Can a biopsy be wrong? - Lymphomas Message Board

twflash · 09-23-2009, 09:47 AM

My husband has had all the B symptoms of lymphoma for several months. CBC is clear, chest xray clear, CT showed some enlarged lymph nodes in groin. An enlarged lymph node on left groin was removed two weeks ago and came back benign (slight Tcell elevation but nothing unusual). Lymph nodes throughout the body routinely swell and cause aching. But the nodes in the groin were consistently enlarged, painless and firm.

We have so far ruled out: testicular cancer, TB, Lymes disease.

Going for blood work to rule out EBV, CMV, Thyroid issues and lupus.

Three rounds of antibiotics had no effect on nodes. They had been swollen for going on 6 months.

CT scan did show "slight" thickening of stomach. Could be nothing. Or could be??? He's sick of being tested and being referred to dr's (currently seeing a hematologist). The fatigue is getting worse and he's continuing to gradually lose weight. Nightsweats eased up a week after node removal.

I know blood work can be wrong. Can a biopsy be wrong? Where do we go from here for a second opinion? The hematologist is not confident that we will get answers to our questions with new round of blood work. That's just not good enough for us.

lymphpre · 09-23-2009, 12:41 PM

I don't have any answers for you, but how big are the lymph nodes in the groin? Nodes which swell and ache are usually a sign of infection of some sort.

twflash · 09-24-2009, 09:29 AM

The lymph node in the groin was enlarged enough to cause concern from 4 different physicians. There was no pain in the groin lymph nodes and they did not respond to 3 rounds of very strong antibiotics.

The lymph nodes in the neck and under the arm however do swell up temporarily and cause aching. But this has been more pronounced since having the one lymph node removed.

The lymph node that was removed had grown over a 6 month period with no other signs of illness - he hadn't even had a cold. The only other symptom was testicular pain on the same side and severe pain and swelling there, with lower back pain and blood in the urine. They've ruled out testicular cancer, prostatitis, epididymitis and obstructed kidney stones. Two lymph nodes started swelling on the opposite side of the groin but have remained consistent in size and somewhat smaller but are still painless.

The surgical oncologist was convinced there was an enlarged lymph node in the back of the abdomen putting pressure on the testical and renal artery (causing the blood in the urine) but the CT scan was negative for that.

I know alot of the symptoms can be blamed on epstein barr or chronic fatigue since his lab work doesn't look suspicious. But it doesn't explain the blood in the urine or the testicular pain and swelling. So is it consistent with one illness or separate issues? We just don't know where to go from here.

lymphpre · 09-26-2009, 03:16 AM

If the biopsy from the most suspiscious lymph node did not show lymphoma, that is probably as good an indication as you will get that it is not lymphoma. However, they clearly have not got to the bottom of what is happening. Don't accept a non-diagnosis like chronic fatigue, as that is just medical speak for don't know. Those blood tests might just show something informative. The other thing that might be worth looking at are some of the other hormone levels like FSH and testosterone. There are a lot of things that can cause systemic symptoms that overlap with the B symptoms of lymphoma.

twflash · 09-26-2009, 10:39 AM

Just had a panel done to rule out hormonal issues. Full thyroid, testosterone, adrenal, etc. Get results from hematologist on Tuesday. We have had a couple of medical professionals tell us that because he had been on heavy antibiotics before and during the biopsy that it could result in skewed results.

I would love to move beyond this possible diagnosis but I'm just not convinced it should completely be ruled out. His surgical oncologist wanted to rule out stomach lymphoma because of results of CT scan but the hematologist wants to "wait and see". We can't do the wait and see. He's too young and otherwise healthy. So next stop will probably be GI. He has had history of stomach lining ulcers so it's reasonable to check in my opinion.