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  • Lymph Node Size Increase

    Been a year since I finished 3xBEP for Stage 2A Non-Seminoma, did a CT yesterday and the results indicated that one of my lymph nodes went up by 1mm from 5x8mm to 6x8mm from the scan a year ago. The report states there's NO evidence of recurrence by 'CT sizing criteria' (which I presume means it's still less than 1cm). It's however still concerning that it went up in the size, and has worried me a fair bit.

    I did blood work about 2 weeks ago and everything was normal.

    Anyone else have seen this before?
    Last edited by jerrie85; 03-22-19, 06:49 PM.
    2018:
    1/10 - Felt mass in right testicle.
    1/11 - LDH: 287 (max = 246), AFP: 16, HCG: 87
    1/18 - Orcheictomy. Non-sem, 80% EC, 15% Teratoma, 5% Yolk. LVI present. pT2, Tentative stage 1B.
    1/29 - Chest CT, Brain MRI, all clear
    2/19: HCG = 5.6, AFP = 13, LDH = 187 (ref = 340)
    2/20: Abdomen CT, 3 large lymph nodes, 0.8, 1.0 and 1.3. Stage 2A
    2/22: 3x BEP start
    2/22 - 4/26:
    AFP: 13, {11, 9, 5}, {4, 4, 3}, {3, 2, 2}
    HCG: 5.6, {2.7, <0.6, <0.6}, {<0.6, <0.6, <0.6}, {<0.6, <0.6, <0.6}
    LDH: 187, {208, 149, 196}, {215, 197, 222}, {277, 270, 240}
    5/3: CT scan, all clear. Lymph nodes <1cm (largest 0.8cm)
    7/5: Repeat MRI, lymph nodes unchanged. Markers still normal
    9/1: Repeat MRI, unchanged

  • #2
    I don't understand how 1mm could possibly be construed of as "Evidence of Recurrence" !

    Have you asked your Onco. what they think of the report ?

    I am sure if you had another radiologist read it they will notice zero change and maybe a third opinion would even say it went down 1mm. Lets not loose touch with how small a mm is, the resolution of the scans, combined with the fact even normal nodes vacillate slightly in size over time.

    I wouldn't do anything other than keeping up with your surveillance checkups. If it were to be cancer I am sure that size would be going up much more noticeably than a single mm.

    - Matt
    March 4th 2014: [AFP = 2.5; bHCG = 6; LDH = 618]
    March 13th: Left IO 100% Classic Seminoma
    6.3 x 5.1 x 3.8 cm, no invasion of anything
    LDH never fully normalized
    Stage: IS
    Watchful Waiting
    May 1st: promoted to Stage IIB with two PET active tumors in the para-aortic lymph nodes 2.5 & 2.4 cm
    May 12th: started 3xBEP
    Neupogen during Cycle 2 and 3
    July 8th: Last Bleo shot of Cycle 3 -- chemo completed !
    August 4th: Post Chemo CT/PET scan
    September 4th: Port removed
    Jan 9th 2019: 4.5 YEARS ALL CLEAR !

    Comment


    • #3
      I mis-wrote - they stated there was NO evidence of recurrence. Still would like to know if other folks who have had CT scans have seen fluctuations like this.
      Last edited by jerrie85; 03-22-19, 08:26 PM.
      2018:
      1/10 - Felt mass in right testicle.
      1/11 - LDH: 287 (max = 246), AFP: 16, HCG: 87
      1/18 - Orcheictomy. Non-sem, 80% EC, 15% Teratoma, 5% Yolk. LVI present. pT2, Tentative stage 1B.
      1/29 - Chest CT, Brain MRI, all clear
      2/19: HCG = 5.6, AFP = 13, LDH = 187 (ref = 340)
      2/20: Abdomen CT, 3 large lymph nodes, 0.8, 1.0 and 1.3. Stage 2A
      2/22: 3x BEP start
      2/22 - 4/26:
      AFP: 13, {11, 9, 5}, {4, 4, 3}, {3, 2, 2}
      HCG: 5.6, {2.7, <0.6, <0.6}, {<0.6, <0.6, <0.6}, {<0.6, <0.6, <0.6}
      LDH: 187, {208, 149, 196}, {215, 197, 222}, {277, 270, 240}
      5/3: CT scan, all clear. Lymph nodes <1cm (largest 0.8cm)
      7/5: Repeat MRI, lymph nodes unchanged. Markers still normal
      9/1: Repeat MRI, unchanged

