Aa
Aa
A
A
A
Close
Avatar universal

Lymphoma or something else?

I am very worried about my boyfriend. He is 25 and pretty healthy. About two months ago he noticed a swollen lump on his neck. It wasn't painful but very moveable and he could push it around. Several weeks later it started becoming very painful. He went to the doctors and they prescribed him some type of amoxicillin and sent him home. After his last dose he broke out into a full body, severely itchy rash and went into the hospital. They ran tons of tests and CT scans on him. They found that his liver and spleen were both enlarged, his lump was a swollen lymph node about 3 cm, and he had several but not worrisome small, swollen lymph nodes in his groin. His white blood count was normal but his red blood cell count was slightly lower. They tested him for mono, hiv, lupus, etc.. All negative. So they did a fine needle biopsy on his lymph node. It came back also negative. The rash went away about a week later after taking steroids.

Now it's been about a month and his lymph node still hasn't gone down. He went back to the oncologist and they did more blood work. This time they found his red blood cell count and his iron were very low. (i'm not sure the numbers) They also found he had a slight slight fever. However, his spleen and liver had returned to normal. Anyways, they referred him to a gastroenterologist next Tuesday to check for possible ulcers or internal bleeding of some type. The oncologist also said it appears he has anemia.. But they don't know if perhaps cancer is causing it.

They're doing another CT scan Tuesday to check if he's clear for another biopsy to remove a chunk from the swollen lymph node. They said the FNA could have produced inaccurate results.

His symptoms include weakness, fatigue, and dizziness. (possibly from anemia) He has also lost some weight but no night sweats or anything like that. But this is all very confusing and worrisome. Perhaps the low blood count and swollen lymph node could be completely unrelated.. But that seems unlikely. But is cancer likely if his white blood count is normal?

Any advice would be greatly appreciated.
4 Responses
Sort by: Helpful Oldest Newest
1081992 tn?1389903637
COMMUNITY LEADER
I'm sorry to hear that news, but on the plus side HL is generally more treatable than NHL.

Yes, you're right that they'll want to examine the biopsy to look for Reed Sternberg cells (and even to confirm lymphoma, though at over 3cm and with the other nodes enlarged nearby that probably will be confirmed). The onc might be assuming HL because that has a much higher probability than NHL at his age.

Your assistance will be invaluable in helping him be on top of everything that happens from now on. You'll want to learn about "response rates" and so on. I'd look heavily into minimizing side effects of treatment. Good luck to both of you.
Helpful - 0
Avatar universal
I don't believe his kidney was affected and I haven't been able to get a copy of his CT report. He has been negatively tested for lyme.

He got another CT scan this morning and his 3 cm lymph node has gotten bigger and about a dozen other lymph nodes around it are also considerably swollen. He will be getting a more invasive biopsy later this week or next. And on Friday he's getting scoped to check for internal bleeding.

However, the oncologist told him this morning it looked like lymphoma. I'm feeling really devastated. I'm taking it especially hard because we're in a long distance relationship. He has no one to take him to these appointments.

I'm confused why the oncologist feels this would only be hodgkin's lymphoma and not non-hodgkins lymphoma. I thought they could only tell after getting the biopsy results?
Helpful - 0
907672 tn?1381025723
Welcome to the forum.  Sorry to hear about your boyfriend, this must be scary for both of you.  Ken has made some very good points and hopefully this is just a reaction to the antibiotics.  I'd also like to add that swollen nodes from lymphoma are usually painless unless directly pushing against other organs, so the pain he's experienced is hopefully a good sign.  I think the excisional biopsy and the CT scan will be very helpful in leading you to a correct diagnosis.  Please keep us posted on the results.
Helpful - 0
1081992 tn?1389903637
COMMUNITY LEADER
Hi, some thoughts:

It sounds very possible that he had an allergic reaction to the antibiotic. Very important to know for future safety. Corticosteriods in high dose (maybe 80mg prednisone) would be the Tx. Was his kidney function (BUN etc) affected?

Can you post the CT report? This is very important. Hopefully, it gives more than just the size, e.g preserved architecture or not.

What about Lyme?

Your thinking re Lloyd Morgans' Canon is correct. It could be that cancer has invaded the marrow and is crowding out normal blood cell production. But it could be that a hemolytic pathogen is causing everything, even if indirectly by provoking autoimmuntiy. Or maybe a gut pathogen is inhibiting iron absorption. What he has is likely going to turn out to be rare, so I wouldn't blame the docs for not knowing.

Or a drug allergy can create autoimmune hemolytic anemia.

An FNA is like inserting a needle into raisin bread, looking for raisins - hit or miss. They probably are not talking about doing a full resection because of danger to nearby structures, nerves or blood vessels, e.g.

No, you wouldn't normally associate elevated lymphocytes with lymphoma as you would with leukemia (though a lymphoma might possibly have a leukemic phase in advance stage).

3cm is pretty big, getting at the upper limit to be reactive. If it was cancer, you'd expect fast growth also in the inguinal nodes.

"Now it's been about a month and his lymph node still hasn't gone down." Not necessarily a big deal at all - not to be fixated on.


Will know better once you post the CT report.

Helpful - 0
Have an Answer?

You are reading content posted in the Leukemia and Lymphoma Community

Top Leukemia & Lymphoma Answerers
1081992 tn?1389903637
PA
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
An interview with the co-discoverer of one of the biggest breakthroughs in cancer research
From causes to treatment options, get answers to your questions about CML, a type of blood cancer
New drug options on the horizon may make CML, a type of blood cancer, one of the few success stories in cancer treatment
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.