Ultrasound for swollen lymph nodes... I have a bad feeling about this
 

Reader's Digest version: I found a lump under my chin about a month ago. It was so tiny I wasn't even sure it was really there. A month later it was measured at 12mm via ultrasound. BUT, they found a dozen more around my chin, jaw line, and neck. Doc tried a course of antibiotics a couple of weeks ago, but that changed nothing.

Two weeks from today I have an appointment with the ENT who took out my tonsils. I'm going in tomorrow with the US report to see if I can get it moved up. The appointment was made without knowing any of the info on the report.

I'm a chronic Googler. I know docs hate that, but oh well. Based on what I've read I'm getting a sinking feeling that this isn't going to turn out well.

From the report:

FINDINGS: Left of midline 5 x 4 and 3 x 3 rnm hypoechoic nodules. Midline 4 x 3, 12 x 4 x 6 mm solid nodules.

Right submandibular 4 x 4 mm nodule. 3 x 3 mm nodule below the right ear and 4 x 4, 5 x 4, and 6 x 5 mm nodules caudal below the left ear.

IMPRESSION: There are multiple, mostly hypoechoic nodules in the area of patient's palpable abnormality. Some of the nodules have curvilinear area of increased echogenicity including the largest 12 mm nodule near midline compatible with partial fatty replacement of suspected lymph nodes. Findings are most compatible with reactive lymphadenopathy.

Sorry to hear about this. Have you had any other symptoms at all? Have you had any blood work done? Did you experience any infectious symptoms before the finding of the nodules? How old are you (if I may ask)?

No other symptoms, infectious or otherwise. Nodules are not tender at all. Yes, doc ran blood work about a week after I finished the antibiotics. I haven't seen the report, but was told everything was normal. I'm 47.

Difficult to say then although "reactive lymphadenopathy" is usually benign. I suspect they will need to extirpate a lymph node to examine it more closely.

Back in 2000 the lymph node in the left side of my neck grew to the size of a 50 cent piece. They found a tumor on it which luckily was benign. They had to remove everything to get it all. I am still a little confused about it after all this time. They said it was abnormal but it was benign....uhm ...abnormal ???????

wanna see swollen? this is when cancer spreads from tonsil to lymph node. fun times..
http://forums.pelicanparts.com/uploa...1307626259.jpg

Size-wise these are not significant (I mean lee's, not Johnco's...).
You want certainty? Have one node taken out (local procedure) and sent to pathology.
All the rest is conjecture.

I'm not a doctor.

But I'd ask the doc if you're "sed rate" on your blood is normal. This can be out of whack if you've got lymphoma, or so I've heard.

And I'd be pushing hard for a biposy asap. It's the only way to tell for sure.

Best of luck, man. Been there, done that (Hodgkins). 26 years ago and still kicking.

Martin

Fingers crossed for you. 47 is too young. At my age I realize that it can be "anything at any time"...after all, the mortality charts say I have 6-7 years left.

sedimentation rate is a non-specific measure that is elevated in a ton of different conditions

you do need the full blood work thing, and to have one of those nodes plucked, sliced and closely inspected by a pathologist

Thanks for all the info. I dropped the scans & report off at the ENT's office this morning. They said he'd take a look and work me in if he felt it was urgent. Also got my appointment bumped up a week due to a cancellation.

Back in April I posted about my jaw being out of alignment:
http://forums.pelicanparts.com/off-topic-discussions/604803-dentist-doctor-chiropractor-jaw-alignment-issues.html
I'm wondering if there's some correlation between the jaw mis-alignment (which is still an issue) and the lymph nodes.

Lee,
By your description and the u/s I'd say almost certainly benign, reactive LN. 1 big painful node would be bad. Those are quite small. Good luck.
B
(surgeon btw)

Lee, keeps us posted on your Dx.
Best Wishes are with you.

I'm hoping for the best, Lee.

Keep us posted.

I got a call from my ENT's office saying he didn't see anything urgent on the scans/report. Guess I'll find out what's going on soon enough. Just bugs me that these things have been swollen to some degree for over a month now. Can't imagine they're just bored.

Lee, good luck with this.

Although I've removed the pictures, something similar happened to me a while back

Turned out to be some sort of infection that lasted a month. Sliced open, drained out. Looked like I had an egg in my throat before it was taken care of.
Some of the worst pain I've ever been through.

Yeah, I'm wondering if that's the case with me. First thing my doc did was give me dose of antibiotics, but I know that doesn't always work. I don't have any symptoms other than the lymph nodes, but I still wonder.

One thing I've considered is a staph infection centered in my jaw as a result of my tonsillectomy. I'd be thrilled if that's the case and one more dose of antibiotics fixed my jaw alignment problem and my lymph node issue. Yep... I just said I'd be thrilled to find out I had a staph infection. :confused:

Waiting for test results is a harrowing time. Hoping for good news.

Well.... the ENT said he's not worried, but wants to have another ultrasound done in a month to compare to the one I already had done. I guess that's good news.... better than when they saw a little spot on the bone on my shoulder and suddenly everything had STAT stamped on it.

Doc made it clear that if I wanted a CT or biopsy in order to feel better the he'd be happy to order one or both, but that in his opinion it would be a waste of my time and money. Guess I'll get the US in a month and see what's happening then.

Good to hear, man.

Keep us posted, Lee.