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What Do My Lab Test Reports Indicate?
Question: Hi, i had tonsillitis about 3 months ago and since then maybe once or twice more but less severe, and for at least the past 2 months or so my jugulodigastric lymph nodes have been swollen (had a CT scan and chest X-ray, X-ray was clear all around, CT scan reported 1.4cm jug digastric lymph node calling it minimally prominent, otherwise no lymphadenopathy), just on my left side, and i only have one tonsil which is also on the left…. after blood tests and different diagnostic tests there isn't a sure cause for the persistently swollen couple of nodes in my left jugulardigastric area.. so i am scheduled for an excisional biopsy simultaneous w/ a tonsillectomy on the left tonsil…. After many doctors visits I am nearly in a panic still because i somehow FORGOT to ask why my node appears to new visibly pulsating.. idk if its the node itself or a vein or artery beneath but the node seems to be the most prominent spot of pulsation for sure… two questions really, is this VISIBLE pulsation normal, also does the fact that the node may be right atop an artery or vein mean i should not have it excised.. Im not sure if either ENT I saw about this noticed the pulsating.. they only ever felt for the nodes.. they haven't stared at the area for a few seconds such as i have.. thanks so much.
Brief Answer:
The pulsating node is likely due to an artery near to it
Detailed Answer:
Hi xxxxxxxxxxx,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. The neck contains a large number of lymph nodes which enlarge due to infection and inflammation. An isolated 14 mm node is not a serious problem and is usually from reactive lymphadenopathy. An acute infection is not always mandatory and chronic low grade infections can also cause it. However, if it is superficial then doing an excision biopsy is acceptable.
2. The node might be pulsating due to transmitted pulsations from the artery below it. If the node has been reported on CT scan neck then it is unlikely to be any other structure. The pulsation is normal in thin people.
3. It is good if the ENT can go through the images and get an idea of the plane of the node and the exact location. It is important not to disturb any artery or vein when removing such a node and your doctor will be aware of it. The plane of separation between the node and vessel will be clearly seen on the CT scan. A carefully planned excision can always be done without any serious problem.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
The pulsating node is likely due to an artery near to it
Detailed Answer:
Hi xxxxxxxxxxx,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. The neck contains a large number of lymph nodes which enlarge due to infection and inflammation. An isolated 14 mm node is not a serious problem and is usually from reactive lymphadenopathy. An acute infection is not always mandatory and chronic low grade infections can also cause it. However, if it is superficial then doing an excision biopsy is acceptable.
2. The node might be pulsating due to transmitted pulsations from the artery below it. If the node has been reported on CT scan neck then it is unlikely to be any other structure. The pulsation is normal in thin people.
3. It is good if the ENT can go through the images and get an idea of the plane of the node and the exact location. It is important not to disturb any artery or vein when removing such a node and your doctor will be aware of it. The plane of separation between the node and vessel will be clearly seen on the CT scan. A carefully planned excision can always be done without any serious problem.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks so much for your thorough and insightful response. You have alleviated some degree of stress for me in that. Do you believe it would be more beneficial to go through w these surgeries, given statistics you encounter along w the details I've provided… I am considering bail out of both surgeries because i feel mostly fine and part of me thinks I'm making something out of nothing.. i am only 25 and seem quite healthy, apart from some anxiety coping issues.. I also have regular allergies, seasonal and otherwise like cats and have just moved in w my girlfriend who has 3.. I think theres a good chance id be okay to just back out of the surgeries, watch and wait, then perhaps return if nodes get bigger or other illness arises.. as the surgeries seem somewhat risky w complications and such.. Frankly, Im scared.. would it be a reasonable decision to hold of on any surgery and further monitor my own symptoms, or does something like what is happening to me strongly warrant the tonsillectomy and excisional biopsy… also, it is one node mainly, that 14mm jug digastric, but also another one right below it that isn't quite as large but no doubt swollen along w it. i also smoke. my blood tests all reported "normal" .. I also have noticed i have a couple deep-looking crypts in my tonsil and have seen the occasional white tonsil stone lodged in and probably on its way out, but have never pushed or tried to pick anything out myself.. thanks again, really
Brief Answer:
Please take an informed decision
Detailed Answer:
Hi,
Thanks for writing back with an update.
1. Surgery is a procedure which is done when medicine treatment does not give the desired response and the symptoms continue to persist. If you are falling sick too often like sore throat more than once in 3 months then the tonsillectomy might bring you significant relief and allow you to stay healthy. If you do not get sore throat often then probably the surgery can be put on hold.
2. The lymph node excision is a small surgery. It would be good to see the pictures before giving an opinion but however I guess that the node is on a superficial plane and approachable. I am not sure without images but if you want to avoid excision biopsy then you can go for FNAC of the lymphnode. This is a needle prick and not a surgery. It will give necessary information on the cells and if there is a doubt of any significan disease then you can go for lymph node excision biopsy.
3. I hope my observation will help you take a call.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
Please take an informed decision
Detailed Answer:
Hi,
Thanks for writing back with an update.
1. Surgery is a procedure which is done when medicine treatment does not give the desired response and the symptoms continue to persist. If you are falling sick too often like sore throat more than once in 3 months then the tonsillectomy might bring you significant relief and allow you to stay healthy. If you do not get sore throat often then probably the surgery can be put on hold.
2. The lymph node excision is a small surgery. It would be good to see the pictures before giving an opinion but however I guess that the node is on a superficial plane and approachable. I am not sure without images but if you want to avoid excision biopsy then you can go for FNAC of the lymphnode. This is a needle prick and not a surgery. It will give necessary information on the cells and if there is a doubt of any significan disease then you can go for lymph node excision biopsy.
3. I hope my observation will help you take a call.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much.. One more question. I have been under general anesthesia 2 or 3 times in the past w/ no adverse reaction, would you say that's a good indication that I can look forward to a other positive experience?
Brief Answer:
Anaesthesia should not be a problem for you
Detailed Answer:
Hi,
Thanks for writing back with an update.
1. There should not be any problem with general anaesthesia if you have got it earlier. Wishing you good health.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
Anaesthesia should not be a problem for you
Detailed Answer:
Hi,
Thanks for writing back with an update.
1. There should not be any problem with general anaesthesia if you have got it earlier. Wishing you good health.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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