[37F] Experiencing multiple symptoms including swollen lymph nodes and mid-back pressure

Question

Can anyone tell me if I should be worried…

Patient Description

A 37-year-old female has been experiencing a range of symptoms for a few weeks to three months, including swollen cervical and head lymph nodes, mid-back pressure described as a constant 6/10 pain, neck pain, daily headaches with an 8/10 severity rating, vomiting, nausea, cold hands, and dizziness. The patient reports a lack of appetite and that nausea is often severe enough to induce vomiting, which is watery, foamy, and full of bile. The patient has been feeling lightheaded and dizzy, particularly by the afternoon, rating the dizziness severity as 8/10. Ultrasound imaging of the neck revealed multiple lymph nodes with the two largest measuring 1.8 x 0.8 x 1.6 cm and 1.8 x 0.8 x 1.3 cm, both showing thickened cortex. The patient has also been experiencing night sweats but no fever. There is a family history of cancer and autoimmune diseases. The patient has been diagnosed with HPV and Hepatitis C and has been on Lithium, tizanidine, and Lunesta for over 10 years. The patient denies any recent injuries, tobacco, alcohol, or recreational drug use.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Lymphoma: This is a type of cancer that begins in infection-fighting cells of the immune system, called lymphocytes. These cells are in the lymph nodes, spleen, thymus, bone marrow, and other parts of the body. Lymphoma can cause many different symptoms, including swollen lymph nodes, unexplained weight loss, and night sweats.

    • Diagnostic tests for lymphoma typically include a physical exam, blood tests, imaging tests (such as a CT scan or PET scan), and a biopsy of a swollen lymph node.
    • Treatment for lymphoma can include chemotherapy, radiation therapy, immunotherapy, targeted therapy, or a stem cell transplant, depending on the type and stage of the lymphoma.
  • Gastroenteritis: This is an inflammation of the digestive tract, usually caused by a virus, bacteria, or parasites. Gastroenteritis can cause nausea, vomiting, and diarrhea.

    • Treatment for gastroenteritis typically involves rest, hydration, and over-the-counter medications to help with symptoms.
  • Migraine: This is a type of headache characterized by intense pain, often accompanied by nausea and sensitivity to light and sound.

    • Treatment for migraines can include over-the-counter pain relievers, prescription medications, and lifestyle changes to help manage triggers.

Please note that these are potential diagnoses based on the symptoms you've described. You should see a healthcare provider for a formal diagnosis and treatment.

What you can do

  1. Seek immediate medical attention. The combination of your symptoms - particularly the swollen lymph nodes, unexplained weight loss, and night sweats - is concerning and should be evaluated by a healthcare provider as soon as possible.
  2. Keep a symptom diary. Note when each of your symptoms occur, how long they last, and any potential triggers. This can help your healthcare provider make a diagnosis.
  3. Stay hydrated and eat nutritious foods. This can help your body fight off infection and recover from illness.

What you should look out for

Seek immediate medical attention if you experience:

  • Difficulty breathing or shortness of breath
  • Severe pain
  • Confusion or difficulty staying awake
  • Blood in your vomit or stool
  • A high fever (over 100.4°F)

Remember, I'm an AI and this advice is based on the information you've provided. It's always important to consult with a healthcare provider for an accurate diagnosis and treatment.

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10 mo ago

People Also Ask


What are the common symptoms of lymphoma?

Common symptoms of lymphoma include swollen lymph nodes, unexplained weight loss, night sweats, fever, fatigue, and itching. Some people may also experience pain or a feeling of fullness in the abdomen.


How can gastroenteritis be distinguished from other gastrointestinal issues?

Gastroenteritis is typically characterized by sudden onset of nausea, vomiting, diarrhea, and abdominal cramps. It can be distinguished from other gastrointestinal issues by its acute nature and the presence of symptoms like fever and dehydration. A healthcare provider may perform stool tests to identify the specific cause.


What are effective treatments for managing migraines?

Effective treatments for managing migraines include over-the-counter pain relievers like ibuprofen or aspirin, prescription medications such as triptans, and preventive medications like beta-blockers or antidepressants. Lifestyle changes, such as avoiding known triggers, maintaining a regular sleep schedule, and managing stress, can also help.


What are the potential side effects of long-term use of medications like Lithium, tizanidine, and Lunesta?

Long-term use of medications like Lithium, tizanidine, and Lunesta can have side effects. Lithium may cause thyroid and kidney issues, tizanidine can lead to drowsiness and liver problems, and Lunesta may result in dependency, memory issues, and daytime drowsiness. Regular monitoring by a healthcare provider is recommended to manage these risks.


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3 Comments


Margot#4035

10 mo ago

The main issue seems like the lymph nodes with cortical thickening which means the part that produces B cells (antibody cells) is overactive and responding to something. You are also having night sweats, fatigue, and a family history of cancer. All this does NOT mean you have cancer, but this certainly warrants a proper work up by an oncologist just to be safe. Tests include a lymph node biopsy, blood tests to see what kinds of antibodies you have, and whole body imaging. I understand your assessment mentions possible lymphoma, which is scary, but there are some very effective treatments for blood cancers when caught early

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Margot#4035

10 mo ago

Also, in terms of your light headedness toward the end of the day, I think that might be related to your vomiting and lack of appetite. Essentially you might get dehydrated throughout the day. Make sure you keep drinking water. This is another reason why whole body (or at least abdominal/chest) imaging like a CT might be indicated. You might have some sort of bowel blockage or narrowing

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Leo#3962

10 mo ago

Agree with Janine. I would urge you to get urgent medical attention, preferably at a major medical center, even if just for peace of mind. The fastest way to get this care is to go to the emergency room.

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