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Lymph nodes in the setting of night sweats; when is enought testing enough?
May 3, 2003

I have had two separate lymph node biospies, one just a year ago in my neck. These lymph nodes are painless. All my blood work is normal. I see a hematologist/oncologist because I also have night sweats. I had a CT scan done in Jan. 03 and small lymph nodes were found. He repeated the CT scan in April 03, there are 3 there. I have no infection. Now I must have an HIV blood test. He always ask me if I have new symptoms, nothing of significance. I'm wondering how long this will go on, he says it could be something just festering, and eventually will come to light. Or it could be nothing, it seems like alot of testing to do for nothing. I am wondering about getting a second opionion. What do you think?

Response from Dr. Dezube

You raise a problem, which unfortunately is very common. You have symptoms (night sweats) in the setting of some enlarged lymph nodes. It is difficult to ignore this combination (i.e. lymph nodes with symptoms). The usual next step is a CT scan, which you indeed have. At this stage, I would do exactly what your doctor recommended-- specifically to follow your symptoms, do serial (i.e. repeat) CT scans, and blood work to see what if anything develops. Sometimes, diseases do only declare themselves in time. And often, as your doctor suggests, nothing ever shows up. I know this can be frustrating indeed. HIV testing is very very reasonable and needs to be done given that HIV can present with enlarged lymph nodes in the setting of night sweats. Should you get a second opinion? Perhaps. It depends what's happening to your symptoms-- are they getting worse or better? I presume you have a general doctor/internist who is also involved with the picture.

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