Swollen Lymph Node On The Collar Bone, Cough, Weight Loss. Diagnosed With Esophagitis And Osteoporosis. Concerned About The Suggestion For X-ray

Posted on Mon, 2 Jul 2012

Question: I have found a tiny swollen node maybe the size of a lentil above my right collar bone. my right shoulder blade hurt and I was diagnosed oesphagitis a month ago. I have slight cough triggered by a tickling sensation in my throat. no mucus with a burning sensation in my upper chest. I went to my doctie and he put me back on nexium and ordered a chest xray. I am a long time smoker. I have lost about 4 pounds with the last couple of months but my appetite has not changed at all. I was also diagnosed with osteoporosi. my blood work came back fine. no sign of XXXXXXX bleeding. all vitals are good no sign of fatigue. except my vitamin D was very low < 30. I am a little anxious about the chest xray.
thank you for your input.

Answered by Dr. Abid (25 minutes later)

Hi there and sorry to hear about your problem....

I will help you out and properly guide you according to info that you provided....

First thing as you mentioned you are smoker and smoking is associated with acid reflux disease and disease of airways both of which can be the reason of cough.

With the back ground history of esophagitis, a swollen lymph node above collar bone (which is referred to as sentinel lymph node) and burning sensation in chest can be concerning. You should get Endoscopy (camera test to see the stomach) at the earliest to rule out any changes in the stomach. So in my opinion the next step as I mentioned would be to consult Gastroenterologist and plan for Endoscopy followed by FNAC (FINE NEEDLE ASPIRATION CYTOLOGY) of lymph node and CT scan chest if Endoscopy is non conclusive. Treatment depends on exact diagnosis. Endoscopy will help to reach the final diagnosis after that next plan of management may be offered to you.

Regarding your apprehension about the result of Chest X-ray, the probable findings would be airway changes and lung tissue changes as well. They a mean a lot while planning treatment. All in all, quit smoke is probably the best and unchanged suggestion by any physician for all the problems that you have. If I were your physician I would add Vitamin D and calcium supplements as well. I recommend Quit smoking program.

Trickling sensation in the throat causes cough for which other reasons apart from reflux oesophagitis (RE) can be evaluated. Note that RE causes trickling throat.

Hope this answers your query. Let me know if you have more help.

Regards and wish you good health.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Abid (3 hours later)

Thank you so much for your reply. Just wanted to let you know that I did get an endoscopy that confirmed the oesophagitis and no sign of cancerous cells. I have to tell you that I have been suffering for quite some time now (4+ years) of shoulder blade pain, hips, thighs and leg pain that comes and goes depending if I had a good night rest. I think I am going to quit smoking today. I have done it cold XXXXXXX in december 2009 but unfortunately I came back in 18months later except that I gained a lot of weight and my triglycerides went through the roof. Everything is back to normal. If only I did not have this little nod. I just checked it and I might be mistaken but it feels like it went down a little. Again thank you for you help.

Answered by Dr. Abid (1 hour later)

Thanks for your follow up information...

Thanks for the appreciation.

As you have had low levels of Vitamin D on blood testing, I want to tell you bodyaches, bony pain can be because of low Vitamin D level. You should be supplemented with Vitamin D accordingly.

As far as node is concerned and you have had no evidence of cancerous cell that is a good news. Inner strengths, perserverence and family / peer support is crucial to successfully quit smoking right now and enjoy healthy life. I am just a click away if you need further assistance towards this healthy program.

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Have a nice time

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