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Q: Enlarged lymph nodes - TB or cancer ?
asked by: vanithamsw on October 15th, 2009
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I am 27 years female. 3 months back I noticed a lump at the root of my neck. Further CT/Ultrasound showed several enlarged lymph nodes on the right pre/para tracheal regions. ESR was 45, FNAC showed granulomatous lesion and Mantoux was 21mm induration after 48 hours. I was started on anti TB medicines (4 drug combination for 2 months followed by 2 drugs for 4 months). I have completed 2 months of medications. Suddenly couple of weeks back I noticed a peanut sized lump above my collar bone on left side, which was not there earlier.
My GP sent for blood tests. Biochemistry was normal, ESR is 11 (has come down from 45). I am extremely worried if this could be cancer. But GP ruled out cancer because my blood tests are normal. I am soooo worried because despite 2 months on treatment my nodes have not regressed even a bit and additionally new nodes are appearing at a different site. I have mild pain in my lower jaw and arm pits(on and off).
My appetite and sleep are normal. I have also gain 2-3 kgs in past 2 months. can you tell me what this could be? I am panicing so much that this may be a malignancy. Please clarify.
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Dr. Robert Wascher , MD
replied on October 21st, 2009
While it is rather unlikely that you have lymphoma (cancer of the lymph nodes) given your recent history of confirmed TB infection of your lymph nodes, it is also not possible to rule-out lymphoma with blood tests. If you have newly enlarging lymph nodes, then you should probably undergo another biopsy of one or more of these enlarged lymph nodes.


Sincerely/ Robert A. Wascher, MD, FACS

http://doctorwascher.com

http://oncoguard.com





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salehsaeed
replied on November 8th, 2009
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worried of lymphoma
dear vanithamsw
I have similar symptoms, with a small difference: I have my enlarged lymph nodes underarm (right). a biopsy was taken from one of the elarged nodes, the pathologist suggested that it is highly suspeousus of T.B.
I noticed the painless lump under my arm about 5 weeks ago. I'm also extremely worried of lymphoma.
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vanithamsw
replied on November 10th, 2009
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Hello there
I can understand how you would feel as I am in the same boat. But if a biopsy has been done and it is suggestive of TB but not conclusive, you have to request for a culture to be 100% sure. If you are in a developed country, this is mandatory; but in countries like India, doctors may not mention to you that such an option exists. So insist to your GP/Pulmonologist that you need culture of the biopsied material. Though it takes 6 weeks for the result to come back, you can have peace of mind after that.
Dont worry! From what you say it seems more like TB. I would strongly recommend you send the sample for culture. If culture is positive for AFB then a diagnosis of TB can be confirmed.
Take care. Keep me posted.
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