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Enlarged lymph nodes - TB or cancer ? (Page 1)

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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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replied 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.


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replied November 8th, 2009
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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replied November 10th, 2009
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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replied December 5th, 2009
hello,
already part of the biopsy was sent for culure. but I'm not confenesed that I have TB, because I have no symptoms, what so ever! I have enlarged lymph nodes under my arm, that's all I have!it's been shown by ultra sound.
they gave me the TB skin test, and the result was read positive, but still I'm not confensed! have you had the TB skin test? it is an injection under the skin, usualy in your forearm.
thnks
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replied December 14th, 2009
Hiya
Yes I had skin test. It was positive for me too. 21 mm induration. Well, I did not have symptoms too... No fever, cough, night sweats or loss appetite. I did have loss of weight; but that was secondary to my dysphagia.
My FNAC was indecisive. I am going to complete 4 months of medicines. Since a month, my nodes on neck are enlarging. But my doctor (not GP chest physician) discarded that saying 'it is paradoxical reaction'.
I have asked all possible questions to the doc but he is unmoved and refuses to do another biopsy or FNAC.
Do u have biopsy result? What does it say? Have u started on TB medications? Do you find any improvement in ur health? Always watch out for positive signs.
Though nodes are getting bigger, I feel physically well (touch wood). So keeping fingers crossed.
The good news for you is, extra pulmonary TB, especially the lymph node TB can be subclinical, meaning there may be no overt symptoms. It varies from person to person.
Dont worry. U dont have cancer.
Be sincere to take medicines. Eat a healthy diet and complete the course for 6 months. You will be fine.
Keep me posted.
Cheers,
Vanitha
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replied December 16th, 2009
hello Vanitha,
as I mentioned earlier, part of my biopsy was sent to a patholigist, who reported his findings as follows: "chronic granumelatous lymphadenitis with focal caseating nechrosis. highly suspecous of tuberculosis".
another part was sent to a microbiology lab for culture, which is not reported yet.
I started the tb medication about a month ago. I didn't notice any reduction in the size of the lumb under my arm.
I've read that most of people who have lymphoma, experienced enlarged lymph nodes as a first symptom, and then later on they develop other symptoms, do you know how long it takes for other symptoms to appear after the enlargment of the lymph nodes?
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replied December 16th, 2009
I am not sure of this. But for me, it took alomost 3 months to notice any reduction in the nodes. I think this varies with people; thats what the doc said. TB bacteria grows very slowly. so it takes 6 weeks for the culture.
Other common symptoms of Lymphoma are night sweats, fever without known cause, loss of appetite and weight, fatigue and breathlessness. But also note that these are the symptoms for TB too.
If you have lymphoma, the cancer cells would have been identified in the biopsy. The presentation you have mentioned 'granulomatous lesion with caseating necrosis' is specific to TB. Even though the pathologist is pretty sure it is TB, he will not give it in writing unless he sees the TB bacteria. So be patient until you get the culture results.
One advice I could give u is, PLEASE STOP SEARCHING GOOGLE. YOU WILL COME ACROSS ALL KINDS OF STUFF AND GET CONFUSED.
take care.
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replied January 4th, 2010
i agree with vanithamsw,stop looking in on google...please go to the right doc.i too have lymph node TB and initially i googled and got so much info that it scared me away.Vanithamsw,have you gained much weight during treatment? im finishing off mine and i have gained 8kgs in 6months..im trying to find out if it's normal though my doc told me it's ok....
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replied January 5th, 2010
Hello Nandu I am happy u have recovered. I have so far gained 6 kilos. I was shocked to know I have put on so much. But I think it was becuase my family was pumping me with food for past 5 months:)
Just wanted to ask... did ur nodes go back to normal size completely or do u have any residual nodes still?
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replied January 5th, 2010
Hi vanithamsw,i still have a week of medicines left then i have a CT scan.from the outside the nodes look normal.the doc said the nodes r returning to normal.i will know for sure after the CT scan,will keep u posted.Happy recovery to you too.
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replied January 7th, 2010
Hey Nandu
I went for followup yesterday and to my utter shock I am 59 kg now, meaning I have put on 9 kilos. I have never weighed more than 53 kg until now.
Since my cervical nodes are enlarging, the doctor has requested for an ultrasound.
waiting with fingers crossed..
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replied January 7th, 2010
Good Luck to you Vanita,i will be going next weekend for a CT scan...hope everything will be alright.
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replied January 9th, 2010
hello vani and nandu,
I received my culutre results two days ago. it confirms that I got Mycobacterium , and it was put for tb drug resistance. this will take quite long. i've been taking my medication for 2 months, but i've never noticed any reduction in the size of my nodes!
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replied January 10th, 2010
hi salehsaeed,

don't worry about that.my node size started reducing after 3months or more of treatment.It differs for each person.keep a positive outllok and you will be fine.don't ever pity yourself.Good luck!
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replied December 20th, 2010
as I've understood from my doctor, the mycrobactrum of TB won't go away. it stays in my body, and have the potential to be aggressive in any stage of my life!!
is this correct?
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replied May 10th, 2011
Have to punish Doctors as well for wrong investigations
Here in india Doctors are not having enough knowledge on Lymphoma. Both TB & Lymphoma are having similar kind of symptoms. and they are treating the patient for TB and later they are realizing that its a lymphoma. but its too late for patients. there is no punishment for those doctors. its very bad
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replied February 1st, 2014
lymph node swlling. what reveals this infection or cancer?
i have swelling on cervical lymph node. FNAC reports showed that smears with rich cellularity comprising of lymphocytes, neutrophils and discrete cells resembling epitheloid cells against a caseous background

what this test reveals? tb or cancer? i dont have any symptoms like fever, weight loss, loss of appetite but swelling at neck region is there. it is quite annoying me a lot. please give suggestion for this problem
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replied January 1st, 2016
I had enlarged lymph node (in upper neck side, just below the jaw line).

My ultrasound says that it has - central necrotic content.

I had FNAC 2 weeks back and report says -
"Smear consist of many neutrophils, lymphocytes, plasma cells and few histocytes in a necrotic backgrund. No granuloma/atypical cells seen.
AFB strain - Negative"

When i meet to Pulmonologist, he said its TB and have started the treatment however i am not sure that its TB only or if i can rule out lymphoma?

I want to understand how to differentiate between lymph node TB and lymphoma. Please help to understand the same.
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replied June 1st, 2016
I am having lump just above my left collar bone
hello i have 3 lumps on just above my left collar bone. i have been go through ultrasound,ecr,CBC,mantoux test,FNAC. Mantoux was negative and in fnac report tuberculosis bacteria did not find but some other bacteria was there which are related to T.B. so to be make sure that this is not the case of T.B. docter suggest me radio matric culture and after 1 week report there were no growth found for T.B. in second week also no growth detected. now i am worried because docter has not been started any treatment and i am feeling that the size of lump is increases and may be it cause of any serious problem
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