Lymph Nodes- I need your opinions?!
Question: I've had two swollen lymph nodes on my neck for about a year now and I went to my doctor who told me to see an ENT. I went to the first ENT and they said it was an artery, so I went back to my original doctor and told them they said it was an artery and nothing about a swollen lymph node. I then went to see a second ENT who said it was nothing and I'm most likely just fighting an infection(everyone says this but since they've been swollen for so long I don't think I am). I also have been very fatigued and have been coughing where it hurts and feels like pressure on my chest. I've found things about Non-Hodgkin's Lymphoma and I think this could be a possibilty? I'm nervous to ask my doctor incase they think I'm overreacting, and my mom doesn't really like to talk about it. I feel shes scared theres more wrong with me than we've found out. Any help and opinions or past experiences are welcomed. Also if you have NHL, can you say what symptoms sent you to the doctors for it?
Answers: I've had two swollen lymph nodes on my neck for about a year now and I went to my doctor who told me to see an ENT. I went to the first ENT and they said it was an artery, so I went back to my original doctor and told them they said it was an artery and nothing about a swollen lymph node. I then went to see a second ENT who said it was nothing and I'm most likely just fighting an infection(everyone says this but since they've been swollen for so long I don't think I am). I also have been very fatigued and have been coughing where it hurts and feels like pressure on my chest. I've found things about Non-Hodgkin's Lymphoma and I think this could be a possibilty? I'm nervous to ask my doctor incase they think I'm overreacting, and my mom doesn't really like to talk about it. I feel shes scared theres more wrong with me than we've found out. Any help and opinions or past experiences are welcomed. Also if you have NHL, can you say what symptoms sent you to the doctors for it?
My dear Belgian ; this guy is sweating out an acute fear of having lymphogranuloma and there you go serving up a salad of Anatomy 101 and Pathology 102. For crying out loud.
For the questioner: you should have a biopsy done. Swollen lymphnodes not necesseraly mean a malignancy. Ever heard about mononucleosis? Dr House.
Lymph nodes are components of the lymphatic system. They are sometimes informally called lymph glands but, as they do not secrete substances, such terminology is not accurate. They are found throughout the body.
Lymph nodes are filters or traps for foreign particles and contain white blood cells.
Function
Nodes act as filters, with an internal honeycomb of reticular connective tissue filled with lymphocytes that collect and destroy bacteria and viruses. When the body is fighting an infection, lymphocytes multiply rapidly and produce a characteristic swelling of the lymph nodes.
Structure
The lymph node is surrounded by a fibrous capsule, and inside the lymph node the fibrous capsule extends to form trabeculae. Thin reticular fibers form a supporting meshwork inside the node.
The concave side of the lymph node is called the hilum. The artery and vein attach at the hilum and allows blood to enter and leave the organ, respectively.
The parenchyma of the lymph node is divided into an outer cortex and an inner medulla.
Cortex
In the cortex, the subcapsular sinus drains to cortical sinusoids.
The outer cortex and inner cortex have very different properties:
Location Name/description Predominant lymphocyte Has nodules?
outer cortex nodular cortex B cells yes
deep cortex juxtamedullary cortex or paracortex T cells no
The cortex is absent at the hilum.
It is made out of the fluid from the blood called plasma.
] Medulla
There are two named structures in the medulla:
The medullary cords are cords of lymphatic tissue, and include plasma cells and T cells
The medullary sinuses (or sinusoids) are vessel-like spaces separating the medullary cords. Lymph flows to the medullary sinuses from cortical sinuses, and into efferent lymphatic vessels. Medullary sinuses contain histiocytes (immobile macrophages) and reticular cells.
Shape and size
Human lymph nodes are bean-shaped and range in size from a few millimeters to about 1-2 cm in their normal state. They may become enlarged due to a tumor or infection. White blood cells are located within honeycomb structures of the lymph nodes. Lymph nodes are enlarged when the body is infected due to enhanced production of some cells and division of activated T and B cells. In some cases they may feel enlarged due to past infections; although one may be healthy, one may still feel them residually enlarged.
Lymphatic circulation
Lymph circulates to the lymph node via afferent lymphatic vessels and drains into the node just beneath the capsule in a space called the subcapsular sinus. The subcapsular sinus drains into trabecular sinuses and finally into medullary sinuses. The sinus space is criss-crossed by the pseudopods of macrophages which act to trap foreign particles and filter the lymph. The medullary sinuses converge at the hilum and lymph then leaves the lymph node via the efferent lymphatic vessel.
Lymphocytes, both B cells and T cells, constantly circulate through the lymph nodes. They enter the lymph node via the bloodstream and cross the wall of blood vessels by the process of diapedesis.
