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Lums on Left side of Neck... Is it cancer?
Hi friends,I need your help please help me.....
Recently (15days back) i got two lumps on side of my neck. I went to an ENT specialist and done some Fine Needle AspirationCytology. The report has the following... the doctor said it is not cancer or TB... but i am still worrying about
it, can you please make me understand what is the report saying... The report is as follows...
Clinical Findings:: Cervical lymphadenopathy posterior triangle larger one m/s -1.5X1.5Xms, smaller one m/s-1X0.75cms, Mild tenderness, No Matting.
Microscopic Exam:: Multiple smears studied show mixed population of lymphoid cells, centoblasts,centrocytes,immunoblasts,histiocytes with intracytoplamic nuclear bedris, in a background of
hemorrhage. No other pathology noted.
FNA Details::
Hemorrhagic apirate
Interpretation::
FNA-Suggestive of Reactive Lymphadenopathy left cervical Lymphnodes.
Is my condition is o.k or any thing wrong is going on?
Also please tell me what all tests are required for me to do? Please help out with this.
Regards,
Recently (15days back) i got two lumps on side of my neck. I went to an ENT specialist and done some Fine Needle AspirationCytology. The report has the following... the doctor said it is not cancer or TB... but i am still worrying about
it, can you please make me understand what is the report saying... The report is as follows...
Clinical Findings:: Cervical lymphadenopathy posterior triangle larger one m/s -1.5X1.5Xms, smaller one m/s-1X0.75cms, Mild tenderness, No Matting.
Microscopic Exam:: Multiple smears studied show mixed population of lymphoid cells, centoblasts,centrocytes,immunoblasts,histiocytes with intracytoplamic nuclear bedris, in a background of
hemorrhage. No other pathology noted.
FNA Details::
Hemorrhagic apirate
Interpretation::
FNA-Suggestive of Reactive Lymphadenopathy left cervical Lymphnodes.
Is my condition is o.k or any thing wrong is going on?
Also please tell me what all tests are required for me to do? Please help out with this.
Regards,
I had a Lymph Node Biopsy (Node completely removed) last week and my report is as follows....
"Features favor reactive follicular hyperplasia of lymph node"
What does it means? My ENT only told me that it is just reactive lymph node and nothing else and he has n't recommended any tablets are anything else. Please help me to understand it completely and also do i need to take any antibiotics are anything else.
"Features favor reactive follicular hyperplasia of lymph node"
What does it means? My ENT only told me that it is just reactive lymph node and nothing else and he has n't recommended any tablets are anything else. Please help me to understand it completely and also do i need to take any antibiotics are anything else.
COMMUNITY LEADER
I don't what what Predwet is, I assume it's a different class of antibiotic. Different bacteria get killed by different classes on antibiotics. I hope it takes care of your infection.
HI Ken_PA,
I am 26 years old male from India. I don't have feaver or chills or cough or blood in sputum...
I am 26 years old male from India. I don't have feaver or chills or cough or blood in sputum...
Hi Ken_PA,
Sorry for writing wrong it is " evidence of necrosis noted with in these nodes. No evidence of classification".
Yesterday my E.N.T saw the report and she told me there is nothing to worry and asked me to wait for two weeks. Mean while she asked to have Predwet tablets for 5 days. Forget to tell you they had done the F.N.A again, this time the report says "Smear are cellular & show sheets of small mature Lymphocytes, reactive Lymphocytes and numerous scattered tingible body macrophages".
No necrosis/granulomas/malignant cells seen.
Features are suggestive of Non Specific Reactive Lymphadenitis.
Regards,
Sorry for writing wrong it is " evidence of necrosis noted with in these nodes. No evidence of classification".
Yesterday my E.N.T saw the report and she told me there is nothing to worry and asked me to wait for two weeks. Mean while she asked to have Predwet tablets for 5 days. Forget to tell you they had done the F.N.A again, this time the report says "Smear are cellular & show sheets of small mature Lymphocytes, reactive Lymphocytes and numerous scattered tingible body macrophages".
No necrosis/granulomas/malignant cells seen.
Features are suggestive of Non Specific Reactive Lymphadenitis.
Regards,
COMMUNITY LEADER
Hi, Gani. You wrote, "Evidence of necrosis noted with in these nodes. No evidence of necrosis noted with in these nodes." Those sentences contradict each other. Which is correct?
