Hey everyone. I hope you're enjoying the holidays even through the hardships of life. This will be a long post but please bear with me.
I am very worried for my boyfriend. He is 24 years old, has a history of heavy smoking since he was 17 and also drinking. He stopped both cold turkey for a whole year now. He has been feeling a lump on his neck just below his jaw and above his adam's apple. After a year or so of it being there I finally convinced him to go get it checked out (very stubborn). He has also had yellow/clear and at some point bloody phlegm for over a year now. From his throat and it's always most prevalent in the mornings. Also mucus from his nose. The bloody phlegm he hasn't had in a few months now. No cough, no ear pain, sometimes headaches but not often at all. He has dust allergies as well and cystic acne for years which we still don't know why. We gotta see a dermatologist as well.
He had an ultrasound of the neck and these are the results:
- The thyroid gland is normal in size, showing homogeneous echotexture without focal lesions.
- Right thyroid lobe measures 4.9(L) x 1.4(AP) x 1.6(T) cm.
- Left thyroid lobe measures 5.1(L) x 1.4(AP) x 1.8(T) cm.
- Thyroid isthmus measures 0.2 cm AP.
- Intrathyroid vascularity is symmetric. The adjacent vascular structures are preserved.
- Visualized sections of the submandibular glands show no significant abnormality on either side. Sections of the parotids show bilateral intraparotid lymph nodes, largest on the right side, measures, 1.3 x 0.6 x 0.7 cm.
- Few fatty hilum lymph nodes are seen scattered through the neck, bilaterally at levels I, II, III and V. All measuring less than 1cm in axis. The largest node is seen on the right side, at level V A, measures 2.9 x 0.5 x 2.4 cm.
- Dedicated views through palpable abnormality of the left neck, at level I A, shows a subcutaneous hypoechoic nodule with eccentric echogenicity and no internal vascularity, in favor of subcutaneous lymph node, measures 0.8 x 0.4 x 0.7cm.
IMPRESSION:
- Normal sonographic appearance of the thyroid.
- Bilateral cervical lymphadenopathy. Reactive lymphadenopathy may be entertained. Clinical correlation is needed. Further correlation may be considered, accordingly.
- Subcentimeter, subcutaneous lymph node of the left neck, corresponding to palpable abnormality.
I am now wondering what would be the next step, see an ENT? Have a biopsy of one of those lymph nodes? We won't be able to go back to the primary doctor for a few weeks due to holidays. I'd like peace of mind or at least some sort of direction and/or what to expect.
What could possibly be happening here? Are these reactive and bilateral cervical lymph nodes a sign or something sinister? Is it cancer? If he had a bacterial or viral infection it should've been cleared already? It's been a year or maybe more! I'm worried sick and our anniversary is tomorrow and I want to be able to enjoy this time and Christmas without some sort of light as to what could be happening here. Any input will be appreciated.
Hi Jesscarlet, I'm afraid all these figures and words are quite difficult to understand for most of us, this is more for medical people as we are people who are either starting their cancer journey or have finished it. I have never been given this sort of information all I was ever told was that I might have cancer and would have to wait for the results to either confirm it or not.
It sounds as if you might be from abroad rather than the UK , once we see a consultant he/she will examine us and say what they think it might be, we then get appointments to have scans,x-rays, blood tests, biopsies etc, on the whole, a biopsy is the first test to be carried out as this normally will tell them if its a cancerous tumour or not, if it comes back all clear we are normally discharged and told to keep an eye on it. If it comes back positive for cancer then we then have scans and maybe more biopsies to make certain, which sounds like what your Dr is going to do in the new year.
Your boyfriend has now taken the right steps in getting checked out and the Dr has started the ball rolling by having the ultra scan done but I'm afraid it's now a bit of a waiting game until further checks are done, I know its a worrying time as we have all gone through the waiting game but these extra couple of weeks will not make any difference to the outcome, all I can say is hang on in there and enjoy Christmas as much as possible and fingers crossed for positive results for the New year. Wishing you both all the very best, take care.
Chris x
Its sometimes not easy but its worth it !
Hi jess
sorry to see you here but I hope we can give you a hand.
You can ignore everything above IMPRESSION
His thyroid is normal
The clinician suspects the lymph nodes on each side are reactive which means they are mopping up infection.
The lymph node on the left is abnormal and needs further investigation.
Im not absolutely positive but I think the next likely step would be a good look round his throat under anaesthesia and a biopsy of the abnormal node.
You can’t diagnose cancer by ultrasound alone. There is only a suggestion if something abnormal. As the other nodes might be suspect a PET/CT and/ or MRI are what might be prescribed too.
I would certainly take this report to an ENT or a Maxillofacial consultant.
Here in the uk your boyfriend would already be in the hands of the referring hospital
Best of luck.
Dani
Base of tongue cancer. T2N0M0 6 weeks Radiotherapy finished January 2019
Usually an MRI is done first as it shows up soft tissue better than a CT. if the doctors suspect cancer but they don’t know where (cancer in lymph nodes is often a spread from somewhere else) a PET/CT is the most useful scan.
if something is found he would get a CT anyway of both where the disease is and the chest. Chest CTs are routine for obvious reasons.
If radiotherapy is decided upon the the radiation from three CTs will pale into insignificance.
Hopefully it’s nothing serious, but if it is the good news is that most lymph node cancers which have spread from the throat are caused by Human Papilloma Virus which responds well to treatment and cure.
I hope all goes well for you.
Dani
Base of tongue cancer. T2N0M0 6 weeks Radiotherapy finished January 2019
