Thank you to all that responded to my inquiry about parotid swelling. I went for an Ultrasound and the results came back as 2 perauricular hyperecholic nodules likely reflecting lymph nodes. My next step is a biopsy of the lymph nodes. Anyone have any knowledge on this finding they can share with me?
Always so greatful for your help. Thank you!
Hi 313313,
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It may seem unusual, but I have been in several seminars and conferences where expert pathologists strongly prefer having the entire lymph node excised instead of a fine needle biopsy. They explain that the different types of NHLs (Non Hodgkin Lymphomas) will only be detectable if they can examine a full slice of a node. The needle biopsies can miss the affected tissues for types like follicular, mantle cell, marginal zone, etc.
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Len
Here is a 3-year-old posting with replies that may be helpful for you to read.
There are several possibilities for what may be happening as you will read from other's experiences in this post.
Please request a surgical removal of a node for biopsy rather than a needle aspiration. I had two needle biopsies neither of which provided any useful information. A full excision of a lymph node provided what was needed for my SLL diagnosis.
Hi,I had a lump in my R submandibular salivary gland. The US showed a hypoecholic mass which sounds very different to yours. After 2 fine needle biopsies with no results, I had my salivary gland removed. The labs came back with adenoid cystic carcinoma. Not fun. I think it is a very good sign that your nodule is hyperecholic that cancer is not likely.
I was diagnosed with CLL 11 years ago, still in watch and wait.
I have a painless 5x5x2cm pre-auricular node on the ledt side for the last 2 years or so. Fine needle biopsy by my ENT did find CLL cells. I also have a few painless, smaller, swollen subclavian nodes. My ENT is fairly fascinated by it, but my oncologist yawned. Neither has made a compelling argument for removal yet.
It's pretty clear to me that in my case, the swollen pre-auricular node is partly due to chronic infection of the eye and ear on that side. I had shingles 5 years before my CLL diagnosis, and it got into my cornea. So I've had more hand to eye contact than most people get due to pain and itching over the years. I've also had 2 long infections of the ear and sinuses that closed the eustachian tube for 2 months at a time a couple of years ago, eventually resolving after several series of different antibiotics. The node noticeably swelled the following year. I've had antibiotics for shorter sinus infections since then. My ENT always cultures before prescribing antibiotics.
Allergy season is upon us here in New Orleans, and is when I have more trouble with the eye and sinuses. I have an appointment with an infectious disease doctor to discuss infections in general next week.
I theorize that a local infection of the eye or ear draws both normal and CLL cells to the node, and that's why only one side is swollen. Given enough time, the right side may swell also, but I hope to have treatment by them. After all 11 years, my lymphocytes are rising much faster the last few 6 month periods (ALC 50K to 75K) , but not yet doubling.
I wish you the best of luck, and look forward to hearing what you experience.
=seymour=
I don’t know the technicalities of my parotid node, but I wanted to add that I had a needle biopsy first and then based on the results, a larger biopsy so they could get a sample from different areas.
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