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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Swelling In Neck. Have Epidermoid Cyst. How Can I Get Rid Of It?

Hello Doctor, I am having a swelling in the right side of my Neck from last 05 months. I went to General medicine doctor initially on 07-May-12 where doctor provided the medical terminology as ‘Submandibular swelling’. He given me some antibiotics and given CBP with ESR test and T3, T4 and TSH test. The Results of Hematology are – RBC – 4.83 (N); Hg – 15.3 (N); Red Cell Distribution Width – 10.9 (Low); Segmented Neutrophils in WBC – 39 (Low); Lymphocytes – 54 (high); ESR – 04; T3 – 106.39 (N); T4 – 9.20 (N); TSH – 2.27 (N). He suspected Cervical Lymphodenopathy and directed me to Surgeon’s opinion and possibly FNAC . I went to surgeon after some time on 08-Aug-12 and Surgeon observed matted multiple cervical lymphocytes on right side, non-tender. He suspected Rt. Cervical Lympathy and Koch’s disease (TB). Given the test for USG Neck (matted lympathy); ESR (20, 35); X-ray chest PA view (Normal); Mantoux Test (negative); Quantiferon TB Gold (TB Feron) – Negative; FNAC Test (Gross – Swelling in the lateral side of neck measuring 4*5 cm from tp hard in consistency; Aspiration – Fine needle aspiration of the swelling revealed white gritty material with haemorrhagic aspirate; Microscopic Exam – Smears studied showed plenty of squamous epithelial cells with normal nucleocytoplasmic ratio aganist necrotic and haemorrhagic background; Impression – Features suggestive of epidermoid cyst . Advised further evaluation and follow-up). Doctor suggested to go for a Biopsy, however, he is having a little doubt on the FNAC results and therefore discussed with Radiologist where the point came out is a big lesion approx 4 cm long with 2cm thick mass. Doctor again advised to go for a FNAC from a different place and depending upon the result followed by CT neck contrast. The test result is due for tomorrow (20-Aug-12). The pathologist spoke to the doctor where he mentioned of something called as PUS. He could take out 1ml of the mass during FNAC. He mentioned to go for other specific test in the same region. I am confused now as what it may be. Am I suffering from some deadly disease. Please provide suggestion and your thoughts going through my current medical condition. Please note that I don’t have Fever, pain, significant weight loss (very minute happened in last quarter), cough. I don’t have any past medical history and I am average smoker. I do lead my daily Normal life without any issues. Please let me know what I should do now. Is that Biopsy would give a clear picture or CT scan or MRI. I am not sure. Please help me. I want to get rid of the same as early as possible.
Fri, 27 Dec 2013
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ENT Specialist 's  Response
hello. please relax, you are not suffering from any deadly disease. it is likely that you have a tb infection of the lymph nodes in your neck. i would recommend that you do the ct scan first and then go ahead with the biopsy , to be clear as to what the swelling actually is. thanks
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Have Swelling In Neck. Have Epidermoid Cyst. How Can I Get Rid Of It?

hello. please relax, you are not suffering from any deadly disease. it is likely that you have a tb infection of the lymph nodes in your neck. i would recommend that you do the ct scan first and then go ahead with the biopsy , to be clear as to what the swelling actually is. thanks