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Hodgkins or other Lymphoma, what are the chances?
I've had a small palpable swollen supraclavicular node on the left side for a year now. It sometimes gets inflamed, with visible swelling over the supraclavicular fossa area. I initially had an ultrasound, which the doctors believed appeared normal -- it was under half a centimeter in size, with a normal shape, and visible fat hilum. At the time I was in my last semester of nursing school and had a decent amount of knowledge regarding the disease process, so after reading through hours of lymphoma, nodal drainage, and metastasis related research -- I thought further testing was indicated.
Unfortunately my doctors didn't agree, saying my age/symptoms/US results did't fit the criteria for further referral and told me to come back in 3-4 months for a follow up US. A couple of months later the node was still palpable, so while on vacation in Thailand I decided to take advantage of the access to affordable healthcare, and sought out a second opinion. When I explained my history, and because of the length of time, the doctor was really concerned about potential malignancy deciding it best to have a CT w/ contrast performed with a possible biopsy following... if the results came back abnormal. (I had the CT, US, and blood test done within three hours of first arriving and getting final results) Although very scared, it was refreshing to feel like someone was finally considering my livelihood as seriously as I do.
The CT showed, "multiple lymph nodes along bilateral submental, internal jugular, and posterior triangle.. size 0.3-0.6cm. No gross mass seen, minimal fibrosis in bilateral apical lungs”.
Although ‘no definite focal mass was noted’ limitation of the study was mentioned by the doctor because of a beam from one of my dental fillings had creating artifact on the scan, and I guess obscured the total view. Regardless, at the time I felt confident with the results, and was glad to continue the trip with it off my shoulders.
Fast forward to… right now. Over a year later, and it's still here. My anxiety is out of control. I spend all of my nights off reading article after article, re-diagnosing myself after each one.
As far as classic symptoms go, I don't have any night sweating, and have gained weight, not lost. My scalp has been super dry and flakey lately, which never happens, and my hair is shedding way more than normal, which can be pretty itchy. This is the only “itch” type symptom though, and I attribute this mainly to stress, but could be wrong. My extremities are often cold to touch, and my feet can sometimes tingle or feel numb — mainly in my big toe. My body seems more and more tense and achy all time, with subtle joint paint, muscle twitching (a recent twitch just started in my right eye). I have had new onset of heart palpitations, which started maybe a month ago, amd though seldom, still pretty scary. As far as fatigue, I feel like I've been perpetually tired since the start of nursing school up until now. Finding a normal sleeping pattern while working nights can be pretty difficult.
Really, I could go on with the details for days, but will spare anyone who’s reading this. I guess in summary, I am very worried. I don’t know whats going on with my body and it’s super scary. I’ve found it really hard to establish a relationship with a doctor who shares my same sense of urgency in seeking answers. Receiving a referral here in the states for any diagnostic procedure other than a US, in my situation, has been a losing battle.
In the event this is something that need serious medical treatment, I want to limit any time wasted. Hell, if I could biopsy it myself I would... although, I’m sure my insurance company would still find a way to bill me :)!
seeking advice from hematologist/oncologist...
Unfortunately my doctors didn't agree, saying my age/symptoms/US results did't fit the criteria for further referral and told me to come back in 3-4 months for a follow up US. A couple of months later the node was still palpable, so while on vacation in Thailand I decided to take advantage of the access to affordable healthcare, and sought out a second opinion. When I explained my history, and because of the length of time, the doctor was really concerned about potential malignancy deciding it best to have a CT w/ contrast performed with a possible biopsy following... if the results came back abnormal. (I had the CT, US, and blood test done within three hours of first arriving and getting final results) Although very scared, it was refreshing to feel like someone was finally considering my livelihood as seriously as I do.
The CT showed, "multiple lymph nodes along bilateral submental, internal jugular, and posterior triangle.. size 0.3-0.6cm. No gross mass seen, minimal fibrosis in bilateral apical lungs”.
Although ‘no definite focal mass was noted’ limitation of the study was mentioned by the doctor because of a beam from one of my dental fillings had creating artifact on the scan, and I guess obscured the total view. Regardless, at the time I felt confident with the results, and was glad to continue the trip with it off my shoulders.
Fast forward to… right now. Over a year later, and it's still here. My anxiety is out of control. I spend all of my nights off reading article after article, re-diagnosing myself after each one.
As far as classic symptoms go, I don't have any night sweating, and have gained weight, not lost. My scalp has been super dry and flakey lately, which never happens, and my hair is shedding way more than normal, which can be pretty itchy. This is the only “itch” type symptom though, and I attribute this mainly to stress, but could be wrong. My extremities are often cold to touch, and my feet can sometimes tingle or feel numb — mainly in my big toe. My body seems more and more tense and achy all time, with subtle joint paint, muscle twitching (a recent twitch just started in my right eye). I have had new onset of heart palpitations, which started maybe a month ago, amd though seldom, still pretty scary. As far as fatigue, I feel like I've been perpetually tired since the start of nursing school up until now. Finding a normal sleeping pattern while working nights can be pretty difficult.
Really, I could go on with the details for days, but will spare anyone who’s reading this. I guess in summary, I am very worried. I don’t know whats going on with my body and it’s super scary. I’ve found it really hard to establish a relationship with a doctor who shares my same sense of urgency in seeking answers. Receiving a referral here in the states for any diagnostic procedure other than a US, in my situation, has been a losing battle.
In the event this is something that need serious medical treatment, I want to limit any time wasted. Hell, if I could biopsy it myself I would... although, I’m sure my insurance company would still find a way to bill me :)!
seeking advice from hematologist/oncologist...
COMMUNITY LEADER
Sorry, but there are no docs here that answer questions.
I would like to say, though, that nothing there really points to lymphoma. That is most especially true if your most recent ultrasound still shows the fatty hilum. (A cancer in a node will eventually efface the fatty hilum and also all other internal nodal architecture.) If the node hasn't increased in size, that's also a big clue.
Metastatic nodes tend to be very hard because of calcification. As you would know, that shows up very obviously on a CT, or even just an x-ray just like bone does.
Lymphoma can cause itching because it results in release of immune cell inflammatory chemicals. But even benign inflammation that involves histamine causes itching. You can try topical diphenhydramine as a test, or cortisone creme as a treatment.
You must have had your thyroid tested, right? Tiredness, weight gain, hair loss, itch are all symptoms.
Or you can look at some possible scalp condition causing a lot of secondary effects from immune activation - especially if you have an Fx of odd or exaggerated immune conditions.
I would like to say, though, that nothing there really points to lymphoma. That is most especially true if your most recent ultrasound still shows the fatty hilum. (A cancer in a node will eventually efface the fatty hilum and also all other internal nodal architecture.) If the node hasn't increased in size, that's also a big clue.
Metastatic nodes tend to be very hard because of calcification. As you would know, that shows up very obviously on a CT, or even just an x-ray just like bone does.
Lymphoma can cause itching because it results in release of immune cell inflammatory chemicals. But even benign inflammation that involves histamine causes itching. You can try topical diphenhydramine as a test, or cortisone creme as a treatment.
You must have had your thyroid tested, right? Tiredness, weight gain, hair loss, itch are all symptoms.
Or you can look at some possible scalp condition causing a lot of secondary effects from immune activation - especially if you have an Fx of odd or exaggerated immune conditions.
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