious Condition(Mononucleosis) your suffering.

A biopsy of the swelling itself can be done to find the cause of the swelling.

You may test for various cancer tumour markers like(Ca 125, Alpha fetoprotein etc..) to rule out other cancerous conditions.

Hope the answer helps you,
Please to answer other queries.
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