"Necrosis" means cells dying, and that can also result in some minor bleeding there. You had some blood in your FNA.
Also, "Chest X-Ray : Increased pulmonary brocho-vascular markings seen in bilaterral upper zones" looks like a possible infection in the upper lung. You should show these results on the TB forum and ask if that could be from TB. But I'm *guessing* that it's not from TB, because the neutrophils would be high and maybe also monocytes. If not TB, then maybe you have a virus infection - especially since your lymphocytes are high and neutrophils are at low end of normal. If you have a virus infection, that would explain why your test for TB is negative and also why the antibiotics are not helping you.
I don't know what virus infection would start in the mouth and also result in enlarged, bleeding lymph nodes, and also get into the lungs.
Btw, I have been assuming that your age is in the 20s. That would tend to rule out other causes for those markings seen by x-ray in the blood vessels of the upper lung.
Also, on your neck ultrasound, "No significant vascularity" tends to say that the nodes are *not* cancer, since cancer makes new blood vessels grow to feed it.
"Necrosis" means cells dying, and that can also result in some minor bleeding there. You had some blood in your FNA.
Also, "Chest X-Ray : Increased pulmonary brocho-vascular markings seen in bilaterral upper zones" looks like a possible infection in the upper lung. You should show these results on the TB forum and ask if that could be from TB. But I'm *guessing* that it's not from TB, because the neutrophils would be high and maybe also monocytes. If not TB, then maybe you have a virus infection - especially since your lymphocytes are high and neutrophils are at low end of normal. If you have a virus infection, that would explain why your test for TB is negative and also why the antibiotics are not helping you.
I don't know what virus infection would start in the mouth and also result in enlarged, bleeding lymph nodes, and also get into the lungs.
Btw, I have been assuming that your age is in the 20s. That would tend to rule out other causes for those markings seen by x-ray in the blood vessels of the upper lung.
Also, on your neck ultrasound, "No significant vascularity" tends to say that the nodes are *not* cancer, since cancer makes new blood vessels grow to feed it.
HI Ken_PA,
Today i had lots of tests and i would like to share them with you so that you can get more clarity on my case.
Chest X-Ray : Increased pulmonary brocho-vascular markings seen in bilaterral upper zones.
Rest of the lung fileds are clear.
Both costo-phrenic angles are clear. Both the domes of diaphragms are normal. Cardiac size is with in normal limits. Mediasttinum is normal. Thoracic cage is normal. Soft tissues around chest are normal.
Ultra Sound : Few enlarged lymphnodes are noted in posterior triangle on left side. Largest one measured 18X9 mm. Evidence of necrosis noted with in these nodes. No evidence of necrosis noted with in these nodes. No vidence of classification. No significant vascularity.
No signeficant cervical lymphadenopathy seen.
Blood Test:
Haemoglobin 15.4 (130.-18.0 ) Normal
Leucocyte count 8000 (4000-11000) Normal
Neutrophils 43 (40-75) Normal
Lymphocytes 47 (20-45) High
Eosinophils 4 (1-6) Normal
Monocytes 6 (2-10) Normal
Basophlls 0 (<2)
E.S.R 03 (0-20) Normal
Absolute Eosinophil Count 320 (40-400)
Platelets 185000 (150000-450000)
R.B.C Morphology : Normocytic Normochromic.
W.B.C Morphology : Normal in Number, Morphology with Lymphocytosis
Platelets: Adequate in number
Haemoparasite: Not seen
Impression: Normocytic Normochromic Blood Pictures with relative Lymphocytosis.
Are these tests help you to know any thing better?
Regards,
Gani453.
Today i had lots of tests and i would like to share them with you so that you can get more clarity on my case.
Chest X-Ray : Increased pulmonary brocho-vascular markings seen in bilaterral upper zones.
Rest of the lung fileds are clear.
Both costo-phrenic angles are clear. Both the domes of diaphragms are normal. Cardiac size is with in normal limits. Mediasttinum is normal. Thoracic cage is normal. Soft tissues around chest are normal.
Ultra Sound : Few enlarged lymphnodes are noted in posterior triangle on left side. Largest one measured 18X9 mm. Evidence of necrosis noted with in these nodes. No evidence of necrosis noted with in these nodes. No vidence of classification. No significant vascularity.
No signeficant cervical lymphadenopathy seen.
