WOMENS-HEALTH Messages for June, 2000: Re: (Dr M/others) Lymph/problems update

Re: (Dr M/others) Lymph/problems update

From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Sat, 24 Jun 2000 21:11:12 -0500 (CDT)

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At Sat, 24 Jun 2000, anonymous@obgyn.net wrote: >
>Hi Dr Marchbein,
>
>I know you replied to my message re this topic before, can't remember others
>that did though, so addressed this to you and others that replied to me.
>
>I had my CT scan with the yummy contrast drink :-P and IV the night before
>last, to re-evaluate my lower abdominal lymph node enlargement, as it had
>been four/five months since the last time they were viewed. Since I've been
>having fevers and appetite loss as you know, I've been seeing a hem/onc at
>another clinic nearby to evaluate this. So I asked to get the films today to
>show my doctor at my appointment early Monday morning, which they said I
>could do. I had a look at them after the test, they put it up on the screen
>for me, and I compared the two. I didn't get to look long at them as I had to
>get going, but I could see they were still there.
>
>I went back to get the films today, which were late out of the reading room
>of course. I looked at the front sleeve, which listed any abnormal results on
>them. I was extremely suprised to see question of gallstones written on the
>front, then on the next line, said the lymph nodes were there and prominant
>(only noted as slight before).
>
>I don't know what the story is with the gallbladder thing. I wouldn't have
>thought twice about it except for the recent pain I'd had an ultrasound for.
>I looked over the films and they had it circled in several places. What
>perplexes me most is that I just had the ultrasound the week before last,
>and it showed my gall bladder was fine. (I don't know if I posted it here,
>but I'd been having pain and nausea in the area, so my GI had me come right
>in for an exam and usound, and did mention he'd be interested in the CT scan
>results. I had severe pain in the area when he pressed on it, and had no
>appetite whatsoever. But it did pass, and I have only had some mild pain in
>the area off and on since then.)
>
> So....how are these stones diagnosed?

Sonos will pick up most of them.

>Is there any treatment besides surgery
>that can be done for them?

Depending upon the specific problem (size, number, exact location in the gall bladder), there is surgery, sometimes medication and diet and some endoscopic procedures I'm not well versed in.

>How about an inflammation rather than actual
>stones?

Tougher diagnosis. Sono may see thickened gall bladder walls.

>I am very concerned about it, but won't be talking to anyone about it
>till Monday so I'd really appreciate some of those answers there.
>
>The lymph nodes I'm not as concerned about....I sort of expected they'd still
>be there. So they've been there at least five months....does this mean I need
>a biopsy?

Can't be answered without seeing them. the hem/onc wil have to make that determination.

>If so, how on earth is this done through the abdominal wall....a
>long needle maybe?

Depending upon the location, they may be accessibel via sonographically directly needle biopsy. If not, laparoscopic biopsy may be possible.

>There is no chance of any kind of infection anywhere - I
>have had my blood, urine, and especially my stool cultured...my GI had
>suggested at first maybe an intestinal infection caused the LN enlargement,
>but its impossible - when I'd seen him about the pain I'd also had many
>episodes of diarrhea, and a CDC study rep had contacted me for permission for
>my stool to undergo thorough testing for research purposes...they were
>literally testing it for anything possible under the sun...and nothing
>showed. So I know its not that. My only abnormal blood tests were SED rate
>and ANA and that SPAP test, but they were only off a little anyways.
>

Mesenteric adenitis? Inflammation of the lymph nodes of the back abdominal wall which can cause pain.

>I know no one can diagnose anything over a computer, I just want some ideas
>here.....I don't have an infection....I don't have any lower-digestive
>diseases....what could cause these lymph nodes and problems to keep arising
>in someone? I just had two more pop up within the past two weeks - one on my
>face and one possible underarm, but said that could be a cyst too....where do
>I go from here?

Many would recommend biopsy of at leaste one noide to get a representative sample and rule out more serious conditions.

>Thanks!
>
>Kas

--
Harvey S. Marchbein, M.D. FACOG, FACS
Great Neck, New York

**Note:  Opinions expressed here are for educational purposes only
and, as such, do not constitute a physician-patient relationship.
This information is not intended to supplant the need for you to
consult with your physician prior to choosing therapeutic options
and/or interventions.

**Private emails cannot be entertained due to time constraints,
consequently no private emails will receive a response.

**Thank you for your understanding ;-)

Next message: Harvey S. Marchbein, M.D.: "Re: about uterine fibroma"
Previous message: M.H.: "Re: Missed Depo shot and starting the pill"
In reply to: Kelly Shanahan, MD: "Re: Polyp/Colonoscopy"
Next in thread: Robin: "Re: (Dr M/others) Lymph/problems update"

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