Does lymphadenopathy indicate a higher risk of cancer?

Question

Hello doctor,

I am a 35-year-old female. Four years ago, I got the bad flu and I felt horrible pain around my neck. When I put my hand on my neck I found two small balls one on my right side and one on my left side.

My doctor said it is because of the flu and I got one pack of antibiotics. After one month I found that two lymph nodes may be smaller but did not disappear. I ordered blood tests again, and they came back normal.

I went to another doctor, who ordered a blood test, and he said nothing to worry about. I went back to the previous hospital, and they kept doing blood tests for me every three months. Last year, after I fought with them, they did a CT scan and found the biggest one size is 0.31 inches, and they said it is normal and I should not worry.

So far I saw five doctors and they said not to worry the last one I saw was last week, and she told me to stop touching it and try to forget it because it will not disappear, they refused my request for a biopsy and they said the size is normal.

But I am really scared and I cannot stop thinking about it, and what if it is cancer and they do not know.

How would they know if they did not do a biopsy? In the last visit, she said if it were cancer and you have it for four years, you would have other symptoms. I do not know what to do, especially after they said no need for a biopsy, and I am really scared. When I go to bed at night, I touch them, and I cannot stop crying.

Please let me know what you think. I am tired of doctors, each time they touch me and I get a smile, do not worry, you are fine. If I am fine, why did they not disappear?

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern. After going through your elaborate history, it appears that you have had cervical lymphadenopathy secondary to the flu you had four years back.

Lymph nodes are basically the policemen of the human body; they are the first to get inflamed and enlarge when the vicinity that they drain gets infected. It appears four to seven days after infection.

If one takes antibiotics, as you did, the infection, which is contained in the lymph node, gets treated and the swelling reduces in size. But whenever the healing occurs by some amount of fibrosis, the lymph gland healed but did not return to its original size.

Now again, if the gland has not been increasing in size, or is painful, or has recruited other lymph nodes, or there has been a continuous weight loss in these four years, or the natural immunity has gone down.

You have suffered multiple infections all this while, and they all suggest or at least indicate towards a malignant change or cancer. In the absence of these signs, malignancy is unlikely.

Secondly, the size of the largest is 8 mm. Malignant lymph nodes are way larger, from 4 to 8 cm (40 to 80mm), and multiple and aggressive in nature. There are two ways of finding any form of malignancy in lymph nodes.

1. HIDA (hepatobiliary iminodiacetic acid) scan to look for the hot spot.

2. If a hot spot is not found in HIDA, then considering the lymph gland benign, further diagnosis can be established by FNAC( fine needle aspiration cytology).

3. If costs permit, a PET (positron emission tomography) scan can be done to put rest to any further doubt. Depending on the SUV (standardized uptake value) values, the malignant and benign nature may be ascertained.

I hope this helps you.

Take care.

Regards.