Understanding My Lymphadenopathy - Insights on FNA Findings
Hello everyone, I hope you’re all doing well. I’m reaching out as I have some inquiries regarding my health, particularly concerning the results from my fine needle aspiration (FNA). Is there a chance I might be dealing with lymphoma? Here’s a bit of background: In March 2024, I discovered a firm lump just below my ear. My physician suggested it was likely a lymph node, but he seemed unconcerned. As a result, no further action was taken at that time. Then, in November 2024, I experienced a sinus infection that progressed to an ear infection in my right ear, which resulted in temporary hearing loss. I was treated with a five-day course of azithromycin, which alleviated most of my symptoms and restored my hearing. However, post-infection, I continued to feel a sense of fullness in my ear and neck. I returned to my doctor, who recommended a 10-day course of Flonase, but that didn’t provide any relief. Following that, I was prescribed prednisone for a week in hopes of resolving the ear infection; unfortunately, it also failed to alleviate my symptoms. By March 2025, I was referred to an ENT specialist. During my appointments, both an audiology evaluation and an ENT consultation indicated no signs of lingering ear infection. When I brought up the lump on my neck, they recommended an ultrasound. The ultrasound confirmed that I had an enlarged lymph node. I subsequently underwent fine needle aspiration and was informed that the cells obtained were atypical, necessitating an excisional biopsy. Current diagnosis includes: - Lymphadenopathy (Primary Concern) - ADHD - Anxiety - Asthma My current medications are: - Vyvanse 30mg (daily) - Albuterol inhaler (as needed) Test results include: - **March 18, 2025 (Ultrasound):** Enlarged cervical lymph node at the upper cervical level 2, measuring approximately 3.1 x 0.8 x 1.3 cm. The findings are indeterminate and may reflect a reactive nature due to a history of infections. The right parotid gland appears normal without discernible lesions. The bilateral submandibular glands show minor heterogeneity. - **March 20, 2025 (CT with IV Contrast):** Right cervical level IIA node measuring up to 8 mm short axis, which is not enlarged according to CT guidelines and is comparable to the left side. No additional prominent nodes detected. Fat planes around the parapharyngeal area appear intact. No significant lesions in the oropharynx or nasopharynx; brain images show no clear abnormalities. All glands and lung apices seem normal, and cervical alignment is appropriate. - **March 20, 2025 (CBC; BMP):** Elevated platelet count (415), elevated leukocytes (101), and slightly high calcium levels (10.1). - **March 25, 2025 (FNA with Ultrasound Assistance):** Atypical lymphoid cells were identified, but their significance remains unclear. Smear analysis shows a mixed lymphoid population, including larger lymphoid cells and many small lymphocytes. No signs of granulomas or cancerous cells were observed, but the presence of larger cells raises concerns due to their atypical nature. I have an excisional biopsy coming up, but I feel somewhat perplexed regarding the underlying causes of my lymph node issues. I would greatly appreciate any insights you could provide! Thank you all for your help!
Answers (1)
3/31/2025, 3:01:11 PM
OpenHealth AI
It sounds like you’re dealing with a complex situation regarding the lump in your neck and the results of your fine needle aspiration (FNA). Your concerns about lymphoma, especially with the presence of atypical lymphoid cells, are completely valid given your symptoms and the diagnostic process you've been through. I want to provide you with clear insights and supportive guidance.
Key Points:
- Atypical lymphoid cells can indicate various conditions ranging from infections to malignancies, including lymphoma.
- Your upcoming excisional biopsy is an essential next step to clarify the diagnosis.
- Other recent tests have shown evidence of inflammation but not conclusive signs of cancer.
- Continuing to manage any symptoms and stress is important while you await further results.
Explanation:
The findings from your FNA indicate that while there are atypical lymphoid cells present, the complete picture is still unclear and not definitively indicative of lymphoma. It is important to understand that atypical cells may be a response to previous infections (like your sinus and ear infections) or other reactive changes rather than cancer.
Your elevated leukocyte count could suggest an inflammatory response, and the elevated platelets may also be related to inflammation or infection rather than malignancy. The excisional biopsy will allow for a more comprehensive examination of the tissue and a more accurate diagnosis.
Recommended Next Steps:
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Prepare for Your Biopsy: Ensure you are informed about what to expect during and after the excisional biopsy. Discuss any concerns with your healthcare provider to alleviate anxiety.
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Manage Symptoms: Continue to monitor any symptoms you experience, such as fullness in your ear or changes in the lump. Keep a symptoms diary to document any changes which can be helpful for your doctors.
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Stay Hydrated and Healthy: Focus on maintaining a balanced diet and hydration, which can support your overall health while your body is dealing with these issues.
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Mental Health Support: Given your anxiety and previous ADHD diagnosis, consider utilizing stress management techniques such as mindfulness, meditation, or talking to a mental health professional if you feel overwhelmed.
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Follow-Up and Communication: Stay in regular communication with your healthcare team. Don’t hesitate to reach out if new symptoms arise, or if you have further questions.
Please remember that it's natural to feel anxious when waiting for a diagnosis, especially with complex health issues. You're taking proactive steps by seeking information and preparing for your biopsy, which is commendable. You're not alone in this journey, and your healthcare providers are there to help guide you through the process. If you have any more questions or need further clarification, feel free to ask.
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