Blood Test:
Haemoglobin 15.4 (130.-18.0 ) Normal
Leucocyte count 8000 (4000-11000) Normal
Neutrophils 43 (40-75) Normal
Lymphocytes 47 (20-45) High
Eosinophils 4 (1-6) Normal
Monocytes 6 (2-10) Normal
Basophlls 0 (<2)
E.S.R 03 (0-20) Normal
Absolute Eosinophil Count 320 (40-400)
Platelets 185000 (150000-450000)
R.B.C Morphology : Normocytic Normochromic.
W.B.C Morphology : Normal in Number, Morphology with Lymphocytosis
Platelets: Adequate in number
Haemoparasite: Not seen
Impression: Normocytic Normochromic Blood Pictures with relative Lymphocytosis.
Are these tests help you to know any thing better?
Regards,
Gani453.
COMMUNITY LEADER
Glad to be of some help to you, Gani.
Trying another antibiotic is the safest option, requiring no 'cutting'. A new antibiotic is what I might have recommended except you have that time deadline. But I suppose you still have plenty enough time to try another antibiotic.
The CBC might be for determining what type of infection you have. The ultrasound is for getting a look inside a node without actually cutting it out. Remember to ask the ultrasound technician if they see a "fatty hilum", which means there is no cancer. But still, I see no reason to think that you do have cancer - asking will be just a further reassurance.
Your life is not anywhere near to being over, you'll have so many years at the dream job that you'll grow tired of it and be looking for a new dream job :)
Maybe you're a little better already from the Cefprozil. The first sign might be having no pain, then the nodes getting smaller.
Trying another antibiotic is the safest option, requiring no 'cutting'. A new antibiotic is what I might have recommended except you have that time deadline. But I suppose you still have plenty enough time to try another antibiotic.
The CBC might be for determining what type of infection you have. The ultrasound is for getting a look inside a node without actually cutting it out. Remember to ask the ultrasound technician if they see a "fatty hilum", which means there is no cancer. But still, I see no reason to think that you do have cancer - asking will be just a further reassurance.
Your life is not anywhere near to being over, you'll have so many years at the dream job that you'll grow tired of it and be looking for a new dream job :)
Maybe you're a little better already from the Cefprozil. The first sign might be having no pain, then the nodes getting smaller.
Thanks a lot for your reply, every time i read a reply from you i feel a bit relaxed. Today i met another doctor and she told me to use another antibiotic for 5 days, if the lumps present even after that she said i need to have a total blood count test, ultrasound and FNA once again. Even now also the lymph nodes are still swollen. Currently i am using Cefprozil 500mg tablets. I really don't want end my life with cancer. I hope i will get normal with less pain and strain.
COMMUNITY LEADER
Gani, that's in the realm of infectious disease medicine now, but to me everything your doc says seems like the right way to go. They need to remove some larger sample of infected tissue to determine what exact microbe is causing the infection, and once they have a sample they might also test it to see if it is resistant to the antibiotic you were already given.
Normally, a lymph node enlarges as the immune cells inside of it multiply to fight an infection. In your case, though, the infection is happening right insde the nodes.
One thing you might ask the doc, though, is if they can somehow get a sample from the area of the mouth infection instead and so then you wouldn't need the surgery to have them remove a node. The mouth infection is what caused your lymph nodes to enlarge, as they geared up to fight the infection.
However, keep in mind that for some types of infections in nodes, the removal of the nodes is a treatment in itself. You get rid of the bad areas outright.
Another thing is that how your neck nodes had bleeding inside is what could be expected from TB, since T destroys cells like that. So maybe your test for TB was what is called a "false negative". You can ask for a second opinion on your biopsy sample, in which a different pathologist looks at it and that doesn't require another FNA since they use the same tissue as from before.
If you really don't have TB then you have some other micro-organism like a bacteria that acts the same way that TB acts
Please let me know how this ends up. I think you will be cured in plenty of time for your dream job. Good luck, Gani..
Normally, a lymph node enlarges as the immune cells inside of it multiply to fight an infection. In your case, though, the infection is happening right insde the nodes.
One thing you might ask the doc, though, is if they can somehow get a sample from the area of the mouth infection instead and so then you wouldn't need the surgery to have them remove a node. The mouth infection is what caused your lymph nodes to enlarge, as they geared up to fight the infection.
