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Visibility of Lymphoma During Biopsy Procedure

Temflake
Posted by

Hello,

I had an excisional biopsy of a level 5 neck node yesterday and after the procedure the consultant appeared to speak to me in such a way that it made me feel as though he fully expected that I will be diagnosed with Lymphoma.  Is it possible that something might have been seen during the procedure which would be suggestive of this?  I know that testing a biopsy sample is the only way to properly diagnose, but are there certain features of lymph node appearance or the like which he may have recognised.  The tone of conversation just seemed to switch very quickly from lymphoma being a possibility to saying that the haematologist would "give me my diagnosis so we can discuss next steps."

I understand that I may be looking too much into this but I have just never experienced a doctor talk to me about the situation in that particular manner before.

Any insight you can offer on this topic is appreciated.

Ellen M-Macmillan
Posted by

Hello Temflake,

Thanks for getting in touch with us.

I see from your activity that you’ve been talking to others on our supportive Non-Hodgkin Lymphoma group. They have given you lots of great advice and support over the weekend. It’s great to see as there really is nothing quite like the support that you can get from others who know what it feels like.

It’s natural to look into things deeper than you would normally do when you’re faced with uncertainty. It’s also not unusual for some doctors to talk about possibilities of what something may be, so that you’re prepared if this were to be a lymphoma.

It may be that your scan was suspicious that it could be a lymphoma, and the doctor thought you knew what they were thinking when he was talking to you. But the only way to know for sure is to do a biopsy. He wouldn’t have been able to tell from looking at the sample, only a pathologist looking at the tissue under a microscope can give you an accurate diagnosis.

The positive thing is that it sounds as if he is being proactive, if this turns out to be a lymphoma you’re getting seen by the right type of doctor to treat you. Rather than going back to see your ENT specialist and having a further wait to be seen.

Best wishes and take care.

I hope you don’t have to wait too long to get an answer.

Please don’t hesitate to get back in touch with us and let us know how you get on.

Ellen-Macmillan Online Digital Nurse Specialist.

 

Temflake
Posted by

Hello Ellen,

Thank you very much for your response.  I have another couple of questions if that is OK.  I have asked other forum members about these too but would also like a medical opinion if possible.

I am still awaiting CT scan and biopsy results which will be discussed at my upcoming haematology appointment.  However, I noticed on my online GPS records that a 7cm lymph node was found on ultrasound, which seems very big (the node is in my neck).  My questions are:

1) How big is big enough to be very worrisome for a lymph node and does the large size of this node have any bearing on the likelihood that lymphoma is the problem (i.e. is it more or less likely to indicate something serious).

2) Because of the location of this very enlarged node, my biopsy was taken from another, much smaller node on the opposite side of my neck.  Does the lymph node from which a sample is taken make a difference to the biopsy results (i.e. could the biopsy be negative for lymphoma in the smaller node but positive if taken from the larger node).  Does this mean that if the biopsy returns negative I will need to undergo a second biopsy of the larger node if still symptomatic?

Any advice and/or information you can offer on this is appreciated.

Thanks,

Tem

Linda J - Macmillan

Hi Tem,

 

Thanks for getting back in touch with us.

In general nodes that are greater than 1 cm are considered to be abnormal. This suggests that the smaller node which was biopsied was considered to be abnormal. Therefore they would test it to see if it contained lymphoma cells. They may wish to look at the larger node again if it is negative or suggest further tests.

 

They can also vary in size and therefore does not always give an indication of what is happening within it. There is little information to suggest a specific diagnosis based on node size. As Ellen suggested the only way to make sure is to carry out the biopsy.

 

I hope this helps. Please get back in touch if you have any other questions.

Best wishes Linda J. (Macmillan Information Nurse)