Hello. I Have A Lump Over My Left Collarbone. My

Posted on Wed, 4 Dec 2019

Question: Hello. I have a lump over my left collarbone. My pcp says it is an enlarged lymph node. The blood test came back normal. Now I'm waiting for the next step. I have an HMO so cannot contact a specialist until my PCP refers me, and he and his office are notoriously slow in moving things along. I'm curious what you think the next step will be? Am I out of the woods, so to speak, since the bloodwork is normal? Thanks

Answered by Dr. Indranil Ghosh (6 hours later)

Brief Answer:
Scans and/or needle biopsy

Detailed Answer:
Hi
Thanks for your query.

I understand your concerns. I assume you don't have any other symptoms and this enlarged gland is the only problem. Blood work is mostly normal in this scenario.

In that case, either the doctor would order some scans like an ultrasound of the neck and then decide on fine-needle aspiration or biopsy, or they can go directly for it if they feel so. This depends on the size and feel of the gland.

Hope this helps.
Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Indranil Ghosh (58 minutes later)

Thank you. The only other symptom i have is itchiness that is sometimes severe, so much so that it wakes me up at night. Sometimes, the itchiness is just bothersome. I have now been referred to an ENT and don't quite know what to expect. From what I understand, and from what PCP told me, these seem like very common symptoms of lymphoma, but I'm curious what benign reason there may be for these symptoms...

Answered by Dr. Indranil Ghosh (1 hour later)

Brief Answer:
Benign lymph nodes are common in the neck

Detailed Answer:
There are many causes of benign lymph glands i neck like throat infections, skin infections, viral, etc, many of which are often unrecognized by the patient.

Is this itchiness generalized or only in the neck? generalized itchiness, if recent onset can be a soft sign of lymphoma, but never confirmatory.

Overall, there is nothing to worry till the evaluation by ENT.

regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (11 hours later)

the itchiness is widespread, mostly on my abdomen, sides, and inner thighs. Sometimes my arms and the tops of my feet itch. The lump on my neck has never been itchy or tender. I have not had signs of an infection, and am curious what kind of viral or bacterial infection I could have without having any other symptoms. Also curious as what to expect at first ENT appt. Are there certain tests I should request on this first appt?

Answered by Dr. Indranil Ghosh (9 hours later)

Brief Answer:
Sometimes infections are unrecognized as they are taken care of by the immunity

Detailed Answer:
This immune activation can lead to enlarged nodes.

The ENT doc will examine the glands as also the inside of your throat. If s/he feels suspicious he may order a fine needle aspiration. You may also ask if this is necessary. If s/he is satisfied with the exam then may not order any tests and refer you to a Dermatologist for the itching.

Regards

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Above answer was peer-reviewed by : Dr. Arnab Banerjee