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Do I Have Lymphoma ?

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Posted on Wed, 18 Apr 2012
Question: I am a 46 yr old male, weigh 235. Noticed the other day that I have a swollen lymph node behind my right ear about the size of a 1/4 inch. Also have been having a hoarse voice. Went to family doc and he said that the hoarse voice was most likley from my GERD which I am recently being treated for; was not concerned with node. To be sure he sent me to an ENT. .

ENT scoped my nose and said he sees no ployps or bad things. But noticed that voval cords were slightly swollen and that it looked like I have a sinus infection. He felt my swollen node and said it was to small to be a concern and was probably from the sinus infection. What was weird is that I have been having no sinus drainage. Gave me Avelox (antibiotic) and Astepro (antihistamin) i also take lisinopril/HCTZ

Doctor also took a chest xray and blood work. Chest xray normal and blood as follow: WBC 4.9. Neuts=60% (3.0), Lymphs 29% (1.43), Mono 8.3% (.41), EOS=1.6% (.08), Baso=.4%(.02), Platelet=233 and TSH .46.

I have two cousins that have fought lymphoma and I am worried about having it. i have the swollen node and itching across my body... I just dont feel right.
Is the low WBC indicative of lymphoma? ALso could the antiobitics and antihistamine and diuretic be lowering my WBC?

I am concerned that something serious could be wrong with me?

I
doctor
Answered by Dr. Indranil Ghosh (2 hours later)
Hi XXXXXXX

Thanks for the query.

Sorry to hear that two of your cousins had lymphoma. I hope they are survivors now. You have mentioned that your mother also had cancer. May I know what type of cancer your mother had and what type of lymphoma your cousins had?

Now coming to your condition, I feel that the tiny lymph node that you are having is not lymphoma. It may be totally normal or else may be due to skin or scalp conditions like dandruff (especially going by the site you have mentioned).

Swollen vocal cords may be due to excessive stress on vocal cords. You have not mentioned your occupation.

The white blood cell count of yours is within the normal range (4000-0000). And the proportion of neutrophils and lymphocytes also appears fine.

Overall, it appears to me that you are doing good and there is no serious problem. However, I feel that you are overweight, what is your BMI (body mass index)? You and your doctor should address that.

Hope I could answer your queries. In case of any doubts, I am available for the follow ups.

Regards,

Dr. Indranil
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Indranil Ghosh (22 minutes later)
My cousins had non-hodgekins. My mother had concer in her uterous. All three are recovering nicely. I am an engineer, don't use my voice much.. but am under alot of stress.

I have a very athletic body... 52 inch chest... run 4 miles every other day... So I could use to lose a 10 to 15... but I have a large frame.

It doesn't worry you that I am at the low end of the acceptable level of WBC's? Would the medicines I am taking cause it to be low?

Could the node behind the ear be from the sinus infection? The swelling I feel on the large muscle running down my neck under the ear ... what could that be? Doctors dont seem to feel it?

Also if I was having a problem with lymphoma.... or other cancers would the blood tests show abnormalties?
doctor
Answered by Dr. Indranil Ghosh (2 hours later)
Hi,

Thanks for writing back to me.

It is true that some of the medicines you have listed (lisinopril and simvastatin may cause low blood counts but this is extremely rare. I don't think your reports are worrisome at this point. However, it would be a good idea to repeat it after some time (4 weeks).

Node behind ear may be due to sinus infection but it is too small to be afraid of.
As for the swelling beneath the neck muscle, as the doctor could not feel it, I think there isn't any abnormality.

Regarding the last part of your query, blood tests show abnormality mostly in leukemias and less commonly in lymphoma (especially in late stages, when the bone marrow is involved). In lymphomas, the most common presentation is abnormally increased size of lymph nodes (>1.5 cm) with or without systemic symptoms like fever or weight loss. You have none of these.

Hope this makes you feel a bit relaxed.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1712 Questions

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Do I Have Lymphoma ?

Hi XXXXXXX

Thanks for the query.

Sorry to hear that two of your cousins had lymphoma. I hope they are survivors now. You have mentioned that your mother also had cancer. May I know what type of cancer your mother had and what type of lymphoma your cousins had?

Now coming to your condition, I feel that the tiny lymph node that you are having is not lymphoma. It may be totally normal or else may be due to skin or scalp conditions like dandruff (especially going by the site you have mentioned).

Swollen vocal cords may be due to excessive stress on vocal cords. You have not mentioned your occupation.

The white blood cell count of yours is within the normal range (4000-0000). And the proportion of neutrophils and lymphocytes also appears fine.

Overall, it appears to me that you are doing good and there is no serious problem. However, I feel that you are overweight, what is your BMI (body mass index)? You and your doctor should address that.

Hope I could answer your queries. In case of any doubts, I am available for the follow ups.

Regards,

Dr. Indranil