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Confusing next steps/help pls: neg biopsy results, enlarged lymph node under ear

Some background about myself, I'm a 34 yr old female, healthy, work out 4-5 days a week and have no symptoms of lymphoma. I have had an enlarged lymph node (1.5cm), relatively small, size of a pea for around 6-7 months. I've also had this prolonged head cold - really minor, but I'm always slightly congested in the nose and have mucus on my throat that causes me to cough. I'm a papillary thyroid cancer suvivor (15 yrs next year), and generally get paranoid about any types of lumps that I find.

I went to the doctor 2 days ago, the visit was brief and he emphasized all my fears and here I am feeling completely confused and hopeless as I am reliving my first cancer diagnosis. He didn't question my head cold at all, which I thought was strange, said that my lump was not a lymph node and either a sebaceous cyst or a tumor on the parotid gland or a lymph node within the parotid gland. I had a biopsy - he took 4 samples and called me yesterday with the results and said it is an aggravated lymph node. He found no cancer cells and he said with lymphoma they look for duplicative white blood cells which he did not find, he found a mix which is normal.

He does say this does not rule out low grade lymphoma (I get it, my first thyroid cancer diagnosis they found nothing with a biopsy and then found cancer after removal). But he wants to give me antibiotics and steroids (I heard steroids are not good because they cause anything to shrink and cover the problem?) to see if it will shrink. He also said to come back in 4 weeks, if it hasn't he will remove it and do a pathology.

Part of me is freaking out and going through the worst case scenario. The other part of me is saying, but what about your cold? It's not a huge growth, why is he telling me it could be lymphoma? I've decided I am going to get a second opinion because the overall visit rubbed me the wrong way. However, I am more worried because in a month I am supposed to go through IVF, I am about to get engaged, I have all of these future plans happening and the c-word is making me fall into this deep paranoid depression right before the holidays. My plans to have a child have been top of mind lately, and this is making me worried that it will never happen or become a road block if I do in fact have cancer.

If anyone has some words of wisdom, experience to share, advice - I would greatly appreciate it.

Thank you for listening,
Julia
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1081992 tn?1389903637
COMMUNITY LEADER
Hi, did you mean to say 0.5 cm? That'd be the size of a pea and the difference is important here.

Your situation would not be concerning at all except for your history. In general, when people are concerned enough about an enlarged node to go see a doctor, only about 2% end up having cancer. There are much more common reasons than cancer for a node to stay enlarged over a long period (being generally a chronic infection, or else remnant scarring inside the node from an immune reaction).

I don't know how much your history changes that figure, though. It might be just a little.

If it weren't for your near term plans, I'd say that you should just go through the usual steps. However, with your Fx you might ask for and get a sonogram ordered by the next doc -- even though at 0.5 cm the node is still small. If the "fatty hilum" is gone, then I'd press for the excisional biopsy. But if the fatty hilum is present on the scan, then you can relax somewhat.

I'd also ask the next doc to look in your ear to see if it's inflamed. Ears can also inflame from allergy, btw, and so can nodes.

The antibiotic might cause a reduction within a week or so, it doesn't necessarily take a month. No, the steroid won't reduce a tumor much at all but it can reduce a benign inflammatory reaction in the node.

"why is he telling me it could be lymphoma?"
While not likely, it is still possible -- the only way to rule that out for certain is by an excisional biopsy. But before that we look at the other factors as tending one way or the other. It looks to me at this point that the odds are well on your side.

Good luck to you. I hope you can have something of a Merry Christmas despite this worry.
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