Can lymph node enlargement in mouth, legs and neck mean lymphoma?

Question

Hello doctor,

I was in a car accident four years back. After one week, while I was having a bath, I felt a small lymph node in my left neck. I did not feel it before. It was a little bigger then. By the time it is getting smaller, it is not going back to its original size. I cannot see it now, but I can feel it. So, I am worried and popping it all the time. Recently, I found a gland in the floor of the mouth on the left side, and it is very small and not growing in size. Sometimes I feel swelling in the left side of my mouth and left leg. I got no night sweats, no fever, and no weight loss at all. I got five small petechiae (red blood spots) on the right chest. I have attached my complete blood test history for three months.

Symptoms:

Constant left shoulder pain, bone pain, and hand pain. Extreme fatigue and tiredness. I feel something stuck in my throat. Bowel habit change.

Medications:

Doxycycline Hyclate 100 mg for two weeks. Amoxycillin 500 mg for one week.

My questions to you are as follows:

1. Do I have lymphoma or leukemia?

2. If your answer to no. 1 is no, then why are the lymph nodes not going back to their original size after completing the whole antibiotic dosage?

3. Why are my WBC and lymph percentage fluctuating too much?

4. Can lymphoma be ruled out with the CBC test?

5. What is your opinion about my blood report?

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

Based on your query, my opinion is as follows:

No, it is neither lymphoma nor leukemia. There is no cell predominance (either neutrophil or lymphocyte or any immature cells), nor are the counts high enough to think of leukemia. Lymphoma lymph nodes are usually multiple and do not regress in size. Lymph nodes usually take longer to regress, and sometimes, a mild infection in the location could be making it active. It could also be chronic lymphadenitis, with a variable amount of fibrosis inside it, due to which it may not regress back to its original size. If it were lymphoma, it would be increasing and multiple sites and multiple nodes together would be enlarged.

WBCs are cells related to fighting infections and inflammation. As the body is fighting some infection or other in everything (food, water, air, etc.), it will vary. Also, stress and hormonal variations can affect it too if the count is not shooting excessively over the normal range, not to worry. No, usually lymphoma cannot be ruled out with a CBC test. Fine needle aspiration cytology of the lymph node or biopsy of the lymph node is essential. However, at present, it will not be essential to look at small lymph nodes.

Blood report, overall is good. Mild neutrophil increase, indicating possible mild infection or stress. Stress could be responsible for all the symptoms at present. Nothing in the blood report can explain the symptoms you have. Check the calcium level once. As the platelet count is normal and you do not have any bleeding, petechiae could be due to small pressure spots. It will disappear. Not to worry about it. If it starts occurring at multiple spots, then prothrombin and activated partial thromboplastin time evaluation may be necessary.

I hope this helps you.

Thank you.