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Pregnant with 2.4 cm lymph node and low red and white blood cell count!!?

Hello everyone,

I had an ultrasound on Oct 31 of this year which measured a lymph node in the upper medial thigh at 2.4 x 1.4 x1.0 cm lymph node and no echogenic hilum and there is a peripheral vascular pedicle. The surrounding nodes look "benign " and the largest of these is 1.8 x 1.3 x 0.3 with normal echogenic hilum and without hyperemia. Features most consistent with with lymph node. -

Next i had an ultrasound about 4 days ago by a vascular doctor who did it himself and measured the lymph node at 1.7cm x 1.0 cm.  How do i know that he measured correctly? i mean i saw him measure and saw the numbers but i am so hesitant.  Also my lymphcytes are at 16 and hemoglobin is 11.2 and neutrophils at 73. I am terrified as i am pregnant and have been juicing about 10 lbs of carrots day because i read a book called curing cancer with carrots and know that my options are so limited if this is infact something.  Please if anyone can help or give any insight...my anxiety and ability to enjoy my family and life is almost non existent as i spend hours researching constantly!!!  Thank you in advance.
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1081992 tn?1389903637
COMMUNITY LEADER
Congratulations on the baby! That's wonderful news.

As for your sono reports, that is also good. Most got smaller, the one that got bigger shouldn't be a worry because of the fact that the others that got smaller. So it's not-cancer.

However, the nodes are still enlarged and so the goal should eventually be to find out what is the cause. (The cause, I think, is likely some odd immune system dysfunction.) But you are not in any immediate danger so you can relax. Maybe the nodes will even get smaller and smaller over the coming weeks because of hormonal changes.
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1 Comments
Thank you so much! Will update with any changes in the coming weeks!
Avatar universal
just wanted to update- had my baby july 2.  I had a follow up ultrasound mid pregnancy which read as follows

within the subcutaneous fat of the anterior left thigh peripheral inguinal region there is a lymph node 21 x 10 x 8 mm (previously 2.4 x 1.4 x 1.0 cm) with fatty hilum , normal size and morphology.  this is slightly smaller than the lymph nodes seen in October.  

IMPRESSION
Normal lymph node at site of clinical concern. No evident sonographic abnormality.

Next i had another follow up ultrasound a couple weeks before delivering the baby

Most recent exam- June 20, 2018
Findings - (except as noted, abscence of suspicious features including hyperemia, thickening or irregularity of cortex, microcalcification, effacement of echogenic hilum.
Left inguinal region: Identified lymph node measures 1.9 x 0.9 x 0.9 cm previously 1.6 x 0.7 x 0.6 cm
Left upper thigh : identified lymph node measures 1.2 x 1.0 x 0.7 cm with slightly thickened cortex/efacement of echogenic hilum (previously 2.1 x 1.0 x 0.8 cm)
Right inguinal region; identified lymph node measures - 2.0x 1.2 x 0.9 cm (previously 1.3 x 0.8 x 0.5 cm) along with a larger node which is not seen on current exam.
No solid or cystic mass, fascial defect, hernia or additional lesion noted.

IMPRESSION:  There is not distinctly suspicious adenopathy.  The targeted palpable nodes above are considered likely reactive, minimially larger or smaller than preceding exams without suspicious change and features.


What do you all recommend at this juncture? What could this all mean? thank you in advance.
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Avatar universal
Let me know what you think? Sorry the posts are scattered my phone is acting up.
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2 Comments
Generally, non-cancer nodes hurt when they get overfilled, and that presses against the enclosing capsule.

Whatever process is causing the filling is still ongoing.

I don't know which anti-inflammatories are safe to take during pregnancy.
just wanted to update- had my baby july 2.  I had a follow up ultrasound mid pregnancy which read as follows

within the subcutaneous fat of the anterior left thigh peripheral inguinal region there is a lymph node 21 x 10 x 8 mm (previously 2.4 x 1.4 x 1.0 cm) with fatty hilum , normal size and morphology.  this is slightly smaller than the lymph nodes seen in October.  

IMPRESSION
Normal lymph node at site of clinical concern. No evident sonographic abnormality.

