Swollen lymph node being almost year now

General
1

I posted similar topic awhile back. My wife has swollen lymph node in neck region. Initially, it was around 1.9 cm most recently it is around 1.5 cm. So it has reduced in size but definitely not return to normal size. We did needle biopsy which was normal. Then she has another one is same region. So doctor suggested we get a full biopsy. My wife has surgery last week and we are waiting for results.

She does not have any other symptoms, her blood work results are pretty normal where only ESR is little out of range around 34. I was just wondering if anybody was in a same boat. I am freaking out and getting really anxious.

She was on Humira but we stopped it till we figure out what is causing this swollen lymph node. So she has not taken Humira from past 7 months.

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That’s very frustrating, waiting for results. I’ll be having a biopsy tomorrow and am hoping the results will be returned quickly.

If there’s been no significant change in size I thought there wasn’t much to be concerned about. Is that correct?

3

Good luck @Stoney for tomorrow!

I think you are correct. If change in size is not significant than you can relax little bit. But you cannot be sure until you get results. I am hoping my wife’s results are normal as well.

4

I’m curious who recommended discontinuing treatment for the PsA with Humira? It doesn’t make sense to me. Normally that would be the LAST thing a Rheumy would do. Perhaps temprarily until anyfoem of lymphoma is ruled out, but not for seven months. PsA folk BTW have 14 times the risk of some forms of lymphoma - not all is the nasty cancer type.

Lymphedema is a fairly common condition with PsA/psoriasis. Most commonly it occurs in the eyelids, upper extremities and neck. Lymphedema occurs as a result of impairment of lymphatic drainage, leading to the accumulation of proteinrich lymphatic fluid within tissues. This protein-rich interstitial fluid leads to inflammation and an accumulation of fibroblasts, adipocytes and keratinocytes that transforms soft tissue into hard fibrotic tissue.

I have a fair amount of personal experience with this condition and have had surgery in all three areas to remove lymph nodes that have become “permanently plugged”

Hope it all sorts out for both of you pretty quickly.

Heres a reading assignment:

T. Yamamoto and K. Nishioka, “Psoriasis Arthropathy
and Lymphedema,” The Journal of Dermatology, Vol. 29,
2002, pp. 812-814.

L. Quarta, A. Corrado, F. d’Onofrio, et al., “Two Cases
of Distalextremityswelling with Pittingoedema in Psoriatic Arthritis: The Different Pathological Mechanisms,”
Rheumatology International, Vol. 30, No. 10, 2010, pp. 1367 - 1370

I. M. Braverman and A. Yen, “Microcirculation in Psoriatic Skin,” Journal of Investigative Dermatology, Vol.
62, 1974, pp. 493-502.

5

Thank you @tntlamb.
I hope so too.
Decision to stop Humira was temporary till lymph node issue is resolved. That’s the reason we did incisional biopsy instead of needle biopsy so that we can start Humira back as quickly as possible.

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Update:
Initial biopsy reports are out and cells are not cancerous. So it is not a lymphoma, which is a good thing.
Report said it is non-necrotizing granuloma and doctor ordered few more blood tests, X-rays and CT scan to get more details.
Not sure what non-necrotizing granuloma means, but according to doctor it is non infectious condition.

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That’s great news! They removed it completely?

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Yes! they removed it completely and then did biopsy on it.

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I’d be sure and ask if the pathologist order special stains for mycobacteria and fungi. If those possibilities are eliminated as a cause, you can be pretty sure that it is PsA related. As strange as it may sound, I’d also suggest going gluten free. (No I’m not one of THOSE kind of nuts) Non-necrotizing granuloma is also an early sign of Crohn’s disease…

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They have ordered few more blood tests, Sputum test,CT scan and X-ray. Is there any specific reason that you are suggesting for that? Do you have any experience or what we should expect.