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Medical Forum / General / General / April 2004Thyroid Nodules and Enlarged Lymph Nodes Question
Could someone please advise if enlarged lymph nodes (in the neck) are common occurence, with thyroid nodules and/or thyroid disease? Thanks much. LP > Could someone please advise if enlarged lymph nodes (in the neck) are common > occurence, with thyroid nodules and/or thyroid disease? > > Thanks much. > LP Well, Anita posts to the thyroid and cancer newsgroup. That's how her thyroid cancer presented (at one point she thought it might be lymphoma). When I search Google with "thyroid" and "lymph nodes" cancer is what comes up. http://tinyurl.com/3drxq <http://www.bccancer.bc.ca/HPI/CancerManagementGuidelines/HeadnNeck/Management/Th yroid.htm> Cervical Lymph Node Metastases in Thyroid Cancer A significant number of patients with thyroid cancer present with metastatic lymph nodes in the neck and no palpable thyroid lesion. These patients have a so-called occult cancer. In many patients, preoperative ultrasound can confirm the presence of the primary lesion. All such patients require a near total thyroidectomy and appropriate node dissection. This is for FWIW because I'm not a doctor. I do have a thyroid condition. I've never had swollen lymph nodes. I don't know if others on the thyroid newsgroup do/have. However, I"ve also seen you posting about Hughes Syndrome (and painful ribs and other issues I see on the Lupus newsgroup) which might lean towards autoimmune diseases. Where are you and why don't you see an endocrinologist? J > Where are you and why don't you see an endocrinologist? How about seeing your family doctor first? Cervical lymphadenopathy ("lymph nodes in the neck") are usually caused by something nonmalignant (e.g., infection, etc.). There's no need to think "Cancer!!!" right off the bat. It probably has nothing to do with your thyroid. See your family doctor, and let him/her take a look. They'll arrange appropriate followup, if it's necessary. > > Where are you and why don't you see an endocrinologist? > > How about seeing your family doctor first? Cervical lymphadenopathy > ("lymph nodes in the neck") are usually caused by something > nonmalignant (e.g., infection, etc.). Sure, and how long does a person wait if it's thought to be viral? (for the OP) > There's no need to think > "Cancer!!!" right off the bat. It probably has nothing to do with your > thyroid. See your family doctor, and let him/her take a look. They'll > arrange appropriate followup, which is ? ENT for a needle biopsy? J > Sure, and how long does a person wait if it's thought to be viral? (for > the OP) Patients with a benign clinical history, an unremarkable physical exam, and no systemic symptoms should be rechecked in 3-4 weeks to see if the lymph nodes are regressed or disappeared. Patients with unexplained lymphadenopathy who have constitutional symptoms, risk factors for malignancy, or lymphadenopathy that persists for longer than 4 weeks should be referred for biopsy. Biopsy should be avoided in patients with a probably viral illness because lymph node pathology in these patients may sometimes simulate lymphoma and lead to a false-positive diagnosis of malignancy. > ENT for a needle biopsy? I'd probably refer to an ENT. General surgeons can also do it. Thanks for the info. Autoimmune tests have come back negative, although several years ago were high and gradually went down over time to normal range. Have had the painful ribs for years and years, know the condition well and cannot take Nsaids, just learn to live with it. Didn't have the enlarged lymph nodes when I saw an endocrinologist and he said see you in a year or two. Don't have any infections, fever, cold, flu and we are now going on months of lymph nodes enlarging and/or more coming out (enlarging). ENT is stumped. > However, I"ve also seen you posting about Hughes Syndrome (and painful ribs and > other issues I see on the Lupus newsgroup) which might lean towards autoimmune > diseases. > > Where are you and why don't you see an endocrinologist? > J > Could someone please advise if enlarged lymph nodes (in the neck) are common > occurence, with thyroid nodules and/or thyroid disease? A thyroid nodule needs to be biopsied. Period. Fine needle aspiration is a simple office procedure and most definitely is the place to start with any kind of thyroid nodule. Thyroid nodules in association with lymph nodes in the neck is a worriesome combination and needs to be addressed promptly. HMc > A thyroid nodule needs to be biopsied. Period. Agreed. However, the OP didn't say they had a thyroid nodule; they said they had cervical lymphadenopathy. It sounds