Swollen lymph nodes

Allergies, blood and immune system
1

My story...

I was at work one afternoon a month ago & noticed a lump on my neck - I went to the doctors the following day and had an ultrasound & a full blood count. The ultrasound showed a few swollen lymph nodes in my neck. That night I went to the gym and another lump popped up. 

I went to see an ENT for a follow up and he said it was the start of a throat infection and gave me antibiotics. The antibiotics did nothing and over the course of that week my symptoms got worse. One tonsil was very swollen, the other coated in white. I was having night sweats, had an on/off mild fever & I was having upper left abdominal pain & generally felt awful. My throat was never sore. I also had some heart palpitations, dizzy spells and my chest generally felt uncomfortable. I also was experiencing chronic fatigue. 

I went back to the ENT and requested a EBV Test. This came back positive and I was sent to see an infectious diseases doctor. He went through my symptoms, felt my spleen and said it was enlarged. He agreed on the Mono diagnosis. I had a chest X-ray which came back clear and 3 days later a ultrasound on my abdomon which by that point the spleen pain had gone and all results came back normal. 

I had a liver function test which was very high and my bloods were retested and monocytes and lymphocytes were both very high.  My whole body ached. 

After nearly 2 weeks of very healthy eating and at home relaxing, my symptoms gradually decreased. 

During this period I was very worried about lymphoma and Lukeimia - I went to see a number of doctors who all agreed on the mono diagnosis. 

My bloods were re tested and the liver function returned to normal after about 3 weeks and my lymphocytes are still slightly high at 51%. I have been given iron tablets for 6 months as my iron levels were slightly Low. My blood was looked at and the hemotoglisgt said there are reactive lymphocyte cells. Apart from that the blood looks normal. 

I am still incredibly anxious as 4 weeks on my lymph nodes are still enlarged. After a further ultrasound there are a number of lumps in my neck & a couple under my arms & small ones in my groin. 

My chest is also still feeling uncomfortable & the fatigue is lingering, but not as bad as it was two weeks ago. 

I went to see a surgeon who said he would remove & test one of the lymph nodes to rule any bad things out, but I am extreamly nervous as this will involve general anesthetic. 

Does anyone relate to my symptoms? Do you think I should have the biopsy in 2 weeks time or leave it for now? 

I was thinking maybe to have bloods done again in 2 weeks and have an ultrasound on the nodes & then decide from there. 

Any tips or advise would be great!

2

Reactive lymphocytes tend to return back to normal very slowly.I dont see a reason to perform a biopsy since your symptoms are going away.If you really want to do it make it after 2 weeks.All of your symptoms can be explained by EBV.Can you write down the latest CBC results?If you want you can repeat the CBC and LFT in a month.

3

CBC:

Red blood cells 4.13

Harmoglobin 12.1

HCT/PCV 37.1

MCV 89.8

MCH 29.3

MCHC 32.6

RDW 12.3

Platelet 422

White blood 8.7

I am thinking to have another CBC at the end of September & another ultrasound and then go from there in regards to the biopsy...

Thanks for your advise..what do you think in regards to the current CBC? 

Neutrophils 38%

Lymphocytes 51%

Eosinophils 1%

Monocytes 10%

4

I really wouldn't worry much in your case.

I've had multiple swollen lymph nodes on my head and neck area for almost a year now and still not entirely sure why. Unlike you, I had no symptoms or signs of infection or illness so I was reallllly nervous I had lymphoma. I saw my reg Dr, ENT, dermo, and an oncologist (i wanted a variety of opinions lol), and I had an ultrasound and an MRI done too. All those Drs ^ best guess is that the nodes are swollen from some bad facial acne I've had over the last year. So weird right? Apparently lymph nodes can swell from totally minor things like skin inflammation/infections so it doesn't always mean something bad like we think.

My best advice for you is to just follow what your Drs are telling you and do w.e you think will help you feel better. What are the size of your lymph nodes? All of the Drs I saw told me that the size is really the only thing that matters when it comes to swollen nodes. As long as they are normal sized (like a marble) and not the size of a golf ball, there isn't much cause for concern. In fact, the Oncologist told me I could have 10 swollen lymph nodes on my head for 5 years, and as long as they were normal size and I had no other physical symptoms, then she wouldn't be concerned.

It sounds like yours are 100% swollen from the illness in your body lately, and it will just take some time for them to go back down.

5

Thanks Philly that’s reassuring. My largest lymph node now is 1.78cm x 1cm - the added worry is they have not been tender or sore - I had one at 4cm on my first ultrasound!  What are the size of your enlarged nodes?

The comments the oncologist told you seem pretty reassuring. Fingers crossed you’ll return to new in no time & I hope soon that your skin will calm down too. 

6

I believe mine were all under or aorund 2cm, like 1.5cm area. But that hard/soft, movable/immovable stuff being red flags is bs because one of mine is rock hard and not movable at all - which google says is a red flag. But that's one of the ones I had MRI on and it came back totally normal. And even though size is apparently a red flag, even my oncologist said just bc its larger doesn't automatically mean its cancerous etc. It just means it has potential to be so they need to check it out.

7

The CBC and the differential are not concerning.I dont think the lymph nodes will get smaller in 3 or so weeks,since EBV makes them reactive for a long time.But still do the US to see if they got a bit smaller.About the hard,immovable,tender and nontender thing-oncologist care only about the size.It is also very different from person to person to check the size if they are immovable.

8

As an update...

I have been unable to sleep the past few nights and have been suffering from awful night sweats. 

I think my lymph nodes have come down slightly in my neck. I have another ultrasound on them today. My left tonsils are still inflammed and has a yellow spot on them also I think yellow/white patches appearing too. 

I am feeling exhausted and anxious. I am now 6 weeks in...

Is this normal?

9

Hi guys

As an update, I had a FNA on one of the enlarged lymph nodes today. Results should be back in 2 days. 

Please keep your fingers & toes crossed for me. 

The tiredness is still lingering & my left tonsil still is swollen and has a yellow spot on it. Apart from that and the enlarged nodes, I am ok. 

Hope you are all keeping well

10

Sounds like you have some sort of illness like strep or mono or something along those lines, and that's what is causing your nodes to swell! Good luck with the test results! Hopefully you fig it out soon.