No diagnosis yet--

Giga4

It is a long story but 10 months ago I had a chest ct scan, it showed enlarged mediastinal and hilar nodes 1.5cm on the short axis. I was not able to do the post f/u due to an injury and surgery that had me non weight bearing, my PC received the results but never followed up until I had my check up in Oct and I mentioned it. He was very concerned sent me for CT scan #2 which showed the same results with the hilar being 1.9cm . The impression was possible sarcoidosis or indolent lymphoproliferative process. I am headed to the pulmonologist on Tuesday. I am not sure what comes next my P. C. indicated he thinks a biopsy would be next since I have had 2 c. t. scans. What questions should I ask, which test should be scheduled? I am a 63 year old female who walked 2-5 miles 3 or so times per week but I am tired and lately getting to 2 miles really zaps me, but I also think the mental game of knowing something could be seriously wrong possibly is getting to me. I was very tired before I knew the nodes were still enlarged. It is a little crazy because I have let myself leap right into the rabbit holes on google.

po18guy

Very sorry to hear of this. While enlarged lymph nodes are normally signs of infection, such conditions as sarcoidosis do occur. If there is to be a biopsy, removing an entire lymph node is the gold standard. Oftentimes, a needle aspiration biopsy is offered, as they are less invasive and less costly. They are also less reliable.

If an entire lymph node can be removed (our bodies have hundreds of them), it provides much more information as to what is actually occurring. The question to consider is if a good-sized node is reasonably accessible. At one point, I was told to go home and grow some tumors closer to the skin. So I did.

Needle biopsies obtain only a very small amount of tissue for examination. If lymphoma is suspected, the entire node tells much more. Think of a lymph node like an orange: you have peel, segments, stem and seeds. If a lymphoma is occurring, all of that will be gone and the entire node will be filled with lymphoma cells. Imagine peeling an orange and finding only clay inside. A needle biopsy will reveal none of this.

Most biopsies are fairly simple, walk-in, walk out procedures. Maybe a stitch or two, or quite possibly "steri-strips" which are medical grade tape to close the incision. Needle biopsies require a Bandaid. So, patience is needed and keeping occupied with daily life, friends, hobbies etc. can play a crucial part of maintaining peace of mind.