Hi, I have a Hx of lymphodapathy for 6 months involving the right tonsil (10cm), right supraclavicular and subclavicular nodes (6-9mm), bilateral occipital nodes (7mm), the right postauricle node (3mm) and most recently, the left axillary node. The left axillary node is the largest- about 3 cm. It moves freely but kind of "pops" like a rubber band when moved. The surgeon has suggested removing that one because it is the largest. The occipital nodes are hard and fixed. My question is: should nodes from both the axillary area and another area be taken, or should pathology or lack there of be totally based on the axillary node finding? Aren't axillary nodes commonly found to have reactive hyperplasia, regardless of a cancer diagnosis? Should I ask my surgeon to take an additional node just to be cautious? Is it my decision?
Additional symptoms include: intermittent fevers ranging from 99.4 F to 100.4 F X4 months, EXTREME fatigue X8 months, deep aching in bones and joints, occasional night sweats- not drenching but significant X5 months. All labs are negative for other possible etiology. Serum DHL and B12 have not been checked.
In general, the most clinically suspicious lymph node, or lymph nodes, are removed in order to rule-out lymphoma. As lymph nodes greater than 1 cm in diameter are considered potentially suspicious, most of the lymph nodes that you describe do not meet this size criterion.
Lymphoma (or metastatic cancer) can also affect the axillary lymph nodes.
Thanks, Dr. Wascher! I appreciate your response. My surgery was today and the surgeon found a large node with several other nodes stuck to it. What does this mean? He was very vague in his answers. He said we need to wait for the pathology and that he could not tell by looking. Can't a surgeon typically surmise what the results will be based on the appearance of the node after removal? And my pain level is astronomical! I did not think an axillary lymph node biopsy could be so painful. I was expecting a 4-5 pain level. This is a 10! Wow! Thanks in advance for your help!
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