like they recognize that their thyroid gland is somewhere in their neck, and so they wonder... > Thyroid nodules in association with lymph nodes in the neck is a worriesome > combination and needs to be addressed promptly. Agreed. However (again), we don't know if, in fact, the OP has anything whatsoever wrong with his/her thyroid. Without benefit of a physical exam, we really don't know much of anything. Hopefully, the OP is actually seeing a real, "live, in person" doctor. ;-) > > A thyroid nodule needs to be biopsied. Period. > > Agreed. However, the OP didn't say they had a thyroid nodule; see the subject line and he did mention nodules in his first post. J >>> A thyroid nodule needs to be biopsied. Period. >> >> Agreed. However, the OP didn't say they had a thyroid nodule; > > see the subject line and he did mention nodules in his first post Whatever. They're cross-posting, and it's hard to follow the thread with people replying from different newsgroups. Anyway, it's stupid...they just need to get to their freakin' doctor. > >> Agreed. However, the OP didn't say they had a thyroid nodule; > > > > see the subject line and he did mention nodules in his first post TPFKAA: Yes, subject line does mention thyroid nodules. And who is cross posting? This question/thread posted only to sci.med. People have a right to post their "stupid" questions as much as you have a right to post your "stupid" and uncaring comments. > Whatever. They're cross-posting, and it's hard to follow the thread > with people replying from different newsgroups. Anyway, it's > stupid...they just need to get to their freakin' doctor. > TPFKAA: Yes, subject line does mention thyroid nodules. And who is cross > posting? This question/thread posted only to sci.med. People have a right to > post their "stupid" questions as much as you have a right to post your > "stupid" and uncaring comments. Right. So what's your point? > > Could someone please advise if enlarged lymph nodes (in the neck) are > common [quoted text clipped - 8 lines] > > HMc Does this help you ? (you replied to him earlier on this newsgroup) <http://groups.google.com/groups?selm=40639400%240%2483064%2445beb828%40newscene. com&oe=UTF-8&output=gplain> and on the thyroid newsgroup <http://groups.google.com/groups?selm=aDH8c.9%24YT1.7%40fe07.usenetserver.com&oe= UTF-8&output=gplain> So it looks like he had an ultrasound but no mention of biopsy. J > Does this help you ? (you replied to him earlier on this newsgroup) <http://groups.google.com/groups?selm=40639400%240%2483064%2445beb828%40news cene.com&oe=UTF-8&output=gplain> > and on the thyroid newsgroup <http://groups.google.com/groups?selm=aDH8c.9%24YT1.7%40fe07.usenetserver.co m&oe=UTF-8&output=gplain> No, I've never been on the thyroid newsgroup, and these links aren't working for me. > So it looks like he had an ultrasound but no mention of biopsy. Biopsy of a thyroid nodule is absolutely fundamental. Failure to do so probably represents a substantial deviation from the standard of care HMc > "J" <BlackEyes@invalid.inv> wrote in message > [quoted text clipped - 9 lines] > > HMc I re-did the links in tinyurls (below). http://tinyurl.com/3ghxy You replied to him here on March 25 as follows. ""Hypoechoic" when applied to ultrasound usually applies to a structure with poor internal reflection. the most common hypoechoic nodule in the thyroid would be a thyroid cyst. Thyroid cysts are rarely cancerous." http://tinyurl.com/2y67l "RS" replied to him on the thyroid newsgroup - same date (told him to see an endocrinologist). So who's (which type of doctor) to do the biopsy? or do they draw fluid? J > > "J" <BlackEyes@invalid.inv> wrote in message > > [quoted text clipped - 20 lines] > > So who's (which type of doctor) to do the biopsy? or do they draw fluid? Any doctor who is comfortable sticking a 25 gauge needle into a lump. Most typically general surgeons or ENT . The evaluation is designed to aspirate cells, then the slides are evaluated by cytology, like a pap smear. It's a cytology exam, not really a biopsy. HMc > Could someone please advise if enlarged lymph nodes (in the neck) are common > occurence, with thyroid nodules and/or thyroid disease? Enlarged lymph nodes in the neck are fairly common, but if they occur with thyroid nodules they definitely need to be checked out, as does do the thyroid nodules. It could be thyroid cancer. Usually a fine needle aspiration is done. It can be done in the office or under ultrasound guidance in the radiology suite.  SignatureOrac |"A statement of fact cannot be insolent." | |"If you cannot listen to the answers, why do you | inconvenience me with questions?" |
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