Concerns Over Abnormal Blood Test Results
Hello everyone, I’m in need of some advice and insights regarding my recent health concerns. To provide some background, I’ve been experiencing swelling in my cervical lymph nodes for the past four months. During this period, I've developed night sweats, pronounced fatigue, and noticed weight loss, which I suspect may be attributed to muscle loss from being less active due to my fatigue. Additionally, I’ve encountered peculiar symptoms, such as itching after warm showers or during particularly hot weather. An ultrasound has also revealed some irregularities. There is a concerning family history of lymphoma, with cases resulting in fatalities among my close relatives. A fine-needle aspiration (FNA) biopsy indicated the presence of reactive cells; however, the sample was insufficient for a flow cytometry analysis. I underwent a comprehensive infectious disease evaluation, and fortunately, all tests returned normal results. However, my previous complete blood count (CBC) suggested that my white blood cell (WBC) counts, along with neutrophils and lymphocytes, were on the rise. Interestingly, my latest CBC results indicated a decrease in WBCs, a slightly low red blood cell (RBC) count, and low hemoglobin levels, paired with an exceptionally high red cell distribution width (RDW). To provide context, my RDW was measured at 11.7% the week before, but it has drastically surged to 39.4% in the most recent test. From my findings, such a significant elevation in RDW typically doesn’t occur in healthy individuals and is not common outside of acute disease states. Upon checking, my levels of ferritin, vitamin B12, and folic acid were within normal limits, which likely rules out deficiency anemia as a potential cause for these abnormalities. Thus, my primary concern revolves around whether these results could be attributed to a laboratory error, or do they suggest the possibility of an underlying lymphoproliferative disorder, like lymphoma, given my array of symptoms? Furthermore, even though the FNA biopsy revealed reactive cells, can we confidently rule out lymphoma without the flow cytometry results? For perspective, the biopsy occurred roughly a month prior to this latest CBC. My hematologist seems to believe it’s a trivial issue, but I can’t help but wonder: If there were to be lymphoma present and potential bone marrow involvement, could we expect an elevated RDW alongside a decrease in WBC counts? I’m open to hearing your thoughts on whether I might be overreacting and should simply put this out of my mind.
Answers (1)
7/5/2025, 11:50:40 PM
OpenHealth AI
It sounds like you're experiencing a complex set of symptoms and test results that understandably raise a lot of concerns, especially given your family history of lymphoma. Let's break this down.
Key Points:
- You have swollen lymph nodes, night sweats, fatigue, weight loss, itching, and abnormal blood test results.
- A biopsy showed reactive cells but was insufficient for a thorough analysis.
- Recent blood tests indicated irregular counts, particularly a drastic increase in RDW, which is uncommon and can suggest underlying issues.
Explanation:
Swollen lymph nodes, night sweats, and weight loss can be concerning signs, and your family history adds a layer of complexity. The fluctuation in your blood counts—especially the increase in RDW alongside a decrease in white blood cells—can indeed suggest various conditions, including inflammatory responses or malignancies. That said, a significant elevation in RDW can occur in cases of severe inflammation or acute stress states—not solely indicative of lymphoma.
The reactive cells found in your biopsy imply that your lymph nodes are reacting to something, which could be an infection, inflammation, or possibly a malignancy. However, without flow cytometry results to analyze the specific types of cells, it's challenging to provide a definitive conclusion about lymphoma being present or absent.
Next Steps:
-
Monitor Symptoms Closely: Keep a detailed log of your symptoms, noting any changes or new developments—this will help you track your health and provide valuable information for your healthcare providers.
-
Follow Up on Biopsy Results: Since your biopsy was inconclusive for a full analysis, consider discussing with your hematologist the possibility of repeating the FNA or proceeding with other diagnostic procedures (e.g., excisional biopsy) to gather more definitive results.
-
Stay Informed: Research and understand your symptoms and blood tests. It can empower you in discussions with your healthcare provider and help address your concerns effectively.
-
Lifestyle Adjustments: Focus on maintaining a nutritious diet and light activity as tolerated to combat fatigue and support your overall health.
-
Seek a Second Opinion: If uncertainty persists, and your concerns feel dismissed, seeking a second opinion from another specialist, such as an oncologist specializing in hematology, may provide clarity and reassurance.
It’s natural to feel anxious, especially with your symptoms and family history. Engaging actively in your care and being informed can empower you and help you feel more in control. Let me know if you have further questions or specific areas you’d like to explore.
