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Swollen lymph nodes

My husband who is now 37 has had some things come up. I stressing myself sick, and i feel this is my last resort till we can get some health insurance for him.

So several months ago he had a flesh coloured bump pop up on his chest plate. It's a hard circular bump that doesn't seem moveable. He has then had a few of them pop up on his neck (kind of below his ear, in that area). He now has one on his upper inner arm and one in his belly. He tells me they are painless. He has also developed a cough. He tells me hue is getting night sweats. He has headaches but has had those since I've known him. His belt loop has gone up 6 notches but he's eating normal and still wears his size 32 jeans like he's always had.

Hee takes one blue Xanax a day and drinks regularly (2 or 3 a day). I need help. His job had no insurance and he's actively looking, but won't be able to do anything until he December.

I'm terrified....I'm literally breaking down inside.....any tips or advice????? Please!!
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1081992 tn?1389903637
COMMUNITY LEADER
You can consider getting a chest x-ray, approx $85.Maybe this is a good site, I don't know:

https://www.mdsave.com/procedures/chest-x-ray/d480face/texas/dallas-tx
Helpful - 0
2 Comments
I just called them for you to confirm that you do get the radiologist's report along with the x-ray --  but they are closed.

On their home page, it says "Save $25 on your next procedure when you join our email list."

The x-ray should probably see any large mass inside the chest. I think that the bump on the sternum is the primary concern. It might be the tip of an iceberg, with a larger mass inside. If the x-ray finds nothing, that can be somewhat of a relief.

The chest x-ray should also probably see TB.

The ones around me require a doctor's order. And I dont want a diagnosis before he gets insurance....I hate this. I hate insurance.
1081992 tn?1389903637
COMMUNITY LEADER
Are you saying that there are enlarged bumps above the collarbone? If so, on his left or right side?  

Here is the most clear graphic: https://medsim.in/help/MedSimSoftwareDocumentation.docx_files/image167.jpg


What about any lung sounds, like wheezing or crackling?
Helpful - 0
1 Comments
He has one on the left side of the neck.  None on the collar bone. He does have a few on his arms, not on the armpit.
And the one on his belly.
He said he sounds like he's wheezing, but he's also a smoker. And we just came back from San Antonio, with allergies. Both of us coughing and having scratchy throats.
1081992 tn?1389903637
COMMUNITY LEADER
Yes, this must be extremely difficult for you. Sometimes it's even worse for a family member than for the patient. Maybe learning as much as you can will make you feel less helpless. There's a lot to absorb, so it's natural to feel overwhelmed.


Here's a wholly different way to view of all of this: we don't even know for certain at this point if any of the bumps are actually lymph nodes. It's theoretically possible that something got deposited on the sternum and also at the other spots. Some kind of nodules. If that's the case, everything can possibly be benign.

-----------------------


Probably the most important thing of all right now is to check for enlarged nodes above the collarbones. Take a look at how to do it, about 3/4 of the way down here:  
http://craftbrewswag.info/supraclavicular-lymph-nodes/


(clavicle means collarbone, supra means 'above')
Helpful - 0
1 Comments
It looks like they fall in posterior cervical or clavicle? I believe that's what it said. He checked his groin area and nothing there...yet. Just the one next to his belly button and the one on arm and chest and his neck. He said no difficulty stalling or breathing. But now I'm freaked out its tumors. Being a hypochondriac myself, this is what I felt was a last resort. He keeps talking life insurance to me....and I give no ***** about life insurance. I dont want to lose my husband. I'm a wreck, not eating and being zombified for the last few days

1081992 tn?1389903637
COMMUNITY LEADER
Last for today, here's an example of benign inflammatory sternum tumors. It's about teenagers, but anyway it shows that some sternum tumors can be mysterious in origin but still benign, and even go away on their own after a few months.

https://www.ncbi.nlm.nih.gov/pubmed/20213849
"Self-limiting sternal tumors of childhood (SELSTOC)."
Helpful - 0
1 Comments
I appreciate all of your input and feedback. I'm physically ill going through this. I feel hopeless and helpless. I just want a diagnosis, but have to rely on my patience. Which I dont have any of. I'll ask him more questions and posts later regarding his answers.
1081992 tn?1389903637
COMMUNITY LEADER
Here's an offbeat thought: in most or all states, you can order blood tests on your own. A test called LDH can go high in lymphoma and lung cancer and many other cancers, too.

