DrJoshua.com - Ask Doctor Joshua

Free Medical Questions and Answers plus Health Forum >> Ask Doctor Joshua

Ask a Doctor Online
Medical Questions, Health Questions and Health Advice

Search the Doctor's Answers - type the medical question or symptom here:
Custom Search


Enlarged abdominal lymph nodes

Monday, August 9th, 2010

Ok- so I am 24 and was having some abdominal pain and constipation that I thought may be related to my anxiety/panic disorder. I went to a gastro and had a CT of the abdomen and a colonoscopy and endo…(where they put a camera down your throat).

Everything was normal except for some lymph nodes that were enlarged that showed up on a ct. The lymphs that were enlarged were 1cm or less in the abdomen.

I have no symptoms of lymphoma but I did have a fever for about 24 hours a month ago (on Easter!!) and sometimes I get a little hot at night and sweat but it does not last the entire night and does not dampen my sheets. I don’t know if that is just me being hot (which I normally always am or a “night sweat”)

I just don’t know what to think- I’ve had all of these tests and no one has told me anything. The doctor said he doesn’t think it is lymphoma but can not tell for sure. The lymphs are too small to biopsy.
I also just had a chest ct but haven’t heard back yet from the hematologist.
I am so scared it is cancer. I just feel all alone in this- no one seems to be willing to give me any hope or information…

Posted by: Maria/MD HealthForum.com Team

Cells are constantly formed in the body. Normally, these cells mature and eventually die. In some cases, however, they may repeatedly divide, creating clonal cells. Occasionally, some old cells so not die as they should when the new ones are created. As a result, an abnormal clump of cells known as tumors are formed.

Tumors can either be benign or malignant. Benign tumors are noncancerous cluster of cells.They do not invade nearby tissues, and do not spread to other sites. Malignant tumors, on the other hand, are cancerous, fast-growing, can invade surrounding tissue and may spread to other organs.

Lymphomas are considered as malignant tumors that begin in the lymphatic tissues. The lymphatic tissues help in protecting the immune system from bacteria and other foreign body. The cause of most lymphomas is unknown. They are thought to result from mutations in certain genes in the immune cells known as lymphocytes. These mutations then change the behavior of the cells. DNA damage is also thought to play a role in lymphoma, this leads to abnormal production of proteins which then prevents the cells from dying as they should, or leads to rapid cell division, producing more cells of the same kind.

In lymphoma, cells tend to form tumors within lymph nodes or in other areas of the lymphatic system such as the spleen and bone marrow. Lymphomas that can also occur outside the lymphatic system, these are called extranodal lymphomas. About 25-50% of lymphomas are extranodal.

The abdominal cavity has a membrane that connects the intestine to the abdominal wall, this is called the mesentery. This connective tissue contains lymph nodes. Malignancy that originates from lymph nodes in this area is called mesentic lymphoma. I’ve read that there is a sign on the CT scan image which is highly suggestive of mesentic lymphoma. This is called the sandwich sign in which CT appearance of mesenteric fat and vessels are “sandwiched” between two layers of swollen mesenteric nodes. I can only guess that there was no such appearance in your CT scan, that’s why your doctor does not think that the enlarged nodes are can be considered as lymphoma.

Swollen lymph nodes in the abdomen do not always indicate malignancy. There are many less serious conditions that may cause the abdominal lymph nodes to swell. One of these is mesenteric lymphadenitis, in which the lymph nodes in the mesentery, become inflamed. Mesenteric lymphadenitis occurs mainly in young patients but adults may also have this condition. Its most common cause is a viral infection, such as the stomach flu. Common symptoms of mesenteric lymphadenitis include abdominal pain, fever, malaise, nausea and vomiting. Patients who do not have symptoms rarely need further evaluation. Mild cases of mesenteric lymphadenitis and those caused by a virus usually resolve within a few days or weeks. If the swollen lymph nodes is caused by a bacterial infection, the doctor may prescribe antibiotics.

Swollen mesenteric lymph nodes may also indicate an underlying inflammatory process. This may be caused by a localized inflammation such as appedicitis, pancreatitis or diverticulitis. Systemic inflammatory conditions such rheumatoid arthritis or systemic sclerosis are also known to affect the lymph nodes.

I suggest that you keep your appointments with your doctors and ask them whether they think you would need further tests. Do not hesitate to discuss with them how you feel about the CT scan findings.

This blog entry is for your general information only. I recommend that you discuss your concerns with your own doctor.

Freedman, J. 2005. Lymphoma: Current And Emerging Trends in Detection And Treatment. (Cancer and Modern Science). Rosen Central
Gay, S., Woodcock, R. 1999. Radiology Recall. Lippincott Williams & Wilkins; 1 edition


Tags: , ,

Discuss this topic on the Health Forum

   More answers in Internal Medicine

Comments are closed.