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Hello. I Previously Had An Ultrasound That Showed Some Enlarged

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Posted on Sun, 3 Jan 2021
Question: Hello. I previously had an ultrasound that showed some enlarged nodes in my neck and some smaller ones in my parotid glands on 9/29/20 b/c I had felt some discomfort in my neck. My rheumatologist decided to have a follow up sonogram which I had today 12/14/20 which showed another finding along with what had been seen before. Report states that this could be a small mass. When I got the first sonogram I had been suffering from teeth infections and had just gotten over them. But now I have had no issues and the nodes size remains the same along with this new node finding. I have also not been sick in this time frame.
-How should I proceed from this point?
-Should I have a cat scan, mri, biopsy?
-How long does it usually take for nodes to shrink down in size? Should mine have shrunk already in this 2 1/2 month period?
-Do these enlarged nodes in neck point to more of an issue with neck malignancy or lymphoma due to sjogrens?
-If this is something bad, does it look like it’s in an early stage?

I recently had a spirometry blood test to screen for lymphoma that came back fine and my regular bloodwork is fine as well. Just want to make sure I am covering all my bases. Thank you.
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Follow up: Dr. Indranil Ghosh (0 minute later)
Hello. I previously had an ultrasound that showed some enlarged nodes in my neck and some smaller ones in my parotid glands on 9/29/20 b/c I had felt some discomfort in my neck. My rheumatologist decided to have a follow up sonogram which I had today 12/14/20 which showed another finding along with what had been seen before. Report states that this could be a small mass. When I got the first sonogram I had been suffering from teeth infections and had just gotten over them. But now I have had no issues and the nodes size remains the same along with this new node finding. I have also not been sick in this time frame.
-How should I proceed from this point?
-Should I have a cat scan, mri, biopsy?
-How long does it usually take for nodes to shrink down in size? Should mine have shrunk already in this 2 1/2 month period?
-Do these enlarged nodes in neck point to more of an issue with neck malignancy or lymphoma due to sjogrens?
-If this is something bad, does it look like it’s in an early stage?

I recently had a spirometry blood test to screen for lymphoma that came back fine and my regular bloodwork is fine as well. Just want to make sure I am covering all my bases. Thank you.
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Follow up: Dr. Indranil Ghosh (8 minutes later)
I just re read today’s report and it seems the questionable mass is on my parotid gland. If you could please offer clarification I’d appreciate it. I have sjogrens hence why the concern. Thank you.
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Follow up: Dr. Indranil Ghosh (0 minute later)
I just re read today’s report and it seems the questionable mass is on my parotid gland. If you could please offer clarification I’d appreciate it. I have sjogrens hence why the concern. Thank you.
doctor
Answered by Dr. Indranil Ghosh (14 hours later)
Brief Answer:
It is tiny and indeterminate

Detailed Answer:
Hi
Thanks for your query.

Overall, I don't find anything of serious concern in this new ultrasound. There is a tiny <1 cm new nodule/mass/node in left parotid which was not seen before. But this is quite common in Sjogren's. I don't think it suggests lymphoma or anything.

Nodes of the size mentioned in previous report are often benign and may persist for long. If their character was suspicious then needs FNAC but not these, their character appears benign.

At this point you have two options, one is to get a CT scan immediately to look for mass in parotid. Mostly it would not show anything else apart from USG findings. Another would be to wait a couple of months and get another USG.

Hope this helps.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
It is tiny and indeterminate

Detailed Answer:
Hi
Thanks for your query.

Overall, I don't find anything of serious concern in this new ultrasound. There is a tiny <1 cm new nodule/mass/node in left parotid which was not seen before. But this is quite common in Sjogren's. I don't think it suggests lymphoma or anything.

Nodes of the size mentioned in previous report are often benign and may persist for long. If their character was suspicious then needs FNAC but not these, their character appears benign.

At this point you have two options, one is to get a CT scan immediately to look for mass in parotid. Mostly it would not show anything else apart from USG findings. Another would be to wait a couple of months and get another USG.

Hope this helps.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh (23 minutes later)
Thank you for your response doctor. I’d rather not expose myself to a cat scan unless I really needed it. -What else would a ct show that an ultrasound wouldn’t ? Would an mri give any insight?
-At what size would you consider a biopsy?
-How many months specifically should I wait before another ultrasound?
-If it remains the same size would you opt for a ct or only if it grew in size?
Thank you.
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Follow up: Dr. Indranil Ghosh (0 minute later)
Thank you for your response doctor. I’d rather not expose myself to a cat scan unless I really needed it. -What else would a ct show that an ultrasound wouldn’t ? Would an mri give any insight?
-At what size would you consider a biopsy?
-How many months specifically should I wait before another ultrasound?
-If it remains the same size would you opt for a ct or only if it grew in size?
Thank you.
doctor
Answered by Dr. Indranil Ghosh (3 hours later)
Brief Answer:
Yes you can wait

Detailed Answer:
MRI also may not show anything. best will be to wait and another USG in 2 months. If it remains same then no CT or biopsy. If 1.5 cm or more then CT and possibly biopsy as well.

Regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
Yes you can wait

Detailed Answer:
MRI also may not show anything. best will be to wait and another USG in 2 months. If it remains same then no CT or biopsy. If 1.5 cm or more then CT and possibly biopsy as well.

Regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Indranil Ghosh (13 hours later)

-Is it b/c of the shape/small size of the node/mass/nodule that they can’t tell what it is?
-If this grew in size would it be easier to tell what it is on USG?
-Would you suggest a biopsy for the nodes in my neck if they continue growing and at what specific size?
Thank you.
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Follow up: Dr. Indranil Ghosh (0 minute later)

-Is it b/c of the shape/small size of the node/mass/nodule that they can’t tell what it is?
-If this grew in size would it be easier to tell what it is on USG?
-Would you suggest a biopsy for the nodes in my neck if they continue growing and at what specific size?
Thank you.
doctor
Answered by Dr. Indranil Ghosh (8 hours later)
Brief Answer:
Yes it's too small

Detailed Answer:
As it's too small it can't be categorized. If it grows, even USG will be more informative.

If it grows upto 1.5 cm or beyond on followup, I would recommend FNAC/needle biopsy as feasible.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
Yes it's too small

Detailed Answer:
As it's too small it can't be categorized. If it grows, even USG will be more informative.

If it grows upto 1.5 cm or beyond on followup, I would recommend FNAC/needle biopsy as feasible.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh (13 hours later)
-The nodes in my neck are already over 2cm. One is at 2.5 cm. I was asking at what size would you would suggest a biopsy for these?

-And why is it that the report does not seem as concerned about these nodes in my neck that are over 2cm already but they do mention this small node/nodule/mass on my parotid gland as a possible area of concern when it’s less than 1cm at the moment?
Thank you doctor.
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Follow up: Dr. Indranil Ghosh (0 minute later)
-The nodes in my neck are already over 2cm. One is at 2.5 cm. I was asking at what size would you would suggest a biopsy for these?

-And why is it that the report does not seem as concerned about these nodes in my neck that are over 2cm already but they do mention this small node/nodule/mass on my parotid gland as a possible area of concern when it’s less than 1cm at the moment?
Thank you doctor.
doctor
Answered by Dr. Indranil Ghosh (8 hours later)
Brief Answer:
I am not concerned about that node either

Detailed Answer:
The morphologically unremarkable nodes of upto 2.5 cm were present earlier also with no significant size change over time. hence We are not concerned about that. Their scan features favour benign nodes.

The intraparotid swelling is new and it needs more close observation. If it goes above 1.5 cm then to do FNAC/biopsy.

The lymph nodes don't need biopsy/FNAC at present.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
I am not concerned about that node either

Detailed Answer:
The morphologically unremarkable nodes of upto 2.5 cm were present earlier also with no significant size change over time. hence We are not concerned about that. Their scan features favour benign nodes.

The intraparotid swelling is new and it needs more close observation. If it goes above 1.5 cm then to do FNAC/biopsy.

The lymph nodes don't need biopsy/FNAC at present.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Indranil Ghosh (1 hour later)
Understood. Thank you for your time doctor.
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Follow up: Dr. Indranil Ghosh (0 minute later)
Understood. Thank you for your time doctor.
doctor
Answered by Dr. Indranil Ghosh (9 hours later)
Brief Answer:
You are welcome

Detailed Answer:
regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
You are welcome

Detailed Answer:
regards
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Indranil Ghosh

Oncologist

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Hello. I Previously Had An Ultrasound That Showed Some Enlarged

Hello. I previously had an ultrasound that showed some enlarged nodes in my neck and some smaller ones in my parotid glands on 9/29/20 b/c I had felt some discomfort in my neck. My rheumatologist decided to have a follow up sonogram which I had today 12/14/20 which showed another finding along with what had been seen before. Report states that this could be a small mass. When I got the first sonogram I had been suffering from teeth infections and had just gotten over them. But now I have had no issues and the nodes size remains the same along with this new node finding. I have also not been sick in this time frame. -How should I proceed from this point? -Should I have a cat scan, mri, biopsy? -How long does it usually take for nodes to shrink down in size? Should mine have shrunk already in this 2 1/2 month period? -Do these enlarged nodes in neck point to more of an issue with neck malignancy or lymphoma due to sjogrens? -If this is something bad, does it look like it’s in an early stage? I recently had a spirometry blood test to screen for lymphoma that came back fine and my regular bloodwork is fine as well. Just want to make sure I am covering all my bases. Thank you.