Strange symptoms, Lymphoma?

[David1995]

After a sexual exposure 6 months, I got a bad case of balanitis that i'm still dealing with, I started to realize my neck had a big swollen lymph node which has now lasted 6 months, and have smaller swollen lymph nodes on the other side of my neck which have been there now for around 3 months. I have also had red and splotchy hands, which I have now learned are Livedo Retuclaris. I saw an infectious disease specialist last week and he said I tested positive for CMV and EBV but they weren't recent infections and shouldn't be the cause of my swollen lymph nodes. He also tested me for HTLV and HIV which came back negative. He also told me all my blood test came back normal, even though I had elevated monocyctes a few weeks back they now went back to normal levels. I am scheduling a biopsy to get to the bottom of these symptoms once and for all. I am very concerned that I may have contracted some new sort of STD. Has lymphoma ever caused livedo reticualris of the palms?

[Ken_PA]

"What would be some black walnut husk product you would recommend?"
sorry, I don't know of any. You'd probably have to buy powder and supply some cream to mix it into. Just guessing.

[Ken_PA]

"I thought what I believed to be thrush sine it was a white coat on my tongue, my doctor took a swab and it came back negative for thrush'

candida thrives on sugar, have you eliminated sugar?

---

Also, do you have any instinctive reservations about your doctors?

[David1995]

I don't have thrush, and no not really, I want to get to the bottom of these symptoms so I'm trying my best to try and find out what it is I need to do

[Ken_PA]

"steroid creams"
I think some fungi can feed on steroid creams.

Plants have to protect themselves from fungi all day long. So maybe you can try, starting very slowly for safety, things like oregano oil. Or black walnut husk (everything is dead under a black walnut tree.) There would be others to research and try.

What about a microscopic parasite?

[David1995]

Right now i'm trying a water and vinegar mixture which I read online about and so far seems to be helping out. The creams had no effect but the mixture is make the skin become red and almost looks like it's peeling

[David1995]

What would be some black walnut husk product you would recommend?

[Ken_PA]

IMO, a biopsy is wasted if, in post-biopsy pathology investigation, they only look for lymphoma and don't look for granulomas. That is probably only what they want to do.

I'd also push again for a culture.

Got to go for now.

[David1995]

I was thinking about first doing a fine needle biopsy and then doing the full biopsy if nothing is found.

[Ken_PA]

"Do you believe if I went ahead with the biopsy a systemic illness would come up?"

Nope, and also btw if you get fungus in the bloodstream and it runs away multiplying, that could be deadly. Hence worry over ulceration.

I'd thin they want to he biopsy because they don't know anything else to do. I'd want a reason from them why they don't consider granulomas in the nodes. Nodes with TB in them behave like yours, btw. Though you don't have TB, the behavior is the same.


Also, CRP is a measure of systemic *inflammation*. Imagine sirens going off everywhere, so all troops (immune cells) get out of standby mode and start looking for something to destroy.

[David1995]

I will be asking about granulomas , this is the first i'm hearing about this.

[Ken_PA]

Aspirin is. among other things, an anti-platelet drug. Your palm microcoagulation is, I'm guessing, from excessive platelet activation. Aspirin would take days to have an effect, especially as you have to dissolve the current clots.

Think in military terms: you need able soldiers to be ready on quick notice - but new recruits needing training won't be fast enough into action. So the constantly circulating platelets are like Army Reserve. they are available to be quickly "activated" when needed. But if over-activation is present, you get excess coagulation.

A lymph node is like an army base, mainly empty in peace time. But when needed against invaders, the base fills up and gets larger - so that's like the good immune cells multiplying in a node as they are educated and prepared to go and fight the invader.

Granulomas? That's like invaders inside the base. They are recognized as being enemy, but instead of being killed they get surrounded and locked up everywhere, and the base gets filled with them and grows.

Lymphoma is like enemy in the base that are unrecognized as being enemy. They eternally multiply but don't get killed, so that they eventually crowd out the good guys and even wipe out all the buildings. They also evenntually wipe out the surrounding wall.

Well, I just put that together for the first time. Does that help with understanding? If so, I'll stick to that approach.

[Ken_PA]

Some quick thoughts:
- since no inguinal nodes reacted, we can likely say that the pathogen didn't get through the skin (but be very wary of ulceration now and in future)
- so it seems likely that the same pathogen got through the mouth? and make the neck nodes react via that pathway

- if it's not candida, then maybe some other similar fungus

- the balanitis can result in immune cells flooding your system with cytokines and other signalling molecules, which can be making your neck nodes react more than they would otherwise. maybe. did you have tests for CRP or other systemic inflammatory markers such as IL6?
- were you tested for your INR? did you try aspirin for your palms?

[David1995]

Aspirin? I have taken some Advil but my palms seem to just be stuck this way, I will take some aspirin today to see how how my hands react. Ulceration? never thought of that, I just had a ANA test, and I had a negative RA factor. Do you believe if I went ahead with the biopsy a systemic illness would come up?

[Ken_PA]

"Would the biopsy be able to show whatever it might be?"
I think I put a link in that other thread to a paper on biopsies being possibly helpful, but still being iffy.