Related Questions
Inquiry Regarding FDG-PET Scan Findings
I recently underwent an FDG-PET/CT scan for my brain to investigate some cognitive difficulties I've been experiencing. Although the report is now available on My Chart, my follow-up appointment with the doctor is scheduled for three weeks from now. I have a query regarding the standard deviation scale presented in the report, which lists values from -2 to -4.6. What does the lowest value signify? Is the scale graded on a 1-5, 1-10, or perhaps 1-100 basis? I appreciate your assistance with this! Notable regions noted for decreased metabolic activity include: - Left Inferior frontal gyrus, triangularis: SD "4.6" - Left Heschl gyrus: SD "3.8" - Left Superior temporal gyrus: SD "3.6" - Left Middle temporal gyrus: SD "3.4" - Left Supramarginal gyrus: SD "2.6" - Left Inferior parietal lobule, supramarginal area: SD "2.1" Other areas displaying low metabolism are: - Right Superior frontal gyrus, medial: SD "3.2" - Left Superior frontal gyrus, medial: SD "2.2"
Seeking Clarity on a Pediatric Surgical Experience
One of my earliest recollections involves surgical gauze wrapped around my genitals and being cautioned to exercise caution regarding my circumcision. This incident dates back to around 1972, when I was roughly three years old. My brother, who was eleven at the time, corroborates this memory and recalls that the bandage remained in place for "a few weeks." His recollection is a bit unclear, but he does remember seeing me running around without pants and with a gauze dressing. He believes the dressing wasn't overly bulky and doesn't recall any stent being used. However, I am aware that his memory may not be completely accurate based on other conversations we've had. He recalls being informed that I underwent surgery for an undescended testicle, yet was never made aware of a circumcision being involved. Later, a physician indirectly confirmed that I had undergone an early orchidopexy. This memory piques my curiosity, particularly since my parents have never brought it up with me. I have knowledge of having glanular/coronal hypospadias, and the details of my situation appear to align with images I’ve encountered depicting partial hypospadias corrections. This leads me to wonder if my circumcision might have actually been related to hypospadias surgery. Unfortunately, any tangible proof of these events was lost when I underwent gender confirmation surgery as a trans woman three decades ago. It's conceivable that the standard circumcision procedure typically performed at birth could have been postponed, given that I was born slightly premature and had significant Rh disease and hypoxia. But could it have been deferred until I reached the age of three? I have made attempts to obtain my medical records, but unfortunately, they have been destroyed over the years. While I understand that definitive answers may be elusive, I would greatly appreciate any insights or thoughts on this matter.
Concerns About Potential Peripheral Artery Disease (PAD)
For the past three to four years, I have been dealing with a persistent numbness in my left foot. Initially, I suspected it might be due to a pinched nerve or perhaps something similar, but the sensation has never completely returned. As time has gone by, I've encountered additional worrying symptoms: - My feet have started to develop a purple hue, particularly evident when I sit in positions that put pressure on my legs or when I take a shower. This discoloration has become one of the most alarming signs of my condition. - The growth of my toenails has slowed considerably, and they now appear uneven and ridged. - Additionally, my feet have a temperature that feels significantly colder than the rest of my body, and they no longer grow hair as they once did. I do not smoke and I’m not diabetic; however, I have high cholesterol and received an elevated result on a lipoprotein test. The prospect of PAD is frightening to me, as it seems synonymous with a grim future. I have been referred to a cardiologist, but they are reluctant to conduct an Ankle-Brachial Index (ABI) test since I am under 35. I want to remain hopeful and believe I don't have PAD, yet I struggle to identify any other plausible explanations for these symptoms. What could be potential alternatives to consider, if any exist?
Unexplained Left Chest Pain, Electric-Like Jabs in Lower Back, and Unusual Headaches
Hi there, I’m a 15-year-old experiencing some peculiar health issues lately. A visit to my doctor led to a diagnosis of anxiety and poor posture after I complained about headaches and strange, electric sensations rising through my head. However, after that appointment, I became aware of pain in my heart and strange discomfort in my left chest accompanied by difficulty breathing. Initially, I thought these symptoms aligned with anxiety, but they persisted long enough to cause concern. To rule out any serious conditions, I underwent a blood test, which fortunately came back normal. Despite the positive results, I continued to feel unusual pains in my heart region and a peculiar ache in my lower abdomen. The doctor had previously mentioned my poor posture and identified an issue with my occipital nerve, which I’ve somewhat addressed. Now, though, I find myself having intermittent back pain and brief discomfort just beneath my left lung. These pains are indeed strange; they don’t always last long, sometimes just fading after five seconds or they might stick around for several minutes. I tend to spend a lot of time in bed and don’t often leave the house, yet when I do, these pains still occur. Thankfully, they aren’t debilitating, but I can't help but feel anxious thinking something might be significantly wrong with my health. It’s unsettling and I’d prefer not to dwell on such thoughts. To summarize: I experience chest pain in my lower left quadrant, specifically near my lung, alongside a mild but uncomfortable sensation that waxes and wanes. Additionally, I suffer from headaches located on the upper left side of my head. I apologize for any grammatical errors as I used voice-to-text for this message. Another detail that might be relevant is that I have recently quit vaping, now almost 22 days ago, and I wonder if this could be part of the recovery process.
Expectorated Large Tissue with Blood
At 28 years old, I experienced a fever the previous night, after which I had no other cold symptoms. To my surprise, today I coughed just once and expelled a significant piece of tissue mixed with blood. Following this alarming incident, I sought medical attention at an urgent care facility because I developed a headache immediately afterward and felt a peculiar "butterfly" sensation in my chest. The healthcare professionals did not conduct any laboratory tests or imaging studies, instead opting to prescribe antibiotics for what they suspected might be an infection. Is this an appropriate response to my situation? This is quite concerning.