Enlarged lymph node abdomen

Testing for Lymphoma With Enlarged Abdominal Lymph Nodes

Q1. A CT scan in early October 2007 showed I had enlarged mesenteric lymph nodes. I have no other symptoms. Another scan two weeks later showed no change. My latest scan (three months from the initial scan) showed no change. An oncologist suggests a biopsy; the surgeon says to wait. What is your opinion?

The only way to know the diagnosis for certain is to obtain a tissue biopsy. As you already know, the mesenteric lymph nodes are located in the abdomen, near the intestine. Enlargement could have one of several causes, including viral or bacterial infections, parasites or lymphoma. If the nodes can be easily accessed surgically and there are no other medical reasons to avoid surgery, it may be reasonable to try to get a tissue sample for examination.

It’s somewhat difficult to make specific recommendations in your case without seeing the CT scans. It may also be useful to perform a CT scan of your chest to see if there are any other areas that might be more easily accessed for biopsy. If the nodes are small and you have no symptoms, continued close observation may also be a reasonable alternative.

Q2. I have swollen lymph nodes on the right side of my neck. What causes this?

Lymph nodes help your body fight infection by producing lymph, a fluid that travels throughout your body and filters impurities such as bacteria and abnormal cells.

There are a number of reasons why a lymph node may become swollen, including infection, inflammation and lymphoma. Infection is the most common. Illnesses that can cause swollen lymph nodes include mononucleosis, ear infections, tonsillitis, skin infection due to an ingrown hair, or even an impacted tooth.

If there is evidence of an infection, it may resolve within a week or two, or a course of antibiotics might be prescribed for you, followed by close evaluation. Depending on the size and location of the lymph nodes, and whether they get larger or resolve, you may need a biopsy to fully determine the cause of the swelling.

Q3. Recently, I discovered by a PET scan that my lymph nodes were inflamed. I was diagnosed with MS in 1982 and in 2004 was prescribed Betaseron (interferon beta 1-b) by my neurologist. My immune system has also been affected since 2004. What type of doctor can help me now? I am very concerned about the inflamed lymph nodes.

The first step is to have a biopsy of one of the lymph nodes. Not all enlarged lymph nodes, even when they are positive on PET scan, represent lymphoma. In addition, there are many different types of lymphoma. Typically, a surgeon will do a biopsy if your lymph nodes can be felt on physical exam. If not, what is called a core needle biopsy can sometimes be done under the guidance of a CT scan, if a node is in an accessible location. If a lymph node can not be sampled in this way, patients sometimes require an open surgical procedure to make a diagnosis. Your neurologist should be able to recommend the proper physician in your area.

Mesenteric Lymphadenitis Causes

Sometimes doctors can’t tell the cause of mesenteric lymphadenitis. But the most common cause is infection.

Inflammatory conditions may also be linked with mesenteric lymphadenitis.

Much less often, inflamed mesenteric lymph nodes result from cancer, including:

  • Lymphoma
  • Breast cancer
  • Lung cancer
  • Pancreatic cancer
  • Gastrointestinal cancer

Infections that cause mesenteric lymphadenitis may be located in one place (local) or throughout the body (systemic). The infections may be caused by:

  • Viruses
  • Bacteria
  • Parasites

Common infections that cause mesenteric lymphadenitis include:

  • Gastroenteritis. This may result from viral infections such as rotavirus or norovirus. It may also result from bacterial infections such as salmonella, staphylococcus, or streptococcus. Gastroenteritis is often misnamed stomach flu.
  • Yersinia enterocolitica. This is the most common cause of mesenteric lymphadenitis in children. This bacterium can cause gastroenteritis and other problems. It may resemble Crohn’s disease or acute appendicitis.

Other infections that cause mesenteric lymphadenitis include:

  • Direct or indirect infections related to HIV. This is the virus that can lead to AIDS.
  • Tuberculosis. This is a bacterial infection that usually attacks the lungs. But it can also attack other parts of the body.
  • Acute terminal ileitis. This is an inflammation of the end of the small intestine. It may be due to a bacterium or Crohn’s disease.

