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What Does This FNAC Test Regarding Swelling Above Left Collar Bone Indicate?

Posted on Mon, 14 Jul 2014

Question: I am 24 year old and have observed swelling just above my left collar bone. I have been asked for FNAC test and the report is as follows: Specimen: FNAC from left supraclavicular lymph node
Microscopic Description: Smears show a reactive lymphoid background with few granulomas composed of epithelial histiocytes and lymphocytes. Stain for AFB-TB is negative.
Impression: FNAC from left supraclavicular lymph node showing granulomatous lymphadinitis.
Comments : The possibilities include tubercolsis.
Also my ESR level is 36 and it should be below. I find my FNAC report quite confusing. Does this report rule out the possibility of cancer?

Answered by Dr. Ashish Verma (28 minutes later)

Brief Answer:
yes it shows no cancer

Detailed Answer:
Hi XXXXXXX

The fnac does not shows any cancer cells. Also at your age we usually don't think of cancer. So don't worry about it.

Possibility of TB is also less as there are no Langerhans giant cells in the fnac and esr is also on lower side.

As you have already started anti-tb medication so take if for a two weeks and see of the lymph node reduces in size. If it does, continue anti-tb full course. If it does not then I would suggest that you go for excision biopsy.

Hope i have been helpful.

Regards
Dr. Ashish Verma

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ashish Verma (17 minutes later)

Thanks for your quick reply but I still think that my esr level is high as it should be below 20.
I have been taking AKT-4 since almost a month and swelling is reduced a very bit (infact i am not sure that it is reduced or not) and earlier it was not paining but it pains sometime. Do you think I should go for excision biopsy as it has been a month now?

Thanks a lot !

Answered by Dr. Ashish Verma (1 hour later)

Brief Answer:
get biopsy

Detailed Answer:
Hi XXXXXXX

For TB the esr is usually more than 50.

You are having a chronic infection for sure. Its better to get a biopsy to reach a diagnosis for better management.

Regards,
Dr. Ashish Verma

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ashish Verma (8 hours later)

Hi,
Today I met my doctor and she said fanc rules out the possibility of cancer since granulomas doest show up in lymphoma. She told to take the same medicine for one more month. so my question is that is it true that granulomas doest show up in lymphoma ? Does chronic infection include cancer? I am scared, please help.

Answered by Dr. Ashish Verma (42 minutes later)

Brief Answer:
yes she is right

Detailed Answer:
Hi XXXXXXX

Yes your doctor is right in saying that granulomas are not seen in lymphomas.

And chronic infection does not includes cancer. So you need not worry about the cancer part at all.

You follow your doctor's advice and continue the tb drugs for one more month and see.

Also eat more of fruits and take multivitamins and antioxidants to boost up your immunity.

Regards,
Dr. Ashish Verma

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Above answer was peer-reviewed by : Dr. Vinay Bhardwaj