[David1995]

Thank you very much for your answers so far

[Ken_PA]

being rock hard (calcification) in a cancer generally means a metastasis from some other cancer, not a lymphoma. But on the other hand, granulomas can indeed get calcified, and granulomas arise when the immune system can't kill microbes - so it walls them off. That can also create big nodes as the nodes fill up.

Sorry, I have to go for today. But this does not look at all like lymphoma, it's much more likely something immune related.

I'll check back tomorrow.

Btw, if vinegar + water works somewhat, full strength vinegar sounds like a good experiment.

[David1995]

So its looking like some autoimmune problem? Thats what I suspected as well because I have a rash on my face

[Ken_PA]

"I don't have thrush"
then you'd need to have an alternative diagnosis for the white tongue. It shouldn't just be forgotten, because it's a clue. Maybe the test was wrong.

Also, a negative ANA test doesn't necessarily mean there is no autoimmunity.

[David1995]

Very true, what other test might be able to find some sort of autoimmunity problem? Would the biopsy be able to show whatever it might be?

[Ken_PA]

"It's movable, and yes the ones on the other side of my neck are thing and long but the right side is for sure round. The texture feels hard"
rock hard, or less than that?

[David1995]

A little less than rock hard but I think because of it being movable I can't feel just how hard it is exactly, but it does feel hard

[Ken_PA]

Any thrush?

[David1995]

I thought what I believed to be thrush sine it was a white coat on my tongue, my doctor took a swab and it came back negative for thrush

[Ken_PA]

"Number 6 is the biggest one for me on the right side of my neck"
Okay then, can you be certain that it's round, with it being recessed? It's hard to know. Also, does it seem movable or fixed? Soft, rubbery or hard?

[David1995]

It's movable, and yes the ones on the other side of my neck are thing and long but the right side is for sure round. The texture feels hard

[Ken_PA]

"since my lymph nodes have been swollen for 6 months I should consider the biopsy."
Well, who am I to disagree but I'd tend to the opposite: if it's stopped growing, I'd not want a biopsy to rule out lymphoma because lymphoma is generally not going to just stop growing on its own. So then for followup also finding the fatty hilum by sono pretty much rules out malignancy without doing any cutting.

Please look here:
http://www.medhelp.org/posts/Leukemia--Lymphoma-/Lymphoma-or-false-alarm/show/2926406
and read the sono report in the photos referred to. Finding "reactive" and "hilum" over and over means no cancer.

[David1995]

Alright I will be looking into that and speaking to the ENT about getting that done because I don't want to do the biopsy if it'll just be a waste of time

[Ken_PA]

Round is generally bad, except that submandibular nodes are normally round. Is the biggest and first one here:
https://en.wikipedia.org/wiki/Submandibular_lymph_nodes

[David1995]

Number 6 is the biggest one for me on the right side of my neck

[Ken_PA]

Btw, I'm surprised that a doc would at this point jump to having a biopsy. Excisional biopsies have risks, especially from the anesthetic or infection - though the risk is fairly small.

Also, if a patient had swollen fingers, I wouldn't rush to say "doc, cut one off for examination".

[David1995]

The infectious disease specialist and the ENT  specialist told me since they couldn't find any cause and since my lymph nodes have been swollen for 6 months I should consider the biopsy.

[Ken_PA]

Then do you have reason to suspect that you have weak immunity? Either now or lifelong?

E.g., why hasn't your system overcome the balanitis? It would be either from weak immune system OR a very virulent pathogen. Didn't they try to take a culture sample?

Also important would be the shape of the biggest node: long and thin or round?

[David1995]

Nope had a CD4 count have 804 CD4 cells and my immune function is normal judging from the blood test,  I have the same question, I have tried anitfungal creams and steroid creams and nothing is working, I can't seem to find someone to culture it since the urologist and dermatologist I went to say it looks like a fungus. I've been putting Hydrogen peroxide on it and it seems to be improving. Round

[Ken_PA]

What was your intent for the biopsy? To rule in/out lymphoma? Or to try to identify the pathogen?

"My doctor said Lymphoma typically presents with fever, weight loss, and night sweats"
That's typically only in advanced cases. Most find out they have lymphoma from discovering a bump, and there are no abnormal blood tests. That aside, your infection history should be suspected as the cause of everything. "Occam's razor".

"The one on the right side of my neck feels big."
Well, that's relative so an actual measurement figure would be useful. E.g., 2 inches is *really* big, but 1" is not.

If the biggest nodes have stopped growing, then that tends a lot against lymphoma.

If you wanted the biopsy for lymphoma, I'd suggest maybe a sonogram first to look at the "internal architecture" of the most suitable node. If a fatty hilum is found, I'd not have a biopsy.

Do you have a family history of odd immune conditions?

[David1995]

No family history of immune conditions that I know of, My doctor suggested a biopsy to rule out Lymphoma,  It's around a inch and a half or so, it's visible if you look at my neck it hasn't grown though.

[Ken_PA]

It's remotely possible, but I'd say it's a waste of time to look in that direction and instead look at some post-infection autoimmunity such as Antiphospholipid Syndrome.

As far as the nodes, it's important to first know the size and their recent behavior.

[David1995]

So should I continue with the biopsy? My doctor said Lymphoma typically presents with fever, weight loss, and night sweats. I've had none of those. The one on the right side of my neck feels big. The ones on the other side of my neck are peanut sized. All are payable

[David1995]

I also forgot to mention I have had a negative ANA test as well