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Suggest Treatment For Swollen Lymph Node In The Neck

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Posted on Mon, 13 Feb 2017
Question: Hi there: I have a thyroid nodule that has come back as "FLUS" after a biopsy. I have now noticed a small swollen lymph node on the side of my neck. Can these be related?
doctor
Answered by Dr. T Chandrakant (27 minutes later)
Brief Answer:
There may be an association

Detailed Answer:
Hi.
Thanks for your query.
Noted the history well and understood your concerns.
To recapitulate: Female/42 - history of thyroid biopsy as FLUS - now noticed a small swollen lymph node on the side of neck, wants to know whether these be related...
FLUS means Follicular Lesion of Undetermined Significance - the exact inference is not present.
Hence if you have got a lymph node on one side of neck, it should be viewed with suspicion.
If there is a focus of infection in the drainage area of this particular lymph node a course of an antibiotic and an anti-inflammatory medication say for 7 days should be given and see the response. If there is regression of the lymph node and control of infection, there say not be any problem of significance.
If there is no regression, it may require further evaluation by clinical examination, investigations like high resolution ultrasound, FNAC, excision biopsy and so on till a final diagnosis is done, preferably at the Center where you got your biopsy done to know the exact strategy/protocol and follow it the way they would advise you.

I hope this answer helps you, please feel free to ask for further relevant queries if you feel that there is a gap of communication.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (5 minutes later)
Thank you for your response. I've read that thyroid cancer can spread into the lymph nodes so I'm wondering if this could be a sign that the thyroid nodule is more likely to be malignant?

I should also note that I have an extremely large sebaceous cyst very close to where the swollen lymph node is located. It has been there for 25 + years and has been looked at multiple times.
doctor
Answered by Dr. T Chandrakant (1 hour later)
Brief Answer:
Please give details and post actual reports and photos

Detailed Answer:
Thanks for your feedback.
I was wondering why the extremely large sebaceous cyst has not been excised till now. Since there is a lymph node also, it would be advisable to get excision of both as diagnostic as well as therapeutic reasons.
Yes, one of the reasons for enlarged lymph nodes be cancer from the source of origin, including thyroid.
When was the thyroid biopsy done, please give details about the date, type of surgery and histopatho report of the specimen.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (11 minutes later)
Thanks for your response. The sebaceous cyst has gotten larger/smaller over the course of the past two decades and while it's very unattractive it's positioned toward the back of my neck and I as have long hair, it stays hidden. As I know that it's "fine", I've just left it. I only noticed the lymph node (which is small) a few months ago when I found out about the thyroid nodule, as I was paying more attention to my neck. The thyroid biopsy (FNA) was performed in November 2016 but unfortunately I don't have a copy of the pathology report.
doctor
Answered by Dr. T Chandrakant (17 minutes later)
Brief Answer:
Revision FNAC of the nodule and the lymph node to be certain

Detailed Answer:
Thanks for your feedback.
Agree with you, may be bit worried about surgery, everyone is.
It was FNAC that showed FLUS.
This can be repeated and reviewed please.
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19779 Questions

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Suggest Treatment For Swollen Lymph Node In The Neck

Brief Answer: There may be an association Detailed Answer: Hi. Thanks for your query. Noted the history well and understood your concerns. To recapitulate: Female/42 - history of thyroid biopsy as FLUS - now noticed a small swollen lymph node on the side of neck, wants to know whether these be related... FLUS means Follicular Lesion of Undetermined Significance - the exact inference is not present. Hence if you have got a lymph node on one side of neck, it should be viewed with suspicion. If there is a focus of infection in the drainage area of this particular lymph node a course of an antibiotic and an anti-inflammatory medication say for 7 days should be given and see the response. If there is regression of the lymph node and control of infection, there say not be any problem of significance. If there is no regression, it may require further evaluation by clinical examination, investigations like high resolution ultrasound, FNAC, excision biopsy and so on till a final diagnosis is done, preferably at the Center where you got your biopsy done to know the exact strategy/protocol and follow it the way they would advise you. I hope this answer helps you, please feel free to ask for further relevant queries if you feel that there is a gap of communication.