Metastatic malignancies to the mediastinum from other sites Sarcoidosis (see: pulmonary manifestations of sarcoidosis) The spectrum of conditions that can result in mediastinal lymphadenopathy is extremely diverse and includes: Some radiologists make a point of differentiating between reactive nodal enlargement and pathological nodal enlargement, reserving lymphadenopathy for the latter aetiologies only. In tuberculosis, however, the mycobacterium is actually infiltrating and infecting the lymph node. bacterial pneumonia is associated with reactive enlargement of the mediastinal nodes, but the organism is not generally infecting the node itself. The diagnostic waters are muddied further as some pathologies produce nodal enlargement via reactive change, and not because the pathology is actually infiltrating the node itself, e.g. Many enlarged mediastinal nodes will be pathological, however not all, and conversely, some mediastinal lymphadenopathy will be found in non-enlarged nodes. In the long run, you are the best judge of how you feel.Although mediastinal lymphadenopathy is used interchangeably - by some - with "mediastinal lymph node enlargement", they are not synonymous entities, and it is important to be cognizant of this. Just continue to monitor yourself and use your own best judgment as to what to do next. The main thing to realize is that some of these symptoms look like other normal illnesses and some do not. The doctors do not want to misdiagnose and do harm and the patients do not want to find out that they are sick and can not be cured. It is a frustrating diagnostic process for the patient and the doctors. The watch and wait philosophy is taken until something effects the patient's level of functioning, such as anemia, or increasing bouts of illness that can not be successfully treated with antibiotcs. Once the diagnosis is made sometimes no treatment is recommended for quite sometime. There are certain types of lymphoma and other cancers that have symptoms that come and go for quite a while. I'm inclined to trust the surgeon's advice over the GP's, but I do want to make sure that I'm not overlooking something serious.Īny thoughts or advice? Thanks in advance. I do have an appointment with a new GP tomorrow to have the nodes rechecked before I call the surgeon back to ask his opinion. Since that appointment, however, I've been able to feel one small hard node on each side in the supraclavicular area, and I assume they represent "shotty" nodes. Much to my surprise when I got there, the surgeon said he couldn't feel any nodes, and therefore wouldn't biopsy anything. However, my GP did recently send me to a surgeon to get the nodes biopsied. However, I think it's more likely that I'm fighting off viruses on a regular basis (I have small children) than it is that I have lymphoma. I do have systemic symptoms of low-grade fever (on and off for a year), weight loss (50 lbs in 15 months, but I was trying to lose weight, and it's leveled off in the past 9 months), fatigue, and occasional mild night sweats. I've had 2 rounds of normal blood work and 1 normal chest/abdominal/pelvic CT. The reason I ask is because my GP has been able to feel my supraclavicular nodes for the last six months. I am very thin, though, which may be why mine are palpable. But then I've read that palpable supraclavicular nodes are usually of concern b/c they can't be felt at all on most people. I've read that nodes that feel like buckshot, hence the term "shotty", are usually reacting to a virus. Hi, I'm new with a specific question about "shotty" supraclavicular nodes.
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