What tests are needed for my neck lumps and fatigue?

Question

Hello doctor,

I have random bruising on my body often, more than one lump in my neck that I noticed 11 months ago, and now I have difficulty swallowing, especially while lying down. I have abdominal discomfort sometimes and a sore throat most of the time.

I feel fatigued 24 hours a day (24/7), yet I have insomnia. I went from 168 pounds (lb) to 150.2 pounds (lb) (weighed today). Sometimes my brain feels foggy. Could this be cancer?

I am a transman in a woman's body still. Also, I feel hotter in colder areas, and I have heat intolerance. I do not use tobacco or alcohol. I am concerned that I may have some cancer in the neck.

I feel constant discomfort in my throat or neck, with swelling under the jawline, slightly on the sides, and in the thyroid as well. The lumps do not move and have been present for almost a year, and have gradually worsened. The only related condition is being diagnosed with gastritis, not sure though.

Currently, I am on the birth control pill Ethinyl estradiol and Levonorgestrel. I tried taking thyroid supplements, but they did not help me. I have gone through the following test:

Gastritis.
Rheumatoid arthritis.
Previous kidney lesion that went away.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern, and I appreciate you reaching out with your symptoms. After carefully reviewing your information and the images provided (attachment removed to protect the patient’s identity), it is difficult to reach a conclusive cause of your problem at this stage.

However, certain cancers, such as lymphoma, can sometimes present in a similar manner, which is why they need to be considered. There is usually an associated presence of fever in such cases.

At the same time, other conditions can also produce similar symptoms, including sarcoidosis, infections like tuberculosis, and human immunodeficiency virus (HIV).

To better understand your situation, I would like to know if you have experienced fever in the recent past or any episodes of excessive sweating. Additionally, it is important to check whether you have noticed bleeding from any site.

Based on the current information, it would be appropriate to get a complete blood count and a peripheral smear assessment done. You should also discuss the possibility of the above conditions with your treating physician. In many cases, a lymph node biopsy is required before reaching a conclusive diagnosis.

I hope you are satisfied with my answer. For any further queries, you can consult me at iCliniq.

Thank you.