Intracyst hemorrhage and FNA
Hi all,
My most recent scans on Nov 2 showed resolved primary in left throat and shrinking or stabilizing nodes in the neck. Woohoo! My surgeon was surprised. I was not. I told him that it was the myraid alternative therapies I'm treating myself with. My immune system is on fire with 2 sick family members in the house and I feel 110% great.
There is one issue however which is a still growing node. On the PET, that node is all dark except some mild avidity about the rim. Clinical statistics say there's still cancer there, but oddly everything else is shrinking. What's different about this node?
Well this node was poked. Not once, not twice, but 5 times during my initial FNA that diagnosed me. It's that node. And the most recent scan came back saying there isn't much happening there except for an internal cystic hemorrhage.
My question that I can't seem to get a straight answer from various internet searches is: Can a (poorly executed) FNA that leaves a hemorrhage for 6 months cause the node to continue swelling and growing. Seems like a good way to make a node angry to me. My oncs aren't much help as they aren't thinking critically here about this. They just keep repeating the mantra "neck dissection is next" over and over. Troubling that I can't get anyone to actually THINK about this. I'm not eager to get a neck dissection only to have post-surgical pathology tell me they didn't find anything.
Has anyone else had a node swell that they even suspect is due to an FNA?
David
Comments
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Here’s my 2 cents
I doubt that the mass inside the node is only hemorrhage from the poking (although the CT showed internal cystic hemorrhage). It might be necrotic tissue (and hemorrhage). When new tissue (tumor) forms, there is neovascularization which is not well organized and malformed (so to speak). It breaks easily and does not provide efficient vascularization/”nutrition” to the newly formed tissue. Hence both hemorrhage and necrosis.
The fact that the node is increasing in size (especially if rate of growing is significant) is a concern. So I believe removing the node(s) and sent to pathology exam would be conclusive.
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I tend to agree with Corleone....
When I got my FNA on the swelled node, it was the size of of an almond....after the FNA it swelled up t the size of a plum. Ok, so I went through treatment, 35 rads.....5 months of chemo....and the nodes were all normal, and all my scans were normal for three years. Then they found cancer in the nodes again...no where else, just the nodes and I ended up with a dissection. There were three nodes where the cancer had laid quietly for all that time.....then bingo, it started growing again. This time I had 25 rads....The crappy part was that 2 or the three were extracapsulated....since then I've had to get lung scans every three months (like they're sure the cancer will be making a run for it to my lungs)....
Getting that oddball node out isn't like getting all the nodes removed....one small incision, and out it comes....I wish I'd had a neck dissection along with the chemo and rads in the beginning....chances are I wouldn't be in this 3 month merry-go-round now. Not to mention, if it comes out, and they don't find any cancer, this is one thing you won't be fretting about for the next 5 years.
p
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