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Have tender swollen nodes in groin area after cervical lymphadenopathy. Do I need a lymph node biopsy?

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Practicing since : 2003
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I am a 31 year old female and I have had cervical lymphadenopathy for about 2 months now and now have tender swollen nodes in the groin a well. CT of neck showed a supraclavicular node and others present but within normal limits. It also showed a focal aneurysmal dilation of the left internal jugular vein. I just had a biopsy done on tonsils..both removed, as well as places on posterior tongue. Report states right base of tongue: two pieces of polypoid tissue lined by nonkeratinizing squamous epithelium, submucosa shows increase amount of fibroblasts and capillaries consistent with reactive changes. Right piriform sinus shows polypoid lymphoepithelial with a well developed lymphoid follicle under the squamous epithelium. Right tonsil shows tissue with well developed lymphoid follicles showing germinal centers and well defined mantel zones. Some crypts markedly dilated and filled with filamentous bacterial colonies (Actinomyces). No evidence of malignancy but a mucocele found in a peritonsillar minor salivary gland. Left tonsil shows the same as right only with stromal fibrosis. Please tell me what to do from here. Do I need a lymph node biopsy? Please help!!

Would like to also add that this started as redness andninflammationnon one side of throat...particularly the anterior and posterior pillars on right side. Then inflammation started on left side as well...then all over mouth. Had little nodules or polyps come up by tonsils & back of tongue as well as on alveolar mucosa. Little capillaries are red and inflamed. I have good oral hygiene. None of my dr's know what is going on. Please help! I have now been on an antibiotic, antifungal, steroid, antiviral with no change.
Posted Tue, 24 Jul 2012 in Lung and Chest disorders
Answered by Dr. Gyanshankar Mishra 2 hours later
After going through your query, I would like to coment the following:
1. Your condition seems to be infective at presentation.
2. Non response to anti infective therapy demands that a culture and drug sensitivity be XXXXXXX on the tisuue biopsy sample if possible.
3. If no tissue is available than please go for excision biopsy of the supraclavicular lyph node along with culture and drug sensitivity testing of the same.
4. Other foci of infection elsewhere in the body need to be searched for.
5. A retro viral testing for HIV will be helpful.
6. Meanwhile antibiotic therapy needs to be tailored according to response.
7. A possibility of extra pulmonary tuerculosis also needs to kept and investigation like interferon gold will help.
8. An ultrasonography of abdomen for intra abdominal lymph nodes should be done.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.


Dr. Gyanshankar Mishra
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