Next i had another follow up ultrasound a couple weeks before delivering the baby

Most recent exam- June 20, 2018
Findings - (except as noted, abscence of suspicious features including hyperemia, thickening or irregularity of cortex, microcalcification, effacement of echogenic hilum.
Left inguinal region: Identified lymph node measures 1.9 x 0.9 x 0.9 cm previously 1.6 x 0.7 x 0.6 cm
Left upper thigh : identified lymph node measures 1.2 x 1.0 x 0.7 cm with slightly thickened cortex/efacement of echogenic hilum (previously 2.1 x 1.0 x 0.8 cm)
Right inguinal region; identified lymph node measures - 2.0x 1.2 x 0.9 cm (previously 1.3 x 0.8 x 0.5 cm) along with a larger node which is not seen on current exam.
No solid or cystic mass, fascial defect, hernia or additional lesion noted.

IMPRESSION:  There is not distinctly suspicious adenopathy.  The targeted palpable nodes above are considered likely reactive, minimially larger or smaller than preceding exams without suspicious change and features.


What do you recommend at this juncture? What could this all mean? thank you in advance.
Avatar universal
Thanks so much. So the official results are as follows for the recent sono. There is a lymph node 21mm x 10mm x 8 mm with fatty hilum slightly smaller than the lymph nodes seen in October. No evident sonographic abnormality. What could this mean? Now there is a hilum? And yet there wasn’t before???????
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4 Comments
Congratulations on your good news.

As for the hilum being seen again, assuming there was no error then it's all supposition. Here's some:

You banged your leg which triggered a psoriatic reaction - including the increase in neutrophils. That somehow resulted in inflammatory reactions in the nodes. Whereas I'd been saying that maybe the node is filling with fluid then sometimes draining, maybe it's not fluid after all but instead is suppuration (pus) because of the many neutrophils. maybe that somehow obscured the fatty hilum.

Or maybe the fat of the hilum was indeed gone but came back when the inflammation subsided somewhat and the tumor shrank. Maybe the neutrophils had taken away the fat. Just guessing.

Hopefully you can relax more now.

Thank you. I just don’t understand why the surrounding nodes are so painful still.
Any ideas? Specifically in my pelvis area.
But all in the left side as original node.
Avatar universal
Ok thank you. So there’s still a good chance this is cancer than correct? I hope I’m understanding you correctly. Forgive me if I’m not.
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1 Comments
Nope, I'm saying the opposite. Everything is pointing to it being not-cancer, with some excessive inflammation having occurred in the big node.

There have been other people though here with a similar situation.
Avatar universal
Ok thank you. And if we keep the second sono and the doc did measure correctly st 1.7 cm then what could that mean?
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1 Comments
In the unlikely event that your immune system suddenly got activated to kill tumor cells, it wouldn't just stop. The tumor would continue to shrink - until nothing of it remained.

My guess is it would instead be fluid fluctuation.
1081992 tn?1389903637
COMMUNITY LEADER
If we discard the 2nd sono, then the ~10% decrease in the long axis certainly means that it has not grown, at the very least. That means either it is not cancer, or else if it was cancer (which it likely isn't anyway) then it is very very slow growing and you can wait until after delivery to have an excisional biopsy.


In the past, size alone was considred a great indocator of cancer - but that has since been found out to be not true. So be careful when you read things about how recent they are.

Also, here is a 2011 study which found that "Among reactive nodes, irregular margins were found in 7%, hypoechoic center in 8% and ABSENT HILUS in 9% of nodes". So absent hilus is not 100%, as previooulsy described. You are likely in that 9%.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3050765/

The other sono reportd might only tell the size, not the internal architecture. Unfortunately, it is sometimes done that way.
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Avatar universal
What do you think?
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Avatar universal
Initially the node was 2.4. A week ago the vascular doc said t was 1.7 and today it was 2.1. I honestly believe the vascular doctor did not measure it correctly the first time as I stated in the initial question. It was rushed and he was mainly focused on the veins in my pelvis. I think the node has shrunk to 2.1 but not to 1.7 as vascular doc said. No there’s not a lot of fat to look through. The node is palpable. In the sono it says characteristics most consistent with a lymph node (the first sono that is) I haven’t seen the results of the second one yet. Other than the size as I asked the tech myself to compare the tow tests from oct 31 and today.
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Avatar universal
So just got back from Ultrasound. The ACTUAL current measurement is 2.1 x 1.0. It was actually 2.05 but she said she’s going to round it up. Original size was 2.4 x 1.4. Thoughts.
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2 Comments
The way it went down then up, I wonder if it actually is a node. More so because you said it is deep. Was there anything in the 3D Sono report that said they *think* it's a node, not that it for sure is a node?
Is there a lot of fat tissue that the sono had to look through?
1081992 tn?1389903637
COMMUNITY LEADER
In this case pain is good because a painful node tends to be not-cancer. The pain might be from swelling with fluid.

