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This question was answered on Sat 17, May 2008 08:20pm by Dr Paul S, MD

got app. with an oncologist for swollen lymph node that hadnt went away what does it sound like


    
Asked by user (Female; 43; Mitral valve prolaspe, slight pulmonary hypertension; Relevant drugs:no pres. meds, only iron and vit.d ) on Thu 15, May 2008 08:36pm

hi,about one month ago i was at my dr.for a check up and told him i had a painless swollen lump on my neck that just came up a week or so before that. I also was feeling weak and my joints felt achy. He put me on a strong antibiotic for 10 days in case it was infection and did blood work. when i went back several weeks later for follow up, he said blood work came back o.k. which was reassuring but is sending me to an oncologist june 3 just to be checked since the swollen node hasnt left yet. My joints feel better, the swelling left my hands and my hip gets a little sore still. what does it sound like to you, and what will they probably do at my first visit?

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Answer by Dr Paul S, MD  on Sat 17, May 2008 08:20pm:

Hi there. An enlarged node in the neck can have several causes and it also depends on the location. Drawing an imaginary line halfway across the neck, nodes located above this line is commonly associated with problems on the neck. This is most commonly due to an infection in mouth, tooth, tonsils, sinuses, throat etc. Nodes below the line can still come from problems in the head but more frequently from some problems in the lungs, more commonly infection also. After a course of antibiotics, the infection would have resolved if the node is indeed caused by an infection. I agree with your doctor that the persistence of these nodes should be evaluated further, and a possible malignancy is always a differential diagnosis. The oncologist will take pertinent history that will give him the idea on where to look (head, chest, or other areas). He might request imaging studies such as chest radiographs, or a thorough ENT examination of the head (sinuses, nasal cavity, oropharynx, etc). Some would go directly to a biopsy procedure, in the form of fine needle biopsy of the enlarged node. Depending on the results of the biopsy, the oncologist may perform more specific tests such as CT scanning, MRI, or PET scan. I hope your visit with your oncologist will be fruitful and that everything will be just fine. Regards and God bless.

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