Here's on example place: https://www.walkinlab.com/liver-profile-1-baseline-blood-test-panel.html

It's in a bundle that costs $34. Other places might be cheaper or have monthly specials. It's a front end business, the actual blood tests are done at the same places they are always done when ordered by docs etc, Quest and LabCorp.



Here is a sample value, not to be read now but saved for possibly later:
https://www.ncbi.nlm.nih.gov/pubmed/26240025
Helpful - 0
1081992 tn?1389903637
COMMUNITY LEADER
We can look here: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=22&contentid=chestwalltumors

...which seems to say that malignant is usually painful but benign is usually not painful.



Symptoms of Chest Wall Tumors

People with malignant chest wall tumors might experience one or more of the following:

    Pain or soreness
    Swelling
    Impaired movement or chest expansion
    Protrusion as with a lump

People with benign chest wall tumors might experience one or more of the following:

    Protrusion as with a lump
    Pain (with certain types)
    Muscle atrophy (with certain types)


Diagnosing Chest Wall Tumors

The process usually begins with a complaint of pain or pressure from the patient. After conducting a general exam, the physician likely will order an x-ray. But x-rays tend to show only that there is an abnormality. They aren’t necessarily able to indicate whether the tumor is malignant or benign. A CT (computed tomography) or MRI (magnetic resonance imaging) scan can zero in on the location and size of the tumor, as well as give some information about what type it is.

Once this preliminary information is collected, steps will be taken to conduct a biopsy—that is, to remove and examine a sample of the tumor. The most common procedure is an aspiration biopsy, in which a needle is inserted into the tumor and cells are removed for examination. Sometimes, if it’s difficult or impossible to get at the tumor cells using a needle, the patient might undergo an open biopsy, a surgical procedure that can leave a small scar. It is from these cell samples that the tumor is fully diagnosed.
Helpful - 0
1081992 tn?1389903637
COMMUNITY LEADER
Well, this is unfortunately not my sphere. What I can think of is looking at Differential Diagnosis pages that can be found.

Or we can take the optimistic approach and web search for something like--> benign sternum tumors

A tumor can be benign or cancer.

If it's benign, the nodes would be reacting to the same infection or inflammation that caused the sternum bump. If it's cancer, the nodes are metastases. I don't know if a cancer in the lungs can metastasize to the supertrochlear node (above the elbow). But offhand it doesn't seem likely.

I would guess, but don't know, that if it was cancer in the sternum it would be painful if pressed on.

I did take a brief look around and it all seems very complicated, with no clear indication either way.

When he gets home, can you feel above the collarbones, especially on the left side, for any bumps?
Helpful - 0
1081992 tn?1389903637
COMMUNITY LEADER
Would you say it's the part of the sternum called the manubrium on this graphic:  https://en.wikipedia.org/wiki/Sternum

(upper right of page)
Helpful - 0
1 Comments
It would be the blue part in the graph thingy
1081992 tn?1389903637
COMMUNITY LEADER
By stomach/belly, do you mean near the navel? There is a chain of nodes there.
Helpful - 0
1 Comments
It's about 4 inches to the left of the belly button. If you're referring to his left, not mine.
1081992 tn?1389903637
COMMUNITY LEADER
If his lung sounds have a 'crackle' or anything obviously abnormal, that might be a clue that could be followed up on a TB forum.

