What should I except when i go to the ENT doctor?

Badams6161
Badams6161 Member Posts: 6

I found a swollen lymph node on the right side of my neck about a month ago. My doctor had me get blood work done two days ago that showed my white blood cell count was slightly high at 14 when the high normal is 11. I have no symptoms of being sick, so they were slightly concerned, but, said they werent extremely concerned. I was referred to an ENT appointment this coming week. I was just wondering what to expect when I go in. Are they going to do a biopsy there? Will they do an ultrasound? Or what else might they do while im there?

Comments

  • Miracle3
    Miracle3 Member Posts: 17
    Sometimes the ENT will order

    Sometimes the ENT will order a CT scan of head/neck. Also, he/she may scope you to look for lesions in the nasal passage or throat. It doesn't hurt. They numb the inside of your nose with spray and put a very skinny tube with a camera. Takes 30 minutes and trust me, if I can do it, anyone can. He/she MAY Oder an ultrasound, but I think CT is more common. An ENT will sometimes order a biopsy. A fine needle aspiration biopsy doesn hurt but it's usually not indicated for lymphom. A lymphoma CAN show this way but can also be missed. An excisional biopsy is the norm.  That would of course be ordered for another day.

  • Evarista
    Evarista Member Posts: 336 Member
    ENT & lymph node

    Hi Badams. I had a similar experience several years ago.  Your ENT may handle yours differently, but in my case, Dr. ordered an ultrasound right away and prescribed antibiotics.  They could refer you for a biopsy (likely fine needle), but may want to wait to see if antibiotics clear up the problem.  In my case, they did and by the time I went for my biopsy 10 days later, the pathologist could not even locate the node (by sonogram) to biopsy. So, resolved with no further issues.  Vis-a-vis my current lymphoma:  there is absolutely no indication of lymphoma in that lymph node or any others in that region, so seems completely unrelated.  Good luck.

  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,817 Member
    ENT

    Badadams,

    My take on ENTs is not good.  Obviously, they vary by individual doctor. Reasonably, they are going to make a working assumption that what you have is not cancer, since most people who present like you in fact do not have cancer.  But most will also use reasonable vigilence in checking for malignancy.   Also, I agree with all that Miracle wrote: That is the very likely sequence of events at the ENT Clinic.

    A surgical biopsy is much to be preferred. Aspirational ("needle") biopsies are too commonly wrong or inconclusive.  If the ENT recommends biopsy, specify that you prefer excise. 

    And CT is dramatically better at assessing Lymphoma than is ultrasound.

    Two years after going N.E.D. of Lymphoma, I one day felt a large lump in my throat. It frightened me badly. After it persisted for several days, I went in to see my medical oncologist, a man with 5 Board Certifications, and all-Ivy (Stanford, UCLA, etc).  I asked if he felt it, and he responded, "Oh sure -- it is easy to detect."   A moment later, however, he added, " That is a gland, not a lymph node.  If it doesn't go away in another week, call back. But it is absolutley nothing to worry about."   My ideal choice in a doctor is a person who has common sense, a strong sense of probabilities, and who responds straight-up, immediately. Cut to the chase and let's move forward.  Save the fluff for the next patient....

    It's all about whom you talk to, and whether the right testing is done.  I worked for years in Admin at a large state college.  I soon noted that whether a person got the services they needed depended on "who answered the phone."  One administrator would say, "Sorry, we need this and this, becoause of this and that."  Another would say in response to the exact same particulars, "Sure, I'll handle that for you in a few minutes."  I have observed this 100 times, and it is most common in medicine and government offices. The luck of the draw is ever at play.  Very often, the best way to get service in a large organization is to simply call back five minutes later and ask the exact same question again. You will never have the same person answer twice.

    max

  • Badams6161
    Badams6161 Member Posts: 6
    Thank you for the responses

    Thank you for the responses everyone! The process of me figuring this all out is going quick. The ENT called today and told me what all they plan to do. They want a CT and depending how the appointment goes they'll plan an excisional biopsy. I'm hoping all comes back fine. I have no other symptoms other than the lump and I'm a healthy 22 year old. I'll be looking on the bright side for this. Thank you again and good luck in all of your futures :)

  • lindary
    lindary Member Posts: 711 Member

    ENT

    Badadams,

    My take on ENTs is not good.  Obviously, they vary by individual doctor. Reasonably, they are going to make a working assumption that what you have is not cancer, since most people who present like you in fact do not have cancer.  But most will also use reasonable vigilence in checking for malignancy.   Also, I agree with all that Miracle wrote: That is the very likely sequence of events at the ENT Clinic.

    A surgical biopsy is much to be preferred. Aspirational ("needle") biopsies are too commonly wrong or inconclusive.  If the ENT recommends biopsy, specify that you prefer excise. 

    And CT is dramatically better at assessing Lymphoma than is ultrasound.

    Two years after going N.E.D. of Lymphoma, I one day felt a large lump in my throat. It frightened me badly. After it persisted for several days, I went in to see my medical oncologist, a man with 5 Board Certifications, and all-Ivy (Stanford, UCLA, etc).  I asked if he felt it, and he responded, "Oh sure -- it is easy to detect."   A moment later, however, he added, " That is a gland, not a lymph node.  If it doesn't go away in another week, call back. But it is absolutley nothing to worry about."   My ideal choice in a doctor is a person who has common sense, a strong sense of probabilities, and who responds straight-up, immediately. Cut to the chase and let's move forward.  Save the fluff for the next patient....

    It's all about whom you talk to, and whether the right testing is done.  I worked for years in Admin at a large state college.  I soon noted that whether a person got the services they needed depended on "who answered the phone."  One administrator would say, "Sorry, we need this and this, becoause of this and that."  Another would say in response to the exact same particulars, "Sure, I'll handle that for you in a few minutes."  I have observed this 100 times, and it is most common in medicine and government offices. The luck of the draw is ever at play.  Very often, the best way to get service in a large organization is to simply call back five minutes later and ask the exact same question again. You will never have the same person answer twice.

    max

    Add IT to that list. IT support is just as bad. 

  • Miracle3
    Miracle3 Member Posts: 17
    edited July 2017 #7
    Let us know.

    Let us know.

  • po18guy
    po18guy Member Posts: 1,504 Member
    High whites mean that infection is most likely

    But medicine is running scared from legal challenges, so we get the cancer scare and ENT/Hematologist referrals for little more than the common cold. Now, it could be something serious, but those high white count lymphocytes have to go somewhere, right? Where else except to lymph nodes that are nearest the infection. How are your teeth? How are your tonsils, if you have them? How is your throat? Sinuses? It is far too early to think cancer.  

  • Badams6161
    Badams6161 Member Posts: 6
    edited July 2017 #9
    Hey all, just letting

    Hey all, just letting everyone know whats going on. I went to the ENT today and my throat, nose and ears all looked good. The doctor said she didn't think the lump seemed or felt malignant even though it is now at a 3cm diameter. I was prescribed prednisone and amoxicillan to see if those decrease the size. I get a CT scan thursday then after that the next step is excisional biopsy. I'll be sure to keep everyone informed of what's going on.

     

    Edit: I also went in for blood work today after i left the ENT. They will be checking for mono and a few other infections to rule out some more things.