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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Oval Shape Lymph Node On Neck. Scan Done. Suggestions And Treatment?

Doctor, my dad had an oval shaped capsule node(Lymph Node) measuring 3x2x2 cm on the right side of the neck.
report of the microscopic exam of the same shows tumour with epithelioid features.
later on a test of immunohistochemistry of the same sample express that the tumor cell has Desmin, Myogenin, SMA & EMA and are immunonegetive for cytokeratin, S100 protein &CD 34.

this Lymph node again emerged on the same part in the body this time measurring 2.2x 1.8 cm after 2 months.
a F-FDG PET-CT SCAN of the whole body done on 03/09/2013 shows an increased FDG uptake (SUV:9.31 max)in the heterogenously enhancing lesion
involving the right sternocleidomastoid.

a bone mero scan done show no harm and is deemed as normal by the concerned doctor.

i want your opinion on this disease and also what neccesary treatment should be done.
i also want to know if there are any precaution and preventation should be taken by the patience in order to control this disease
Thu, 19 Sep 2013
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Pathologist and Microbiologist 's  Response
Hello and welcome to HCM,
The microscopic examination of the aspiration cytology of the lymph node reveals presence of metastatic malignant cells.
These malignant cells are immunoreactive for muscle cell markers.
Thus, suggesting the origin from muscle.
The PET scan shows that the origin of this malignant tumor is from right sternocleidomastoid muscle. This muscle is present on the right side of the neck region.
The tumor has spread to the lymph node.
Management consists of surgical excision of the muscle tumor (if possible) followed by chemo/ radiotherapy.
The chemo/radiotherapy- its duration and dosage will be decided by the radiation oncologist.

Thanks and take care
Dr Shailja P Wahal
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Oval Shape Lymph Node On Neck. Scan Done. Suggestions And Treatment?

Hello and welcome to HCM, The microscopic examination of the aspiration cytology of the lymph node reveals presence of metastatic malignant cells. These malignant cells are immunoreactive for muscle cell markers. Thus, suggesting the origin from muscle. The PET scan shows that the origin of this malignant tumor is from right sternocleidomastoid muscle. This muscle is present on the right side of the neck region. The tumor has spread to the lymph node. Management consists of surgical excision of the muscle tumor (if possible) followed by chemo/ radiotherapy. The chemo/radiotherapy- its duration and dosage will be decided by the radiation oncologist. Thanks and take care Dr Shailja P Wahal