      Comment


      • #4
        I agree with Jeski, 1 mm seems well within a margin of error. Like he said 3 radiologists could see that as 1 mm smaller, same, or 1 mm bigger. You never know. Doesn’t seem like something to worry about.
        3/29/17 Diagnosed 100% Embryonal 4/10/17 Left I/O CT scan shows a few suspicious lymph (biggest 1.9 cm) 5/8/17 - 7/3/17 3xBEP 7/20/17 CT Scan Clear, AFP has uptick to 19 8/16/17 AFP Drops in half to 10, ALL CLEAR! 3/20/19 All clears up to here!

        Comment


        • #5
          I'd do a re-scan in a few month & see where it's at, a 1 mm increase is nothing to be concerned about unless it is still bigger a month or two from now.

          Dave
          Jan, 1975: Right I/O, followed by RPLND
          Dec, 2009: Left I/O, followed by 3xBEP

          Comment


          • #6
            Hi Jerrie,

            This to happened to my fiance. 1x lymph node had increased by 1mm. Our oncologist said its so minimal its most likley just the angle of the ct scan this time around. Instead of the next check up being 6 months they changed it to 3 months just to be sure as they want be ontop of these things.

            We went back again in 3 months and it was nothing all was ok and survelliance was pushed back to 6 months. My partner is coming up to his 2 year check up start of june.

            There was also an incident were an unidentified mass showed up in his stomach. They were not to concerned but had to go back again in 3 months and that had also resolved itself and was nothing.

            I know its hard not to stress about these things but we have been through this exact same thing before and turns out it was nothing to worry about.

            I agree with Dave and do another scan in a few months to put your mind at ease.

            Comment


            • #7
              You are 100% fine, got nothing to worry.
              45yo, left I/O 07/30/2018, T1 pure seminoma, surveillance...
              Waiting...

              Comment


              • #8
                As the others said, nothing to worry about. First, CT scan has a resolution of just under a mm anyway, so this may not even be a change in size. Second, your lymph nodes normally will expand and contract within the normal size range as they do their job.
                6/5/15: bHCG 27,AFP 8.66, LDH 361, 5.6cm lymph node - Stage IIC
                6/16/15: Left I/O 85% EC, 10% chorio, 5% yolk sac opinion 2 (mayo) 90% EC, 10% yolk sac
                7/7/15: bHCG 56, AFP 42, LDH 322
                7/13/15: begin 4xEP, end 9/18/15
                10/1/15: bloodwork normal, ct scan shows 2 lymph nodes 1.0cm
                10/26/15: 2nd opinion on CT results - lymph nodes normal. Surveillance!
                4/6/16: 1.7cm X 1.5cm lymph node found with markers normal.
                4/20/16: RPLND @ IU - teratoma only!
                4/15/19: all clears up to this date!

                Comment


                • #9
                  Thank you all, it’s been reassuring to read your responses. My oncologist has said so as much as well, so will rest easy!
                  2018:
                  1/10 - Felt mass in right testicle.
                  1/11 - LDH: 287 (max = 246), AFP: 16, HCG: 87
                  1/18 - Orcheictomy. Non-sem, 80% EC, 15% Teratoma, 5% Yolk. LVI present. pT2, Tentative stage 1B.
                  1/29 - Chest CT, Brain MRI, all clear
                  2/19: HCG = 5.6, AFP = 13, LDH = 187 (ref = 340)
                  2/20: Abdomen CT, 3 large lymph nodes, 0.8, 1.0 and 1.3. Stage 2A
                  2/22: 3x BEP start
                  2/22 - 4/26:
                  AFP: 13, {11, 9, 5}, {4, 4, 3}, {3, 2, 2}
                  HCG: 5.6, {2.7, <0.6, <0.6}, {<0.6, <0.6, <0.6}, {<0.6, <0.6, <0.6}
                  LDH: 187, {208, 149, 196}, {215, 197, 222}, {277, 270, 240}
                  5/3: CT scan, all clear. Lymph nodes <1cm (largest 0.8cm)
                  7/5: Repeat MRI, lymph nodes unchanged. Markers still normal
                  9/1: Repeat MRI, unchanged

                  Comment

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