Inadvertent finding of cervical lymphadenopathy

Posted by sb4ca @sb4ca, Dec 20, 2021

Hi, I have severe degenerative disc disease and went for a second opinion for surgery with an ortho. I was explaining to his PA that I was having pain behind my ear, base of head and side of jaw, but also had bumps around my throat. She then palpated my nodes and said I had enlarged nodes. When the surgeon came in, the conversation was almost entirely focused on these enlarged glands. I said I'd been under the weather but he said he could see other enlarged nodes on the MRI. He ordered a CT scan of the chest. Could someone tell me why they think he ordered a chest CT? If he's suspicious of cancer, couldn't that be from any number of causes? I had the same test 3 years ago–it showed some "Couple tiny micronodules" on right and a stable 3mm nodule on left-both considered normal. I asked if I could just go to my primary doctor for this but he wanted me to get the CT right away and also said I should follow-up with him. It's scheduled for Thursday. I don't know what to make of this. I've been dealing with neck issues for a very long time and have complained about these lumps all along. Honestly I question whether they are in fact lymph nodes. I once had a supraclavicular node that they attempted to biopsy. It had shrunk a bit but the biopsy surgeon said he didn't know what it was but it wasn't a lymph node and nothing came out of the biopsy. Could someone help me better understand?

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@sb4ca Hi and welcome to Mayo Connect! I just hate this total confusion state that you got left in, don’t you? You are going to have a CT on Thursday, correct? The CT will give a good picture of anything going on in the chest. Lymphadenopathy, by itself, means that the lymph nodes are swollen. the CT will give info before/or if the doctor wants/needs to do a biopsy.
Will you get back to me on Thursday, to let me now what you learned?

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@becsbuddy

@sb4ca Hi and welcome to Mayo Connect! I just hate this total confusion state that you got left in, don’t you? You are going to have a CT on Thursday, correct? The CT will give a good picture of anything going on in the chest. Lymphadenopathy, by itself, means that the lymph nodes are swollen. the CT will give info before/or if the doctor wants/needs to do a biopsy.
Will you get back to me on Thursday, to let me now what you learned?

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Thanks for commenting @becsbuddy . Today I have the CT. As I said I have severe DDD and have been treated for myofascial pain syndrome. So I'm used to knots and apparently was unable to differentiate knots vs lymph nodes. Now I can tell I have a large "bump" starting from back of neck to the front. It's hugely uncomfortable and has been for a very long time. But what I don't understand is why this ortho doc ordered chest ct vs neck ct since that is where the lymph nodes are. I understand he's looking for any metastasis from the chest, but that seems like it should follow imaging of the head and neck IMO. I had an appointment from the initial surgeon I saw and of course told him what happened. Thank the lord, he has access to imaging from the facility I'm going to and will call me end of day Monday with the results. PS. I recognize that my first surgeon wants to keep me as his patient so is superseding the other surgeon, lol.

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@sb4ca. Hello again and Happy Holidays! First off, i want to tell you that you’re doing a good job of advocating for yourself! It’s so important to tell doctors when you don’t feel that things are right or that you’re confused about something. Great job!! You had your CT scan yesterday—how did it go? Have you learned anything? Will you let me know?

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@sb4ca

Thanks for commenting @becsbuddy . Today I have the CT. As I said I have severe DDD and have been treated for myofascial pain syndrome. So I'm used to knots and apparently was unable to differentiate knots vs lymph nodes. Now I can tell I have a large "bump" starting from back of neck to the front. It's hugely uncomfortable and has been for a very long time. But what I don't understand is why this ortho doc ordered chest ct vs neck ct since that is where the lymph nodes are. I understand he's looking for any metastasis from the chest, but that seems like it should follow imaging of the head and neck IMO. I had an appointment from the initial surgeon I saw and of course told him what happened. Thank the lord, he has access to imaging from the facility I'm going to and will call me end of day Monday with the results. PS. I recognize that my first surgeon wants to keep me as his patient so is superseding the other surgeon, lol.

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@sb4ca I’m just wondering if you might share your CT results with me? And did you ask about the focus of the CT—why the chest CT?

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@becsbuddy

@sb4ca I’m just wondering if you might share your CT results with me? And did you ask about the focus of the CT—why the chest CT?

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Thanks for asking it was negative thank you Everyone including the tech wondered why he didn’t do the neck So my first surgeon ordered the neck ct but insists I follow up with my primary which is appropriate Its still very tight and hugely bothersome

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