
Sore Throat, Ear Infection, Lumps In Throat. Non-hodgkins Lymphoma Or Thyroid Cancer?

Thank you for your query.
As I believe that more information can help a physician arrive at an accurate diagnosis, I request you to answer the following questions.
1. Since you have a sore throat and ear, the small lump in your throat is most likely a reactive lymph node. Is it tender on touch?
2. Lymphomas and thyroid cancers are rare tumors. Lymphomas are a large group of varied types of cancers and many are low grade. Most thyroid cancers, with the exception of Follicular Thyroid cancers are low grade and locally aggressive cancers that do not spread easily. Hence such cancers which are detected early are treated with good results.
3. The best way to approach this concern is to first get a Neck USG (Ultrasound) done to identify the exact tissue which comprises the neck lump. This should preferably be done with a new generation 4D USG Scanner with Doppler. If the lump is suspected to be cancerous, a FNAC (Fine Needle Aspiration Cytology) will usually settle the diagnosis. A biopsy with tumor marker tests is very accurate. You may also get an endoscopy, an abdominal USG and a Chest X-ray done. This should be accompanied by routine blood tests.
4. Most cancers will have other constitutional symptoms such as weight loss, night sweats, unexplained fever, itching, multiple lumps and so on. Do you have any of these symptoms?
5. I must emphasize that though your age fits into the second peak for lymphomas, if the above tests are normal and there are no other symptoms, then the chances of cancer are very low. Your ear pain may be just a referred pain due to the sore throat. Your sore throat may require medication under medical supervision.
Hope I have answered your query. If you have any follow up queries I will be available to answer them.
Regards


Thank you. I have some version of night sweats occassionally (chest only) and was assuming that those were due to my post-menopausal status. I have no other symptoms, although two very small lymph nodes in my thorax have been slightly enlarged for about 6 years or so. I have, of course, had physicals since then and no one was concerned. The "lump" does seem to be attached directly to my thyroid and is about the size of a marble. I have an appointment on Tuesday. Should I go to urgent care and get a physician to 'feel' things? Am concerned about the wait. Thank you.
Thank you for writing back.
1. There is no need to rush into an urgent examination. There are many investigations which can be done in a systematic and routine manner.
2. Occasional mild night sweats may not be significant. However make it a point to mention them to your physician.
3. Longstanding lymph node enlargement is benign. Lymph nodes usually do not regress to their original size after a reactive state. There are about 1000 lymph nodes in our body. Enlargement in a few is common.
4. A USG Neck will help detect whether the lump is part of the thyroid or not. Swellings attached to the thyroid and larynx (voice box) move up and down during swallowing.
Hope I have answered your query. If you have any follow up queries I will be available to answer them.
Regards

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