However, keep in mind that for some types of infections in nodes, the removal of the nodes is a treatment in itself. You get rid of the bad areas outright.
Another thing is that how your neck nodes had bleeding inside is what could be expected from TB, since T destroys cells like that. So maybe your test for TB was what is called a "false negative". You can ask for a second opinion on your biopsy sample, in which a different pathologist looks at it and that doesn't require another FNA since they use the same tissue as from before.
If you really don't have TB then you have some other micro-organism like a bacteria that acts the same way that TB acts
Please let me know how this ends up. I think you will be cured in plenty of time for your dream job. Good luck, Gani..
HI Ken_PA,
When i went to doctor he done oral check up and he told me that it could be either an infection or TB. So he told me to have FNA directly, but later when the report came he said it is not TB and it could be because of some infection. He asked me to take Azitromycin Tablets 500mg for 5 days and asked me to come after that. But till now i had taken 4 tablets and still there is no result. I need to get rid of this with in a month to save my dream job. He said after 7 days if it won't work, he will cut the lump and do biopsy. I am really scared and don't know how to react and what to do?... I forgot to tell you "I got some severe mouth infection five days before this lumps appeared on my neck" . In fact i totally got three lumps on one the back of the neck near the hair line and exactly at the middle of the neck(back side). But once again thank you very much for your quick reply, it means a lot for me....
Regards,
Gani453.
When i went to doctor he done oral check up and he told me that it could be either an infection or TB. So he told me to have FNA directly, but later when the report came he said it is not TB and it could be because of some infection. He asked me to take Azitromycin Tablets 500mg for 5 days and asked me to come after that. But till now i had taken 4 tablets and still there is no result. I need to get rid of this with in a month to save my dream job. He said after 7 days if it won't work, he will cut the lump and do biopsy. I am really scared and don't know how to react and what to do?... I forgot to tell you "I got some severe mouth infection five days before this lumps appeared on my neck" . In fact i totally got three lumps on one the back of the neck near the hair line and exactly at the middle of the neck(back side). But once again thank you very much for your quick reply, it means a lot for me....
Regards,
Gani453.
COMMUNITY LEADER
Hi, Gani. I think that your local doctor would know what local infections would typically cause blood inside the nodes, and last for so long. Since your nodes are still tender, the immune reaction is ongoing and maybe you'd respond quickly to a trial of an antibiotic for a week or so - with that antibiotic being matched to whatever local infection is the probable cause. It is possibly some bacteria that gets inside the cells and kills them, causing the 'intracytoplasmic nuclear debris' when they rupture to be seen by microscope on the blood smear. I guess it could alternatively be a virus, which means that antibiotics wouldn't work and treatment would not be so simple or quick
Or have antibiotics already been tried and failed? There must be a reason why the FNA was done, that doesn't seem to be a usual step unless there is reason to think it's not an ordinary infection.
Or have antibiotics already been tried and failed? There must be a reason why the FNA was done, that doesn't seem to be a usual step unless there is reason to think it's not an ordinary infection.
Hi Ken_PA,
Thanks for a very quick & informative reply. Yes, i am from India. Actually I am going to join a new company (next month). I need to show that i am medically fit for the job, So i want to get a clarity on my condition before the joining. Can you please suggest me on what i need to ask my doctor to check for any harmful diseases.Also can you please tell me what tests i need to do if i want to know what is the infection that caused my nodes to get enlarged.
Regards,
Gani453
Thanks for a very quick & informative reply. Yes, i am from India. Actually I am going to join a new company (next month). I need to show that i am medically fit for the job, So i want to get a clarity on my condition before the joining. Can you please suggest me on what i need to ask my doctor to check for any harmful diseases.Also can you please tell me what tests i need to do if i want to know what is the infection that caused my nodes to get enlarged.
Regards,
Gani453
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Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
So, don't worry about cancer. But what infection is there? Are you in India? In the U.S., I would think of cat scratch (bartonella), which can give painful swelling in neck nodes.
If weeks go by with no improvement and antibiotics don't help, you can think about an ultrasound of those nodes. Also, when an infection invades a node the inflammatory reaction can produce scarring which might last a very long time - but which usually wouldn't be painful so think of that if the pain goes away but the nodes don't go back to normal size.
However, I don't think that bleeding from an infection in a node is usual. That might give a clue on what organism is causing the infection.
I don't think that taking out a whole node for biopsy is warranted at this point.