Q. I have few enlarged lymph nodes on both sides of my groin. Does it indicate lymphoma?

Answered by
Dr. Parth R Goswami
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 10, 2021

Hi doctor,

I have few lymph nodes on both sides of my groin for one year, but there is no pain in the groin and abdomen. Chest CT scan showed few subcentimeter lymph nodes in the stomach, mesenteric and is non-specific. However, other CT findings are normal, with no fever, weight loss, or other symptoms. My CBC and other blood tests are normal. My groin ultrasound showed few lymph nodes on both sides of the groin, thin cortex, and fatty hilum on both sides; the largest one is 1.9 cm*0.6 cm. I did a needle biopsy which showed small mature lymphocytes with few transformed lymphocytes. It is inconclusive, but I want to know what transformed lymphocytes are in the report. Does it indicate lymphoma? My concern is about follicular lymphoma. Can you see my reports attached below? I saw your answer related to this issue for a patient and found it excellent. Kindly help me.

#

Hello,

Welcome to icliniq.com.

I can understand your level of confusion about transformed lymphocytes. Transformed lymphocyte means enlarged lymphocyte nucleus and prominent nucleoli. So, it will resemble a blast or malignant lymphocyte-like cell. But transformed lymphocytes do not always mean lymphoma.

However, as your FNAC (fine needle aspiration cytology) workup is not conclusive and the material was less in FNAC, you need to investigate further with histopathology of biopsy of enlarged lymph nodes.

Biopsy should be taken from enlarged nodes, and histopathology can be done from that. Histopathology or flow cytometry, like higher investigation, will rule out lymphoma conclusively. So, it would help if you investigated with histopathology or flow cytometry from the biopsy.

Discuss with your doctor about histopathology if your doctor feels so after your physical examination as your attached report is not conclusive.

I hope I have answered your question. Let me know if I can assist you further.

Best Regards.

Thank you doctor,

What else can cause transformed lymphocytes other than lymphoma?

#

Hello,

Welcome to icliniq.com.

Transformed lymphocytes can be seen in reactive lymphadenitis as well. So transformed lymphocyte is not conclusive of either lymphoma or reactive lymphadenitis.

I think you should investigate further with biopsy for histopathology examination or flow cytometry as per my opinion.

I hope I have answered your question.

Let me know if I can assist you further.

Best Regards.

Hi doctor,

Thanks for the reply.

I went for surgical biopsy and removed three lymph nodes on both sidesw of the groin. I got my report but I cannot understand this report. Histopathology report should give final conclusion but I am very disappointed with this report. Can you explain this report to me? Is this report enough to rule out lymphoma or do I need further tests? I need your opinion on this report. Thanks.

#

Hi,

Welcome back to icliniq.com.

I have seen your attached histopathology report (attachments removed to protect the patient's identity). In the report, it is written that histopathology is suggestive of reactive lymphadenitis. So, do not worry about lymphoma. Histopathology report clearly states that it is reactive lymphadenitis. Hence, now you can exclude lymphoma. It is a reactive non-specific enlarged node probably. Doctor has not written microscopic findings because there is no presence of any abnormal cells probably. Discuss all these with your treating surgeon or physician. I hope I have answered your question.

Let me know if you have more questions in mind.

Best regards.

Hi doctor,

Thanks for the reply.

I have one more question. After four days of surgery, I developed swelling on both sides of the groin at the site of surgery which is painful when I stand or walk. It is not going away and is present for one week. I consulted my doctor two times, and he gave me some medicines for inflammation that are not working. I removed the fluid with a syringe, and it is clear white fluid on one side and red fluid on the other side, but the fluid developed again, which is now more painful. My doctor told me that it would take one month. I need your opinion. There is no infection or discharge. Thanks.

#

Hi,

Welcome back to icliniq.com.

Following is my opinion on your questions. Also, the attached image is not clear (attachments removed to protect the patient's identity). So if possible, please resend the image in follow-up.

  1. As per mentioned history, it could be post-surgical inflammation in that area.
  2. The drained fluid could have accumulated in that area due to trauma-induced inflammation, which is seen commonly.
  3. Sometimes it can take up to 15 days for complete resolution.
  4. I suggest you continue to take your anti-inflammatory medicine regularly and avoid water contact in that area.
  5. You can clean the groin area with normal saline.
  6. If any pus comes out in the future, then bacterial infection could be possible for which topical Neosporin cream can be applied.

I hope I have answered your questions.

Let me know if I can assist you further.

Best regards.


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