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Enlarged lymph nodes - 1 inch in size
Sent to Health Experts August 16 11:05 AM

I have a 7 y/o boy who has enlarged lymph nodes present for 2 years. When they were first found they were about 1-2cm. We were sent to an oncologist; who decided not to biopsy; but watch and follow. We moved to another state. He showed no other symptoms. Now the nodes are about 1inch in the neck area. We went to our new pediatrician yesterday for f/up. THey are having us come back in next week after they have all of his records for testing. Should we be concerned with Lymphoma?

 

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Female , Age: 7

Customer (name blocked for privacy)
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August 16 11:14 AM (9 minutes and 6 seconds later)
         
REPLIED to Info RequestCheck Mark

Hello

Any positive family history of malignany?

What is the location of enlarged lymph nodes?

Are the lymph nodes tender?

Any associated fever?

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Dr Amit Munjal -- Physician -- 99% Positive Feedback on 4228 Health Accepts
B.A.M.S{Ayurveda Physician}Worked in various clinical departments like Medicine,ER,Gynae
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August 16 11:20 AM (5 minutes and 17 seconds later)
         
Reply to Dr AMIT MUNJAL's Post: 1. Yes - on both mother and fathers side
2. Both sides of the front of the neck
3. No pain or tenderness.
4. Not presently. However from birth until 2 years ago he was cronically sick- pnuemonia 5 times, severe sinus infections, severe ear infections, upper respritory infections, asthma. But lately nothing more than the common cold.
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August 16 11:36 AM (16 minutes and 7 seconds later)
         
Also, My paternal grandmother died from Hodgkins disease. My maternal grandmother died from a brain cancer.

His grandmother and grandfather on his fathers side also have cancer.
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August 16 11:36 AM (46 seconds later)
         
REPLIEDCheck Mark

Hello

In children neoplasia is rare but Increasing size of lymphnode, a family history of malignancy, all these factors should be considered for further evaluation including investigations like FNAC (fine needle aspiration cytology) and biopsy to rule out malignancy as the cause.Most likely lymphadenopathy is caused by infections especially in childrens but you never know.



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Dr Amit Munjal -- Physician -- 99% Positive Feedback on 4228 Health Accepts
B.A.M.S{Ayurveda Physician}Worked in various clinical departments like Medicine,ER,Gynae
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August 16 11:39 AM (2 minutes and 19 seconds later)
         
Reply to Dr AMIT MUNJAL's Post: He was diagnosed with Lymphadenopathy two years ago, but was not followed throughly.
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August 16 11:42 AM (3 minutes and 21 seconds later)
         
REPLIEDCheck Mark

Hello

Please check the table in link for possible diagnosis

http://www.aafp.org/afp/20021201/2103.html



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Dr Amit Munjal -- Physician -- 99% Positive Feedback on 4228 Health Accepts
B.A.M.S{Ayurveda Physician}Worked in various clinical departments like Medicine,ER,Gynae
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August 16 12:31 PM (49 minutes and 14 seconds later)
         
Reply to Dr AMIT MUNJAL's Post: So do you think we should be concerned that cancer is the cause? If so should I push to have a biopsy done?
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August 16 12:38 PM (6 minutes and 28 seconds later)
         
REPLIEDCheck Mark
Ya you should get one done to rule out malignancy.

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Dr Amit Munjal -- Physician -- 99% Positive Feedback on 4228 Health Accepts
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August 17 1:41 PM (1 day and 1 hour later)
         
Reply to Dr AMIT MUNJAL's Post: Today his dr ran several tests to rule out severeal possible diagnosises (cat scrath fever, ebv and also did a immunno deficency test) as well as the baseline blood work like cbc, sedrate. She told me the base line would give us the red flag if something was wrong. I guess I am still not sure what to do. If nothing shows up on these tests and everything is normal; I should still make them do a biopsy right? And will the white count always tell you if cancer is involved?
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August 17 1:56 PM (14 minutes and 57 seconds later)
         
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Hello

White blood cells dont always tell about cancers.

As with going for biopsy if your doctors finds appropriate cause for lymphadenopathy from these base level tests than its good otherwise biopsy should be considered .



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Dr Amit Munjal -- Physician -- 99% Positive Feedback on 4228 Health Accepts
B.A.M.S{Ayurveda Physician}Worked in various clinical departments like Medicine,ER,Gynae
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August 17 1:59 PM (3 minutes and 13 seconds later)
         
Reply to Dr AMIT MUNJAL's Post: His doctor just called me a said all of his base line levels came in normal the titers will not be in for a while and she said that she thinks it is just "reactive lymph nodes" and doesn't think he needs a biopsy. He does seem ok. I am just afraid there is something there that no one is finding.
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August 17 2:12 PM (12 minutes and 14 seconds later)
         
REPLIEDCheck Mark

One thing i feel should be brought to your doctors notice-

Swollen lymph nodes due to infection are often painful. Localized infection usually affects the lymph nodes that are closest to the abnormality. The lymph nodes decrease in size and are less painful as the infection is treated.

http://www.myelectronicmd.com/get_reference.php?Id=1043&condition=REACTIVE%20LYMPHADENOPATHY&symname=R&typ=3




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Dr Amit Munjal -- Physician -- 99% Positive Feedback on 4228 Health Accepts
B.A.M.S{Ayurveda Physician}Worked in various clinical departments like Medicine,ER,Gynae
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August 17 2:15 PM (3 minutes and 51 seconds later)
         
Reply to Dr AMIT MUNJAL's Post: That is what has always been my concern. He has had no infection for the past several months. The nodes are getting bigger and have NO PAIN at all. She is now recommeding me to have an ultrasound next week (mainly to relieve my mind) and if the tech. sees something she will then order a biopsy. Will the ultrasound definately show if there are any cancer cells??
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August 17 2:26 PM (10 minutes and 51 seconds later)
         
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Hello

Check this link( look at the introduction and conclusion at the end)

http://www.droid.cuhk.edu.hk/web/specials/lymph_nodes/lymph_nodes.htm



Edited by dr_amitmunjal on August 17 2006 at 2:29 PM

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