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Noticed Lump Above Collar Bone. On Antibiotic. Chest X-ray, Tlc Dlc, Esr And Mx Test Done. Any Advice?

Posted on Tue, 28 Aug 2012

Question: hi, my name is XXXXXXX ..m from India...last month on July 06, i got to know a lump on the above of left collar bone...i went to the doctor on the very same day and she gave me anti-bio tic for infection and also she asked me to do some test i.e. Chest ex-ray, TLC DLC, ESR and Mx Test...all the test were normal, however it is been a month and i still have lump with the same size. Moreover i noticed one more lump on the right collarbone...sometimes it does pain a lot.Today again i went to her and she gave me some muscle pain killer...also she referred me to do an ultra sound..which sounds very awkward for me .please advice...

Answered by Dr. Pavan Kumar Gupta (1 hour later)

Hello XXXXXXX
Thanks for the query.
Although most common causes for such type of swellings are due to bacterial infection of lymph nodes but since you have already completed a course of antibiotic and routine investigations have not revealed anything,it raises enough doubts as it could be lymphoma.
Most important cause in your age could be Hodgkin's disease as this is commonly found in age group between 15 to 35 years of age.
Your doctor is right in advising a ultrasound and this may be followed by an biopsy of the lump which will clearly tell the cause for the lump.

I hope to have answered your query however you may revert to me for any further query.
Best of luck.
Thanks

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

Follow up: Dr. Pavan Kumar Gupta (42 minutes later)

Thanks for your reply. Yes, i have few more queries for the same.

After researching the disease lymphoma or Hodgkin's disease through internet, only few symptoms matches i.e. weight loss (Earlier it was 52 kg and after a week it was 49 kg), Sweating, Fatigue and less appetite. Please let me know if i have this disease and if go for the treatment then would it be possible to recover? Also, is there any other diseases which are related the same kind of symptoms. Would you be able to provide me the cost for the treatment?

Thanks in advance!!

Regards,
XXXXXXX XXXXXXX

Answered by Dr. Pavan Kumar Gupta (11 hours later)

Hello XXXXXXX
In 80 to 90% of cases below the age of 45 years,the lump turns out to be minor in nature and becomes alright.
It is not sure whether or not,you are having lymphoma which can be diagnosed only after proper investigations.
There can be various causes for lump above the collar bone and this includes
Infected lymph node
Lipoma
Fibroma
Old fracture collar bone etc

I would advise you to remain calm and get yourself investigated properly.
Nce the diagnosis is made,then treatment can be planned.

Please let me know if there is any other query.
Thanks
Regards

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

Follow up: Dr. Pavan Kumar Gupta (3 hours later)

Thanks for your response.

Definitely, I will go for the further investigation. I asked my doctor to refer me for biopsy instead of a ultrasound then she said yes, you can go for it. She mentioned FNAC test.

Once again thanks for your advice. I would like to contact you for any further query.

Regards,
XXXXXXX XXXXXXX

Answered by Dr. Pavan Kumar Gupta (11 minutes later)

Hello
Yes you can go for FNAC which means FINE NEEDLE ASPIRATION CYTOLOGY.
If the results are inconclusive,then a person can go for biopsy.
Best of luck

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

Follow up: Dr. Pavan Kumar Gupta (3 days later)

Hello Dr.

Today, i have received my FNAC report and it says:

FNA smear reveals mixed population of lymphoid cells with a predominance of small lymphocytes. Centrocytes, centroblasts, plasma cells representing all stages of lymphocytes differentiation is present in logical proportions. Tingible body macrophages present. No granuloma, necrosis or atypical cell is seen.

Conclusion: FNA, Lymph Node right cervical- Reactive Lymphadenopathy.

Please advice on the above report.

Thanks is advance.

Regards, XXXXXXX XXXXXXX

Answered by Dr. Pavan Kumar Gupta (12 hours later)

Hello XXXXXXX
Reactive lymphadenopathy simply means a reaction to some infection.
This reaction could be due to viral,bacterial( including tuberculosis ),fungal or protozoal or this could be due to some auto immune reaction.
However for proper diagnosis and evaluation you must get an excision biopsy done where lymph node is removed and then subjected to the proper examination.
In biopsy you get proper tissue material to comment upon while in FNAC you have only a very small localized material for the investigation.
This FNAC report means that there is no lymphoma or cancer but a proper biopsy is still required for the proper diagnosis.
Thanks

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

Follow up: Dr. Pavan Kumar Gupta (14 hours later)

Thanks for the information

Please suggest for any biopsy diagnosis center in South Delhi as my doctor has suggested me for quantiferon gold TB test.Would it be possible if you could supervise my case under your observation and that i can contact you on your address.

Please help me on my case as i feel very tired nowadays and sometimes feel cold and i feel warm like fever inside but when i check the temperature its generally normal.Also my body aches and sometimes i feel my muscles are beating just like how the heart beats and the muscles pains a lot.I am really scared please help.

Thanks XXXXXXX XXXXXXX

Answered by Dr. Pavan Kumar Gupta (24 minutes later)

Hello
You can consult any surgeon in south Delhi who can get this excision of the node and then sent for histopathology.
If you feel it is comfortable for you to contact me,you are most welcome.
I feel doing a biopsy is much better as compared to getting the quantiferron TB gold test.
Thanks

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

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