Do the swollen lymph nodes in the left supraclavicular region gradually shrink on their own?

Question

Hi doctor,

I noticed swollen lymph nodes in the left supraclavicular region that initially started at 1.97 inches by 1.97 inches, but over seven weeks, they have shrunk to 1.14 inches. The PET scan showed SUV 18, but the core biopsy was inconclusive and showed CD10-positive cells. Also, a lung nodule was found, SUV 4.65 inches with fluid. But by the time I had a second CT scan this week, it had disappeared, and the fluid had disappeared too. They did locate mediastinum nodules that were 0.51 inches by 1.57 inches in length in the CT scan, but it was not detected on the PET reports. These have also shrunk since first seen on the initial CT scan. So all nodules that were suspicious are shrinking, not growing. The doctor was going to send me for an incisional biopsy, but since there was a decrease in size, he wanted me to hold off on the biopsy. Could these be reactive nodes that eventually disappear?

Please give your suggestions.

Answer 1

Hi,

Welcome to icliniq.com.

I went through your query and understood your concern.

CD10 (CALLA - common lymphocytic leukemia acuteantigen) is an aberrant marker, frequently positive in leukemia, lymphoma, and some soft tissue tumors. But their lone presence is not diagnostic of tumors. Instead, it is a co-marker of different other tumor markers and can occur in reactive cases. On the other hand, the clinical behavior of your lesions indicates an infectious etiology.

So I suggest you to undergo CBC (complete blood count), ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), LDH (lactate dehydrogenase), ADA (serum adenosine deaminase), beta-2 microglobulin, T-SPOT.TB (tuberculosis-specific enzyme-linked immunospot assay) tests for further evaluation. I have shared a few points on leukemia and lymphomas below. Kindly read them.

The word leukemia means white blood cell cancer in peripheral blood. Leukemia is a relatively old term. Nowadays, it is called hematopoietic and lymphoid neoplasm. A good share of circulating white cells comes from lymphoid tissues such as lymph nodes, spleen, thymus, etc. And the rest of the cells come from bone marrow. Lymphoid tissue is present all over the body, even in the intestine, lungs, liver, etc. The neoplasms of lymphocytes white blood cells are called lymphomas which are rarely present in the blood and are present in lymphoid tissue. However, they infiltrate blood and bone marrow at later stages (stage 4 disease).

Now, there are certain neoplasms arising from bone marrow. They are myeloid leukemia or lymphoid leukemias. They are mostly present in peripheral blood. In addition, leukemias and lymphoma are not merely the presence of certain types of abnormal cells. It is a whole package comprising anemia, leukopenia or leukocytosis, high ESR, thrombocytopenia, unexplained fever, weight loss, arthralgia, myalgias, bone pain, etc. These are diagnosed using bone marrow biopsy, immunohistochemistry, flow cytometry, radiological surveying, etc. They are treated with chemotherapies selected according to the type of cells involved in lesions.

I hope this has helped you.

Kindly follow up if you have further doubts.