The B cells migrate to the nodular cortex and medulla.
The T cells migrate to the deep cortex.
When a lymphocyte recognizes an antigen, B cells become activated and migrate to germinal centers (by definition, a "secondary nodule" has a germinal center, while a "primary nodule" does not). When antibody-producing plasma cells are formed, they migrate to the medullary cords. Stimulation of the lymphocytes by antigens can accelerate the migration process to about 10 times normal, resulting in characteristic swelling of the lymph nodes.
The spleen and tonsils are large lymphoid organs that serve similar functions to lymph nodes, though the spleen filters blood cells rather than bacteria or viruses.
Distribution
Regional lymph tissueHumans have approximately 500-600 lymph nodes distributed throughout the body, with clusters found in the underarms, groin, neck, chest, and abdomen.
Lymph nodes of the human head and neck
Cervical lymph nodes
Anterior cervical: These nodes, both superficial and deep, lie above and beneath the sternocleidomastoid muscles. They drain the internal structures of the throat as well as part of the posterior pharynx, tonsils, and thyroid gland.
Posterior cervical: These nodes extend in a line posterior to the sternocleidomastoids but in front of the trapezius, from the level of the Mastoid portion of the temporal bone to the clavicle. They are frequently enlarged during upper respiratory infections.
Tonsillar: (sub mandibular) These nodes are located just below the angle of the mandible. They drain the tonsillar and posterior pharyngeal regions.
Sub-mandibular: These nodes run along the underside of the jaw on either side. They drain the structures in the floor of the mouth.
Sub-mental: These nodes are just below the chin. They drain the teeth and intra-oral cavity.
Supraclavicular lymph nodes: These nodes are in the hollow above the clavicle, just lateral to where it joins the sternum. They drain a part of the thoracic cavity and abdomen. Virchow's node is a left supraclavicular lymph node which receives the lymph drainage from most of the body (especially the abdomen) via the thoracic duct and is thus an early site of metastasis for various malignancies.
Signs, Symptoms, & Diagnosis
Symptoms of Non-Hodgkin's Lymphoma
Symptoms of non-Hodgkin's lymphoma (NHL) may appear suddenly or may develop gradually over a long period of time. Lymph nodes and lymphatic tissue are found throughout the body, so lymphoma can occur in many different places and symptoms can vary.
People with non-Hodgkin's lymphoma may experience:
Painless swelling of glands, usually in the neck, armpit, or groin
Fever
Unexplained weight loss
Night sweats
Tiredness and weakness
Diagnosing Non-Hodgkin's Lymphoma
Because all these symptoms can result from many different illnesses, many tests must be performed to either confirm or rule out the diagnosis of non-Hodgkin's lymphoma. These may include:
Biopsy of a lymph node and bone marrow (ie, removing some cells and examining them under a microscope)
Physical examination
Blood tests
Imaging tests (eg, a chest x-ray, CT scan, or MRI scan) [
Have you had chronic allergies or sinus issues over the past year? This will cause the glands and lymph nodes in the neck to be swollen. If you have been having allergy or sinus issues all year, the neck would stay swollen.
Have you told your doc about ALL of your symptoms, how long you have had them, and your concerns. If not, you really need to. Your doc can give you much more sound advice than anyone on here. There may be perfectly legit reasons other than cancer why this is going on. But, if you think it could be cancer, you NEED to voice your concern to your doc. Doc can either run the appropriate tests or give you the medical answers you dont have.
Are you having unexplained fevers, night sweats, unexplained itching or unexplained weight loss? If not then most likely you do not have lymphoma. You may have some type of health problem but there are many possibilities much more likely than cancer unless you are having the symptoms listed above.
Symptoms of malignant diseases and other diseases are often common. You should not conclude anything only on symptoms. It is possible that you may have some malignancy like lymphoma. It is equally possible that you may not have any malignancy.
However, it is very important to get your mind cleared of doubts, if any. As you may be aware that our mind work round the clock till end. Any doubt created in mind, particularly about our health and wellbeing, may have very adverse effects.
You need not be shy about your apprehensions or thoughts in the mind. Since you have doubts with regards to a malignant disease, the best recourse is to have your doubt cleared by consulting an expert like Hematologist.
Has any of the doctors bothered to do a blood test on you? If not, they should. A blood test is generally one of the first courses of action and can reveal quite a bit about your state of health. If you haven't had one done, then go to your doctor and tell him to do one.
insist on a needle biopsy. if they wont do one find someone that will. i had problems with doctors not listening to my symptoms, i turned out to be right. the biopsy takes no time at all to do and its usually only a few days for results. if it is cancer then it is better they get it earlier rather than later. but in your case, i hope for you that it is nothing