Inflammatory conditions commonly linked to mesenteric lymphadenitis are:

  • Appendicitis, inflammation of the appendix
  • Inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis
  • Connective tissue diseases such as lupus, sclerosis, or rheumatoid arthritis
  • Diverticulitis, inflammation of the lining of the large intestine
  • Pancreatitis, inflammation of the pancreas

What’s to know about esenteric adenitis?

Mild cases of mesenteric adenitis often go away on their own, although some treatments may help relieve the symptoms.

Over-the-counter (OTC) medication to treat pain and fever can help to alleviate some of the discomfort.

For moderate to severe bacterial infections, a doctor may prescribe an antibiotic.

Other suggestions to help recovery include:

  • getting plenty of rest to help the body recover
  • drinking plenty of fluids to help prevent dehydration, especially after vomiting and diarrhea
  • applying heat to the abdominal area to ease some of the pain

Home remedies may also help with mesenteric adenitis. Natural treatment options that may support immune health and help to fight the infection include:

  • Echinacea: A herb that is derived from the echinacea plant and is used to help fight infections. The herb can boost the immune system and remove the toxins that cause infection. This can help speed up the healing process.
  • Wild indigo: This supplement is known for its infection-fighting properties, but it must be used with echinacea, or it may be toxic. Used correctly, it can cleanse the immune system and helps to fight disease.
  • Licorice: Used to treat a variety of infections because it is anti-inflammatory and enhances mucosal protection. It can also help with mesenteric adenitis by loading the intestinal tract with healthy bacteria.

At present, there is little scientific evidence to support the use of these natural remedies, however.

Prevention

Mesenteric adenitis is not always preventable, but the risk of bacterial and viral infections can sometimes be reduced.

Some things that people can do to reduce the risk of mesenteric adenitis include:

  • Regular hand washing with soap and water. This can kill bacteria and viruses to avoid spreading them to other people.
  • Avoiding a person who is sick. Some bacteria and viruses can be spread through close contact with others.
  • Disinfection. Try to keep areas where food is prepared clean, and regularly disinfect places, such as bathrooms, that could be contaminated.

Studies suggest that those who experience mesenteric adenitis during childhood or adolescence have a lower risk of ulcerative colitis in later life.

Signs and Symptoms of Non-Hodgkin Lymphoma

Non-Hodgkin lymphoma (NHL) can cause many different signs and symptoms, depending on the type of lymphoma and where it is in the body. Sometimes it might not cause any symptoms until it grows quite large.

Having one or more symptoms doesn’t mean you definitely have lymphoma. In fact, many of the symptoms listed here are more likely to be caused by other conditions, such as an infection. Still, if you have any of these symptoms, have them checked by a doctor so that the cause can be found and treated, if needed.

Some common signs and symptoms include:

  • Enlarged lymph nodes
  • Chills
  • Weight loss
  • Fatigue (feeling very tired)
  • Swollen abdomen (belly)
  • Feeling full after only a small amount of food
  • Chest pain or pressure
  • Shortness of breath or cough
  • Severe or frequent infections
  • Easy bruising or bleeding

Some people with Non-Hodgkin lymphoma have what are known as B symptoms:

  • Fever (which can come and go over several days or weeks) without an infection
  • Drenching night sweats
  • Weight loss without trying (at least 10% of body weight over 6 months)

Swollen lymph nodes

Non-Hodgkin lymphoma can cause lymph nodes to become enlarged. Enlarged lymph nodes close to the surface of the body (such as on the sides of the neck, in the groin or underarm areas, or above the collar bone), may be seen or felt as lumps under the skin. These are usually not painful.

Although enlarged lymph nodes are a common symptom of lymphoma, they are much more often caused by infections. Lymph nodes that grow in reaction to infection are called reactive nodes or hyperplastic nodes and are often tender to the touch.

