Follow up:
Clarification / Comment by emmylou56 on Tue 01, Apr 2008 08:14am:
Hello i tried to send a reply earlier today not sure if it got to you so i thought i'd send it again i
don't think i have been tested for tuberculosis i'm not getting fevers but i forgot to tell you i
have been getting really bad headaches for a couple of weeks and really itchy skin not sure if it means
anything but i thought if you knew it would be best i haven't had a FNAC but the doctor was going to do a
biopsy but decided to do an ultrasound not sure if he will still want to do a biopsy but i go back next
Tuesday to get the results of ultrasound also my thyroid is good they said the blood test came back with
thyroid was normal. So i hope this will tell you more thank you for getting back to me so quickly Emma.
Clarification / Comment by Dr Bobby V, MD on Tue 01, Apr 2008 08:57am:
Hi,
With "more glands up every week", you need a FNAC quickly to reach a diagnosis. If FNAC is
inconclusive, your doctor may then proceed to do a biopsy.
Headache and itching are non-specific conditions. Although they need to be evaluated, they do not either
suggest or rule out lymphoma.
Interestingly, a small minority of patients with Hodgkins disease do indeed report itching. For more on this,
click on this URL:
http://lymphoma.about.com/od/symptoms/f/pruritus.h
tm
Do post your ultrasound result, and also your FNAC/Biopsy results when you do get them. Good luck!
Clarification / Comment by emmylou56 on Wed 02, Apr 2008 12:14am:
Thank you for your help i will post the results to you when i get them and thank you for the link to look at i
don't know if it put my mind at ease but thank you again. Emma
Clarification / Comment by emmylou56 on Mon 07, Apr 2008 08:07am:
Hello i go for my appointment tomorrow and was wondering efore i go can you have small glands that are raised
and still have lymphoma i haven't got my ultrasound results yet so i don't know how big they are was
just wondering if you could tell me before i go tomorrow thank you Emma.
Clarification / Comment by Dr Bobby V, MD on Mon 07, Apr 2008 08:33am:
Hi,
Theoretically it is possible for lymphoma to present with small nodes.
The classical presentation for Hodgkins Lymphoma is to have a group of contiguous lymph nodes in the neck
present as an enlarging mass. Within the mass, individual nodes are discrete, elastic, and painless.
Non Hodgkins Lymphoma may present with neck or axillary or inguinal lymph nodes with an elastic feel.
However, in clinical practice, there is a great deal of variation in presentation of lymphoma. Hence it is
best not to rely too much on the physical appearance, size etc, and to confirm all suspicious nodes with an
FNAC. It is a routine, outpatient, near-painless test.
Lymphomas are, for the most part, treatable.
I wish you all the best!
Clarification / Comment by emmylou56 on Mon 07, Apr 2008 10:49pm:
Thank you for getting back to me so quickly i have been to the hospital appointment and he didn't give me
the results to take home from the ultrasound but he said that the gland on my thyriod that was up looks benign
but because my glands have been up for so long he has put me on the waiting list to have a biopsy done i asked
if it came back benign what could it be then he said maybe a virus or coronic fatigue syndrome what do you
think are they possibilties? Also if they do a biopsy can they tell if it is a virus through the biopsy. Thank
you Emma.
Clarification / Comment by emmylou56 on Wed 07, May 2008 03:24am:
Hi there i was just wondering if you could help me i'm really disheartened i went for my biopsy yesterday
and told them to lay me on my side to be able to get to my lymph node but they didn't listen and
couldn't find it so they didn't take it out now i still don't know what is wrong with me my
question to you is there any other test i can have instead of another biopsy because i heard that you can have
a CT scan with special dye and that can tell you whether there are cancerous cells in you lymph glands
i'm at the end of my rope don't know what to do or where to go to get help i was treat really badly
at the hopsital and they just didn't wanna listen to me they just said they are going to do another
ultrasound which told them nothing last time so what will it tell them this time please please if you can help
me that would be great thank you Emma
Clarification / Comment by Dr Bobby V, MD on Wed 07, May 2008 07:25am:
Hi,
I am sorry you have had to go through a period of uncertainty.
You have asked if a CT scan with contrast enhancement (or a PET scan with FDG dye) can diagnose cancer. The
answer is no. For diagnosis of cancer, the gold standard is pathological examination. Even if radiological
scans suggest malignancy, the diagnosis requires confirmation by biopsy or cytology.
I think that you should focus on the "bigger picture" of your health, rather on the biopsy or
ultrasound. How are you feeling? Have the symptoms worsened, remained the same, or improved? Has your
hoarseness resolved? Have your energy levels improved?
In my opinion, if ultrasound cannot pick up the lymph nodes, and the cytopathologist too cannot locate them,
then it is unlikely that we are dealing with a lymphoma. The natural history of a lymphoma is one of
progressive increase in size of lymph glands. In your case, the glands seem to have a stable size, or even
regressed in size over the last four or five months. Also, you have not reported significant weight loss,
fever, or drenching night sweats. These facts make lymphoma a less likely diagnosis in your case.
Please see an internist, who will examine you, evaluate your lymph glands, order appropriate tests, and arrive
at the correct diagnosis.
All the best!
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