Good luck with you appt tomorrow.
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Avatar universal
Pain- I have soooo much pain! My entire left pelvic area and where the node is.
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1081992 tn?1389903637
COMMUNITY LEADER
I also have a very very strong suggestion for you about anti-cancer food: find videos by Dr Greger and learn all you can about anti-cancer vegetables, fruits and spices. A lot of those act by being anti-inflammatory, which is generally healthy for anybody for many reasons. Those things along with normal food will also be very healthy for the baby.

Please abandon the raw carrot diet, that is just plain wrong on many levels.

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1081992 tn?1389903637
COMMUNITY LEADER
If it's truly gotten smaller then that very strongly says it is not cancer. Very. Having the size reduction confirmed by sono should give you tremendous relief from worry.

You should most definitely ask for another sono, but don't be surprised if they say it's way too soon and you have to wait.

Maybe there was fluid inside scattered all throughout - not in spots like cysts which would have shown. There was never pain?

Having psoriasis gives to you an alternate explanation for the enlarged node(s), because a dysfunctional immune system can do many strange things. Btw, it's my belief that an overactive immune system often goes together with anxiety.

Normally, we'd think of trauma causing enlarged nodes when the node itself is directly hit. But with overactive immune systems, the signalling chemicals that get released from tissue as a result of any trauma might be causing a runaway reaction in downstream nodes. That's not usual but it surely seems possible.

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Avatar universal
Also I have psoriasis
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Avatar universal
Also- I fell and hit my shin very hard about 3 months ago and a month or so later is when I noticed the lump. The part I hit is still heeling and slightly itchy. A  I wear compression stockings 30-40 level every day.
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Avatar universal
Thank you. The node is pretty deep in my thigh so I can’t mark it but it does feel smaller than it did initially. I have another appt tomorrow and may ask for a repeat ultrasound just so I can be certain that it is infact shrinking. I saw the tech measure the node initially and the measurement from what I could see was correct at 2.4 cm. Praying this is not cancer but so scared that I am circling the drain with each passing day.
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1081992 tn?1389903637
COMMUNITY LEADER
Hi, Stressless. I believe I'm following your thinking correctly.

Points against it being lymphoma, though it's showing lack-of-hilum and is large-size:

1) there are other nodes nearby which are benign, so it's reasonable to think that they all have the same, benign cause
2) hilum can be effaced via inflammation in some cases
3) being large sized can result from granulomas in the node, which btw also results in non-rounded nodes (otoh, lymphoma tends to get round as it grows and grows). Being 2.4 x 1.4 x 1.0 cm is not round.
4) increased vascularity can occur from inflammation
5) elevated neutrophils point to some immune reaction, such as hidden infection. (I don't know how blood cells react to pregnancy.)


So did the biggest node actually shrink that much? It's possible, but not likely (because neither cancer nor granuloma should do that). So I understand your doubt. You can use a permanent marker to put 4 marks on the node periphery and give a better way to see if size changes. Maybe even the 1st sono was wrong, and that's why the doc did it personally the 2nd time.

From what I've seen of patients coming here with unusual cases, I don't think you have lymphoma. Point #1 above is the biggest clue.


I would be very disbelieving that carrots can kill cancer. Please don't follow that, but instead switch to giving proper nutrition to the baby.


While you maybe can't have a full excisional biopsy, you can ask for a needle biopsy which uses only local anesthetic. That's better than nothing and then maybe you'll be more inclined to abandon the raw carrot diet. You must even be losing weight from that and you might also be risking gestational diabetes.

Please let me know what you decide.
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Avatar universal
First off dont assume cancer, I know doctor google brings up the worst possible secnarios. Also being pregnant can mess with your blood counts. A lot of people with lymphoma's present with normal blood counts . I would talk with your PCP about your concerns and diet. My wife is a vegan and when she was pregnant the doctor really had to go over the proper foods to eat so she could deliever a healthy baby.
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Avatar universal
also i am eating all raw food. no sugar, no nothing. just salad and 10 lbs of carrots a day which equals 10 cups a day.
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