Here is Dallas County stats:
https://www.dallascounty.org/department/hhs/documents/Tuberculosis2016DiseaseProfile.pdf

and some type of clinic or something related, not for right now but just to keep in mind:
https://www.dallascounty.org/department/hhs/lab.html



Helpful - 0
1 Comments
He coughs sporadically, and clears his throat a lot. It may be beginning stages of TB, but we're an hour or so away from Dallas, and don't go anywhere.
It might be possible, but I'm more worried about cancer than anything.
1081992 tn?1389903637
COMMUNITY LEADER
We also need to be sure you're not talking about the xiphoid process, which is like a bone or hard cartilage that hangs down from the lowest part of the sternum: http://www.innerbody.com/anatomy/skeletal/xiphoid-process-sternum
Helpful - 0
1 Comments
It seems to lie on his upper sternum, on the graph. It's not where the xiphoid is.
1081992 tn?1389903637
COMMUNITY LEADER
Any cat around that might have scratched him?
Helpful - 0
1081992 tn?1389903637
COMMUNITY LEADER
Well, let's see if we can make some progress. We'll start in no particular order by trying to differentiate between tuberculosis and lymphoma.

Can you closely listen to his breathing, ear to chest? TB can make lymph nodes enlarge but it usually starts in the lungs.

Can you feel if his liver is enlarged? It's on the right side below the ribs, please find an anatomy diagram somewhere on the web. Also check the spleen on the opposite side.

I'd asked about the 'chest plate' (sternum/breastbone) because there are no lymph nodes there. So whatever is there gives a clue about why the nodes are enlarged. Can you verify that it does or doesn't look anything like *any* of the pictures here:  https://www.semanticscholar.org/paper/Cutaneous-tuberculosis-in-Hong-Kong%3A-an-update.-Ho-Ho/68cbed44e8e3488eb4ee85f9c379378daf95e0c3/figure/5

Is this the place of the node above the elbow? https://en.wikipedia.org/wiki/Supratrochlear_lymph_nodes

Have there been any news report of TB where you are?
Helpful - 0
1 Comments
I have not listened to breathing yet, but he is also a smoker. I will check this when I get home. He said he has been breathing fine, and no issues there.
I have not heard him complain about anything regarding pain in that area. But I haven't felt it either. Would this cause pain or discomfort?

The pictures are horrible, but it doesn't look like that. It is flesh colored, but it's smack dab in the middle of his chest.
And the elbow pictures depicts pretty close to where I am talking about, he hasn't had any issues in his arm pits. Or yet, anyway.

I have not seen any cases regarding TB. I am in DFW area. And nothing like that. He does work in heating and air and is always in attics/insulation, etc.

We do have a cat, but I don't think he's been scratched.
1081992 tn?1389903637
COMMUNITY LEADER
Hi, lymphoma is among the least likely causes. So don't panic :)  Some infection or immune reaction is more likely.

What is the size of the largest bump? How fast did the bumps come up? Was it mostly overnight for each bump, even though they didn't all come up over the same night?

Where exactly do you mean by "on his chest plate"?

You are saying that each bump is under the skin, not part of the skin like a callous would be part of the skin, right?
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3 Comments
"What is the size of the largest bump? How fast did the bumps come up? Was it mostly overnight for each bump, even though they didn't all come up over the same night?"

Maybe dime to nickel size. In the past several months they have slowly started. I don't believe it happened overnight, he just keeps noticing them pop up here and there.

Where exactly do you mean by "on his chest plate"?

It's in between his nipples in the middle of his chest. You can see it if he is topless. It's very small looking - almost like a cyst. But it feels like the size of a nickel.

You are saying that each bump is under the skin, not part of the skin like a callous would be part of the skin, right?

No, not like a callous at all. Besides the one on his chest plate and arm - they're not visible (like the ones in his stomach or neck)

What is the size of the largest bump? How fast did the bumps come up? Was it mostly overnight for each bump, even though they didn't all come up over the same night?

The largest one would be like nickel size, I would think, maybe quarter. They started a few months ago, and have sporadically shown up over time. I don't believe they all did it over night.

Where exactly do you mean by "on his chest plate"?

The spot in between his nipples, right in the middle of his chest. It's slightly noticeable when he has his shirt off, but the ones on his neck and stomach, aren't.
You are saying that each bump is under the skin, not part of the skin like a callous would be part of the skin, right?

You are saying that each bump is under the skin, not part of the skin like a callous would be part of the skin, right?

The one on his inner, upper arm you can kind of see it. He has to turn his arm a certain way. And the chest is slightly visible, But the ones on his neck and belly are not visible, you have to put your finger on the spot and rub it to feel it under the skin.
I didn't mean to comment twice :/
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