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

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

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 sub centimeter 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 0.75 x 0.24 inches. 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.
Answered by Dr. Goswami Parth Rajendragiri

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.

Patient's Query

Hi doctor,

Thank you for your response.

What else can cause transformed lymphocytes other than lymphoma?

Answered by Dr. Goswami Parth Rajendragiri

Hello,

Welcome back 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.

Patient's Query

Hi doctor,

Thanks for your response.

I went for a surgical biopsy and got removed three lymph nodes on both sides of the groin. I have got my report but I cannot understand this report. The histopathology report should give a 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.

Answered by Dr. Goswami Parth Rajendragiri

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.

Patient's Query

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.

Answered by Dr. Goswami Parth Rajendragiri

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.

Patient's Query

Hi doctor,

I request you to read my above details.

I had surgery for groin lymph nodes enlargement around one year ago. The results were reactive but they did not do the IHC test. I had developed swelling on the left side just after the surgery. Multiple ultrasounds and needle aspirations were done to remove the fluid but it was developing again and again. It was diagnosed as seroma and then the doctor left it untreated. It became hard and painless last month. I had also developed an infection there so I had to go to the emergency. They had cut and drained the pus in the seroma and had kept it open. Fortunately, the infection got cleared but on follow-up, the doctor told me there is lymph nodes enlargement again so they checked it with ultrasound and the result was abnormal. Lymph nodes without fatty helium were detected. The radiologist had advised for the surgery again but I refused to go for it, so I chose needle biopsy. The results showed only blood components in the biopsy. The doctor has asked me to come back after three months. He told me that they had taken the sample carefully and the biopsy report did not detect any abnormal cells, but I am not convinced.

My questions are:

  1. Is it possible that the ultrasound report is wrong, and there is no lymph node enlargement? Only seroma or some swelling is present. I feel it is a hard lump that moves with the skin.
  2. What is the possible cause of biopsy showing only blood, whereas the ultrasound showed lymph node enlargement?
  3. Do lymph nodes without fatty hilum always mean cancer? What else can cause it?
  4. Is it possible that the biopsy during my first surgery had missed lymphoma, and this time the results have shown it?

Thank you.

Answered by Dr. Goswami Parth Rajendragiri

Hello,

Welcome back to icliniq.com.

Following is my opinion on the questions you have asked.

  1. In the first attached report, an enlarged lymph node is seen and they mentioned it as a reactive node. The other USG (ultrasonography) report, probably the one after the surgery shows cystic lesion. Therefore, now your swelling could be either an enlarged node or chronic inflammation-induced hard lesion.
  2. The FNAC (fine needle aspiration cytology) report shows only blood which can be possible if the lesion is vascular and hard.
  3. The FNAC did not report if cellular material is present or not, and shows only blood. The biopsy can be conclusive in that manner.
  4. If your lesion is painful and causing discomfort then it is better to get it removed. After removal, it can be sent for a histopathology examination.
  5. In the groin, reactive node enlargement is more common. It does not seem to be cancer.
  6. Chronic inflammation and infection are other causes of enlarged nodes.

Hope I have answered your question.

Let me know if I can assist you further.

Best regards.

Patient's Query

Hi doctor,

Thank you for the response.

The report detecting the cystic swelling is pre-surgical and pre-infection, and the lymph nodes ultrasound is the latest one. The doctor had removed the infection with seroma, and now only lymph node enlargement is there. In the ultrasound report, there are two lymph nodes detected, one is reactive and the other one is without fatty hilum described as a pathology.

My question is that what is a lymph node without fatty hilum, and can it be reactive too?

Please comment on the biopsy report too, as it is a lymph node biopsy then why it is showing only blood.

Thank you.

Answered by Dr. Goswami Parth Rajendragiri

Hello,

Welcome back to icliniq.com.

The following is my further opinion on your questions.

Lymph node without fatty hilum suggests some pathology but it does not always mean cancer.

According to the attached reports (attachments removed to protect the patient's identity), FNAC was done so it is fine-needle aspiration cytology, not biopsy.

In the FNAC procedure, the needle is passed into the tissue and the material is aspirated. However, in FNAC it is possible not to get enough material sometimes.

It is showing only blood that suggests cellular material was not aspirated so, whenever blood is aspirated in FNAC, reporting is not possible.

I suggest you better get both the nodes removed and their histopathology examination should be done.

Without examination and histopathology report, it is difficult to diagnose the etiology of enlarged nodes.

Hope this information will be helpful to you while discussing it with your doctor.

Let me know if you have more questions in mind.

Best regards.

Answered byDr. Goswami Parth Rajendragiri

Medically reviewed byiCliniq medical review team

Published At June 10, 2021
Reviewed AtMay 11, 2026

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Goswami Parth Rajendragiri
Dr. Goswami Parth Rajendragiri

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