I just had an MRI of the neck for left neck pain. The results stated no masses see, slightly enlarged nodes are seen in the vascular space in the carotid space. They are less than 1 cm in diameter and may be reactive in nature based on size. No inflammatory change or edema is seen in the subcutaneous fat. Musculature is grossly unremarkable.
Impression: Cariotid space adenopathy.
No infection was indicated on recent labs and I have not been sick.
My question: Should this be further examined? If so, by what type of specialist? What could these results indicate?
Gender: Female
How tall are you (feet and inches)?: 5'7"
What is your weight in pounds?: 154
How old are you?: 44
How long has this been going on?: More than a month
Check all symptoms you are currently experiencing:
Palpitations
Diarrhea
Weight Loss
Describe associated symptoms not listed above: Left neck pain. Pain along outer left breast and below left groin area.
Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): A-fib, diarrhea
Check all conditions present in your immediate family... :
Cancer
Cardiac Disease
Diabetes
Hypertension
Please list any medications you are currently taking (and dosage if known) ::
Dilazetam ER 300/24 one qd
Benicar 40 mg 1 qd
When was your last menstrual cycle?: I no longer have a menstrual cycle
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Rarely
HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: Within 8 hours
What could the results indicate?
What type of doctor should I see?
Should I have additional testing?
_____________________________________________________
Hello!
These results in and of themselves are not 'diagnostic' of anything. As to whether they have anything to do with the symptoms for which the MRI was ordered, probably not. This may well be what we call an 'indidentaloma'.... something we found on a study that doesn't mean much. However, I will admit, this is not my area of expertise. We will try to live up to your 8 hour request though our ENT consultant may not be available in that time. And that is who you would want to follow up with, an Ear Nose and Throat surgeon. But as to whether you NEED to or not, that is another question.
3 comments:
I agree with Doc 1 that this is probably an incidental finding.... reactive lymphadenopathy is very common and can last for weeks after the inciting "infection" - which is usual viral, and it is not unheard of that someone doesn't even feel ill.
Of course, when you pair this incidental finding up with the fact that your left neck has been hurting for a while, kinda makes you wonder. I assume your doctor ordered the MRI more to look at your cervical spine to ensure that there was no nerve issue causing the pain - then lo and behold these enlarged lymph nodes show up.
My suggestion is that you set up a follow up appointment with an ENT - nothing urgent, but in a 3-4 weeks. If in that time frame all of your symptoms resolve, you can cancel the appointment. If in 3-4 weeks you are still hurting, take the ENT your current MRI results and let him/ her make the decision whether a follow up MRI (to see if the nodes are still there, have grown, etc...) is in order. I would think that a conservative follow up would be indicated before any big decisions such as lymph node biopsy or any other invasive procedure is warranted. Perhaps in the mean time your primary doctor can order just a plain chest X ray to ensure there is nothing there that could be causing the swollen lymph nodes.
The good news is that your MRI was otherwise normal.... no big neurologic lesion, and no big soft tissue mass... just a few pesky lymph nodes.
Good luck - hope the neck feels better soon!
Doc 7
Dear Carotid Space Adenopathy,
I am an ENT, specializing in Head and Neck Cancer. I have lost count of how many patients I have seen for exactly this issue.
First, you need to take seriously the advise you have received and follow-up with an ENT in the next month or so. Bringing your MRI with you is very important. ENT's are very experienced at interpreting these films for themselves, and determining the significance of the findings.
Second, don't freak out because the chances of this being something "bad" is very low based on the information you have given us. It also is unlikely that the prominent lymph nodes on the MRI are the source of the pain. Furthermore, a lymph node in the neck where you describe is not considered abnormally large until they are larger than one centimeter. However, since there are some important conditions that can first reveal themselves as prominent lymph node, it is important you see an ENT to evaluate this.
My usual routine in a patient with an MRI as you described, who on examination has nothing that worries me, would be to see me again & repeat an MRI in 6 month to a year, and perform monthly self exams of the neck to feel for any changes (if you feel it every day, you won't notice any changes).
I hope this helps. We would love to hear what you do and what your ENT has to say.
Best wishes,
MD.STAT_123
In addition to the good advice by Docs 7 and 123 it would be good not to ignore the left breast pain. How long ago was your last mammogram? Any palpable swelling in the left axilla (arm pit)?
Also to what do you attribute the weight loss, diarrhea, and the pain around the left groin area? Make sure you don't ignore these areas.
Also it would be good to know what kind of cancer there has been in your family.
Hope it does turn out to be something simple---but it
would be good not to ignore the other signs and symptons. Starting with ENT consult sounds like a very good idea.
Good Luck! I think we all would be interested in how this all turns out!
Space Doc
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