Biopsy journey
Hi,
I just wanted to see about getting other opinions on my whole journey I’ve been on for the last three months. The week before Thanksgiving, I noticed there was a big ball formed under my left armpit. Went to urgent care, she said it was an enlarged lymph node. We did blood work and CBC came back showing high LDH, low lymphocytes, high neutrophils, and negative for cat scratch fever. We did an ultrasound a few weeks later which showed abnormal lymph nodes. It was still enlarged and the cortical thickness was bigger than it should have been. Then they ordered a biopsy of the lymph node. That came back inconclusive; my doctor and radiologist disagreed with the results from Mayo Clinic because the node had been enlarged for so long. So they ordered for an excissional lymph node biopsy. They removed the lymph node on the 22nd and then a few days later, got a call saying they sent it to Mayo Clinic cause it was still inconclusive. So now the report from Mayo Clinic is posted. It says “reactive lymph node”. Then it says “intact architecture with patent sinuses. Follicular lymphoid hyperplasia is present, as well as areas of monocytoid B-cell hyperplasia and plasmacytoid monocytes.” I don’t know what that means if anything; I’m just wondering if anyone has an idea or a similar story that might make me less worried. They’ve said that this all could’ve been from an infection, but I haven’t had any infections and haven’t been on any medications. I haven’t had my follow up appointment with the doctor yet and the nurse over the phone told me he would discuss it with me when I come in but I’m just being inpatient since it’s been three months of this mess.
Thanks!!
Comments
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I think you can be cautiously optimistic here. The key is the 'normal architecture' of the node in the pathology report. A malignancy will efface the internal architecture of the lymph node, replacing it with a mass of lymphoma cells. Think of slicing an orange and instead of finding a stem, segments and seeds, you find only a mass of clay. Clearly something is wrong. That is what lymphoma will do to a node.
On the other hand, a non-cancerous lymphoproliferative process seems possible. These are conditions in which the body makes too many normal lymphocytes. They tend to accumulate and since nodes are their normal residence, they may accumulate there. The elevated LDH is also a potential concern, but LDH rises when we exercise, or recover from a sickness or injury. It is associated with many conditions, one of them being cancer. However, your situation bears close watching and quite possibly further diagnostic procedures.
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