Hi doctor,
I am a 55 year old male. I am suffering from inguinal lymphadenopathy. 2 years ago I have this on the right side and now on the left side. There is a square shallow knot present on the right side now. I have stiffness and rigidity especially in the left arm and occasional limited movements. Also I have discomfort in my legs and inguinal region. On ultrasound, it was observed lipomatosis of inguinal lymph nodes. I have painful point in inguinal region, only if I press. I have noticeable weakness, but no weight loss. Occasionally I feel very low energy and could not maintain erection. I feel numbness in the shoulder or finger when I wake from sleep. I have low erythrocyte sedimentation rate. There is no abnormal blood and urine finding. I had blood test and it is negative for all infectious diseases such as Lyme, cat scratch, AIDS, etc. Please help with some suggestion. Thank you.
Hi,
Welcome to icliniq.com. I assure you not to worry as all things may get settled with proper care and follow-up. Inguinal lymph nodes usually get prominent due to some infection (that you say have been ruled out) or some primary pathology of the nodes themselves. The knots you are talking about also warrants to rule out if that is a vein pathology or lymph nodes can be benign or cancerous changes. Biopsy of the nodes is mandatory especially when we see changes on ultrasound. Weakness can be due to hemoglobin or red blood cell deficiency. Other causes of weakness may be hypothyroidism or fluid and electrolyte imbalances. Your low sedimentation rate may be due to red blood cell, white blood cell changes and protein abnormality. Sickle cell disease also may cause it. But clinical correlation is the key and for that your physician needs to do physical examination and if suspicion arises, he may refer you to hematologist. Pain in the lymphatic region can be due to lymph nodes being pressed on or it is possibly from lipomatous changes. I also prefer you to get a detailed heart evaluation from cardiologist as weakness, shoulder and arm issues warrant that too. This kind of symptoms also needs screening for diabetes mellitus. Your physician can help you for that too. If you have got tested the above in past 8 weeks, you may upload the reports here for my review and diagnosis. If more than 8 weeks old, please go for repeat fresh tests. Biopsy and histopathology of the lymph nodes. Treatment can be decided based on investigations reports.
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