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May 25, 2012
 

Enlarged lymph nodes and diagnosis of cancer

Dear Ask The Doctor: Lymph nodes in neck have been enlarged for over 2 years now and continue to grow with no apparent cause or illness. They can be easily felt through a full beard now and I'd estimate 5cm or larger as I could barely feel them at 4cm. A small pea sized node was removed and biopsied (Dr. didn't get one of the enlarged nodes) and was supposedly benign. My question: if the wrong node was removed and tested, is cancer still a possibility? Or would a malignancy show up in ALL the nodes in my neck? No medical insurance and no Dr.Don't know what to do or why they continue to grow.

Dear Richard: It is very difficult for a doctor to answer whether cancer can be detected by doing biopsy on a single node and whether malignancy show up in all the nodes. There are various factor that could govern a successful lymph node biopsy.

  1. Size : In general, lymph nodes larger than diameters of 1.5 x 1.5 cm or 2 cm in a single diameter have the best diagnostic yields, whereas lymph nodes less than 1 cm are unlikely to provide a specific diagnosis. The diagnostic yield from lymph nodes of an intermediate size is variable.
  2. Site : Enlarged peripheral lymph nodes are generally preferred to other lymph nodes for diagnostic biopsy because they are easily accessed and have a relatively high diagnostic yield.
  3. Whether an enlarged node is an isolated finding or is part of more generalized adenopathy also influences the diagnosis.

The clinical presentation of cancer or lymphoma varies tremendously depending upon the type of lymphoma and the areas of involvement. The chances of cancer is higher if there are underlying presentations such as hepatosplenomegaly, fever, weight loss, and night sweats. I hope that answers your question, take care.

Last Updated ( Wednesday, 01 February 2012 )
 

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