Do I need to get FNB or biopsy to check lymph node enlargement?

Hi,

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Based on your query and attached images (attachment removed to protect patient identity), my opinion is as follows:

1. In view of the clinical symptoms, images could be more of neoplastic etiology. Clearly, with the family history and prominent nodes along with the classical history of night sweats, further evaluation is definitely necessary.
2. FNB (fine needle biopsy) is usually an initial test and the final confirmation is by biopsy. FNB has its limitations, however, to avoid any surgery; FNB of two lymph nodes can be done. If suspicious or positive, then can go for a biopsy, which will require further studies for characterization.
3. FNB is usually my initial choice; however, a biopsy will be necessary for confirmation. However, evaluation of nodes is compulsory by looking at radiological findings, family history, and symptoms.
4. CBC (complete blood count), being normal indicates that there is no leukemia or lymphoma spillover into the peripheral blood. Lymph node evaluation is necessary.

Hi,

Welcome back to icliniq.com.

1. Yes, in relation to alcohol use, in a few patients with lymphoma, lymph nodes do become tender. However, the exact cause of it is not identified.
2. Mild elevation of alkaline phosphatase, LDH (lactate dehydrogenase) and albumin are not to be worried about.
3. Increased neutrophil, probably secondary to mild bacterial infection could be causing mild abnormal liver function test values.
4. Get the tests done. Hope, it is only reactive lymph nodes and not lymphoma. Do get back after tests for anything of concern.