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Wednesday, March 12, 2014
Enlarged lymph nodes in the chest cavity
My sons CT Scan reveals large nodes in the chest area. He has a history of non-hodgkins lymphoma and ALL leukemia in childhood. Twenty five years later he has five weeks of fever, 20 lb. weight loss, pains in joints etc. and night sweats. A biopsy of the large nodes in the chest will be ordered. Bone marrow is clear. How to biopsy is the question. What else can it be, does it need to be lymphoma return.
Thank you for your question. The combination of fever, weight loss and new lymph nodes of the chest raises the possibility of several potential diagnoses which can only be determined by a biopsy. Given your son's history, lymphoma must be a consideration, however, there are many both benign and malignant processes that can present this way. There are several approaches for biopsy depending on the location of the lymph nodes. The nodes can often be accessed through one of three approaches:
1) by bronchoscopy which is a camera that is passed into the airways
2) a CT guided needle biopsy
3) a mediastinoscopy which is performed by a surgeon.
You should discuss the best approach as well as the possible diagnoses with your practitioner.
Patrick Nana-Sinkam, MD
Associate Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University