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They stuck a big ole needle in my neck (and I let 'em)
Mar 26, 2007

Even if you can't get to my question, thanks for all ya'll do.

I'm a 45yo male, HIV+ (and HSV2+) (01/07 cd4 425 vl 9k), in overall good health. Treatment naive. No major complaints, get rather tired, have had some unexplained localized itching on my legs (seems fairly resolved), but nothing to drive me over the edge. I've been pretty damn lucky really.

My question regards lab results from an ultrasound guided fine needle biopsy of a swollen lymph node under my jaw (2.3 x 1.2 x2.7cm). The node has been swollen for well over a year. There is no discomfort and its hard as a rock.

I'm told "3cc of purulent fluid was aspirated".

Pathology reads - Right neck mass. Cytospins show leukocytes, macrophages, necrotic debris and red blood cells. Rare multinucleate cells and very rare degenerated atypical cell are noted. No obvious malignant cells are seen.

Basically, my ENT writes this off as a simple cyst and wanted to know if I wanted to shell out $1800.00 to stop snoring (not today thank you).

I tend to believe him, but considering the nightmares I can give myself by self-diagnoses via the internet, I thought, who better to seek a second from.

Again, thanks.

Response from Dr. Frascino

Hello,

Your clinical description and laboratory results from the "big ole needle" in the neck and subsequent aspiration indicate you had a necrotic cyst (or node). That's equivalent to a big ole zit inside your neck. Why self-diagnose when you have an ENT physician to officially give a subspecialty diagnosis instead? I see no reason to question his diagnosis, based on the results of the fine needle biopsy aspirate. As for the $1,800.00 stop-snoring offer, that seems irrelevant to both your HIV disease and cyst problem. Maybe your current bed partner called him on the side and asked him to evaluate your nocturnal noise making??? Or maybe the ENT just bought a new Ferrari? Or perhaps he's practicing for his next late-night infomercial?

Dr. Bob


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