Symptoms from lymphoma in the abdomen

Lymphomas that start or grow in the abdomen (belly) can cause swelling or pain in the abdomen. This could be from lymph nodes or organs such as the spleen or liver enlarging, but it can also be caused by the build-up of large amounts of fluid.

An enlarged spleen might press on the stomach, which can cause a loss of appetite and feeling full after only a small meal.

Lymphomas in the stomach or intestines can cause abdominal pain, nausea, or vomiting.

Symptoms from lymphoma in the chest

When lymphoma starts in the thymus or lymph nodes in the chest, it may press on the nearby trachea (windpipe), which can cause coughing, trouble breathing, or a feeling of chest pain or pressure.

The superior vena cava (SVC) is the large vein that carries blood from the head and arms back to the heart. It passes near the thymus and lymph nodes inside the chest. Lymphomas in this area may push on the SVC, which can cause the blood to back up in the veins. This can lead to swelling (and sometimes a bluish-red color) in the head, arms, and upper chest. It can also cause trouble breathing and a change in consciousness if it affects the brain. This is called SVC syndrome. It can be life-threatening and must be treated right away.

Symptoms from lymphoma affecting the brain

Lymphomas of the brain, called primary brain lymphomas, can cause headache, trouble thinking, weakness in parts of the body, personality changes, and sometimes seizures.

Other types of lymphoma can spread to the area around the brain and spinal cord. This can cause problems such as double vision, facial numbness, and trouble speaking.

Symptoms from lymphoma in the skin

Lymphomas of the skin may be seen or felt. They often appear as itchy, red or purple lumps or bumps under the skin. For more details, see Lymphoma of the Skin.

Hello,

For background information, I’m a 30 year old male, and about 3 years ago now I was diagnosed with testicular cancer. I had a tiny lymph node inflation in my abdomen and very slightly raised white blood cell counts after receiving an orchidectomy, and so I was given 3 cycles of BEP chemotherapy to treat it. The swelling went down and my tumour went away after the first cycle, and the treatment overall went well. I am now more or less back to regular life, though I am about 4 stone overweight.

Three weeks ago, I started feeling aching pains behind my shoulders, around the back of where my armpits are. I figured this would go away and left it for about 10 days, before I went to see a doctor. They claimed that it was probably just a pinched nerve, and sent me off. Over the weekend, I started to notice bumps in my body. Particularly, on my right side, I felt a patch that was roughly halfway between my naval and my right nipple that – when I pushed into it, I could feel several hard bumps. The area itself also felt quite tender to the touch.

Concerned that this was indicative of something malicious such as cancerous lymph nodes, I returned to my doctor and told them where I was feeling the lumps – he was taken aback and told me that I didn’t have any lymph nodes there. He felt the area and said it could be a fatty lump or deposit or something. I took the news as reassuring and left.

However, I have still been feeling uncomfortable. My chest and back and still occasionally hurting as if something is pressing into them. I also have a similarly hard feeling lump on my left flank (about the height of my naval, right in the middle of the side of my belly). Moreover, feeling about my body, when I poke into it and feel the flesh under my fat, I feel lots of places where there are circular bumps. I can feel these bumps almost everywhere, including in my belly relatively close to the naval, in my centre torso beneath my pectoral area, and in both of my sides towards the bottom and up the top. Some areas are more defined than others, and the bumps on the left side of where my firm, tender ones were in my upper abdomen are a bit firmer and rounder than the ones on the side of my belly.

There’s enough of them that my assumption was that this was just lymph nodes all over my body, swolen to varying degrees, but further reading makes me think that’s just total nonsense like my GP suggested – am I right in saying that even if my lymph nodes were swolen, I wouldn’t be able to feel them with my fingers over my belly and my abdomen and sides, particularly if I’m overweight?

Is this just how body fat feels?

Thanks for taking the time to read this,

mh1989

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