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Biopsy follow-up; Report says "reactive hyperplasia". Help me understand this.
Jan 24, 2003

I wrote to you previously about axillary lymph nodes. I am 30 years old and I had 1 palpable lymph node in the right axilla (2cm) and 4 smaller (1-1.5 cm) lymph nodes in the left axilla. After several months of not enlarging or going away, a surgeon suggested a biopsy on the right side (since it felt a little larger) to make sure nothing bad was going on. The right node ended up being 1.5x1.3x1cm and only "reactive hyperplasia" the biopsy report also said that it "appeared to be partially fat replaced." My surgeon assured me nothing further needed to be done and since I had a clear chest x-ray, don't worry about the ones on the left; he was pretty sure they were "benign too." Do you agree that there is no need to do anything further as long as things are not enlarging (as they have not for 10+ months now)? Or would you suggest any other follow-up. I would love to put this behind me now, and would really appreciate your opinion. Thank you

Response from Dr. Dezube

I'm glad you went ahead and got a lymph node biopsy. According to the report, you have REACTIVE HYPERPLASIA. This basically means that your lymph node most likely swelled in response to an infection. The fact that no cancer was found in the lymph node is very reassuring.

You ask a very important question. If your lymph node on the right says reactive hyperplasia, how do you know if the lymph node on the left would be the same? At this point, I would NOT recommend getting the left lymph node biopsied. I make this recommendation based on your statement that "things have not enlarged for more than 10 months". I would recommend biopsying the left lymph node only if was much different than the lymph node on the right (e.g. if it was enlarging more than the other nodes). There is nothing in your e-mail to suggest that the left lymph node is different than that on the right.

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