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Suggest Treatment For Swollen Lymph Nodes
Question: Hi Dr. XXXXXXX
I had a couple of questions for you. If you don't remember, I had asked you about my multiple swollen lymph nodes and some systemic symptoms (random fevers, night sweats, weight loss, etc). My main question is, I am having a consult with a surgeon next week to see about getting an excisional biopsy done. The lymph node in my neck has been there the longest, but the one in my supraclavicular fossa seems to be growing the fastest ( a month ago it was smaller than pea sized. Now nickel sized). Which one of these would be the better one to biopsy? Do I need both of them biopsied?
Also, I had an ultrasound of the node in my neck and they said it looks ok, it is just a little long (2.5cm long), but that's normal. Then a different dr told me that a lymph node that long is not normal? Who is right? Also, is ultrasound good at detecting lymph nodes that are cancerous? Or can they look ok and still be malignant?
Thanks a bunch!
I had a couple of questions for you. If you don't remember, I had asked you about my multiple swollen lymph nodes and some systemic symptoms (random fevers, night sweats, weight loss, etc). My main question is, I am having a consult with a surgeon next week to see about getting an excisional biopsy done. The lymph node in my neck has been there the longest, but the one in my supraclavicular fossa seems to be growing the fastest ( a month ago it was smaller than pea sized. Now nickel sized). Which one of these would be the better one to biopsy? Do I need both of them biopsied?
Also, I had an ultrasound of the node in my neck and they said it looks ok, it is just a little long (2.5cm long), but that's normal. Then a different dr told me that a lymph node that long is not normal? Who is right? Also, is ultrasound good at detecting lymph nodes that are cancerous? Or can they look ok and still be malignant?
Thanks a bunch!
Brief Answer:
supraclavicular LN
Detailed Answer:
hi madam.
thanks for asking question.
the node with fastest growth should be biopsied, as it has highest chances of harbouring disease.
also in neck, if given option out of many lymph nodes, i will prefer supraclavicular LN biopsy.
if both the lymphnodes are lying nearby then it will be better to remove both of them. if you remove both lymphnodes, better to send them for biopsy in different containers.
sonography is not good at defferentiating malignant and benign lymphnodes. usually round and large lymphnodes are more likely malignant. elongated LN are more likely to be benign. but this is not an absolute rule. a LN of size 2.5 cm is considered large sized with elliptical shape. usually such LN occur in benign pathology. final diagnosis is done my cutting the LN and looking them into microscope i.e. biopsy.
sorry for the delay in answering as i was busy in surgery.
feel free to ask further.
supraclavicular LN
Detailed Answer:
hi madam.
thanks for asking question.
the node with fastest growth should be biopsied, as it has highest chances of harbouring disease.
also in neck, if given option out of many lymph nodes, i will prefer supraclavicular LN biopsy.
if both the lymphnodes are lying nearby then it will be better to remove both of them. if you remove both lymphnodes, better to send them for biopsy in different containers.
sonography is not good at defferentiating malignant and benign lymphnodes. usually round and large lymphnodes are more likely malignant. elongated LN are more likely to be benign. but this is not an absolute rule. a LN of size 2.5 cm is considered large sized with elliptical shape. usually such LN occur in benign pathology. final diagnosis is done my cutting the LN and looking them into microscope i.e. biopsy.
sorry for the delay in answering as i was busy in surgery.
feel free to ask further.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Thank you
Sorry, I accidentally pressed submit. I know I asked about PET scans earlier, but I was wondering if it might be good to get one to see if any of the nodes light up and then have them biopsy the one with the highest SUV. Or would this be better done after a biopsy if we still aren't sure whats going on? Thanks!
Sorry, I accidentally pressed submit. I know I asked about PET scans earlier, but I was wondering if it might be good to get one to see if any of the nodes light up and then have them biopsy the one with the highest SUV. Or would this be better done after a biopsy if we still aren't sure whats going on? Thanks!
Brief Answer:
good idea
Detailed Answer:
hi madam,
its great if it is your own idea.
if you have to select a single LN out of many and money/ availability is not a constraint, a PET scan can be done to fine out the extent of disease and to find out the foci of disease. based on which site of biopsy can be decided. even few centres have facility of PET-CT guided biopsy. but a PET scan can not differentiate between a malignant and benign LN. it can just suggest.
but in the region where i practice, getting a biopsy is easier than getting a PET scan done and the cost of biopsy is less than half of PET scan. so i advised for biopsy.
feel free to ask further.
good idea
Detailed Answer:
hi madam,
its great if it is your own idea.
if you have to select a single LN out of many and money/ availability is not a constraint, a PET scan can be done to fine out the extent of disease and to find out the foci of disease. based on which site of biopsy can be decided. even few centres have facility of PET-CT guided biopsy. but a PET scan can not differentiate between a malignant and benign LN. it can just suggest.
but in the region where i practice, getting a biopsy is easier than getting a PET scan done and the cost of biopsy is less than half of PET scan. so i advised for biopsy.
feel free to ask further.
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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