Male1: You get a lot of referrals when someone has lumps on the arms and the neck from a pediatrician, why is that?
Male2: Well, those lumps are something called lymph nodes and those are a component of the immune system of the human. Those gets swollen often and in kids in particular during the first five years of life, it is extremely common for lymph nodes to be larger than expected and that is because they are doing their job.
The lymph nodes we are talking about and they are of concern generally are in the neck area or sometimes in the groin area and if you think about it, our mouth and our nose are open to the world and the genital area is another area where we are open to the world, so it certainly makes sense that the immune system has its portifications somewhere around those areas. Those areas actually.
Male1: The doctor refers to you and there are couple of things, you have got a chest x-ray and you have got a blood count and you have antibiotics for ten days, why do they do that?
Male2: Well, generally, what you want since there are two things that you want to make sure of, one is that these lymph nodes, these swollen lymph nodes are not predicting or are not part of the more serious problem i.e. leukemia or lymphoma or malignancies essentially.
Male1: So if he gave an antibiotic and the lymph nodes got dramatically reduced in size that would be a good sign.
Male2: That is generally an extremely good sign that the problem is infectious and that the antibiotics have taken care of the infection and therefore, most likely, there is no need to do anything further other than wait--
Male1: But why would the doctor do a chest x-ray when the lump is in my neck?
Male2: Well, the lump in the neck is visible, but there are lymph nodes in other organs that belong to the lymphatic system that could be affected by for instance a cancer that are hidden in the chest and if you—and so the only way to check for that is with a simple chest x-ray to see whether or not there is a big lump for instance in the central area of the chest, which would suggest a more serious problem that it is just an infected lymph node in the neck.
Male1: And a negative chest x-ray does not exclude the possibility, it reduces the possibitliyt.
Male2: It reduces the possibility, yes because for instance in a number of cancer of the lymph nodes, may just simply be present in the lymph nodes that are felt, but are not deep inside, but that becomes the beginning if you want of what is necessary when somebody has cancer, where we need to know the extent of the cancer and where it is because of what we call staging essentially is the amount of cancer that people have and their risk is generally important in defining the treatment.
Male1: And if you were not sure it was good or bad, what should be done?
Male2: Well, the next step there is to actually do what is called a biopsy which means that we would ask generally a surgeon to take this mass out and give it to the pathologist because then we would be generally be able to have the so-called definitive diagnosis. We would know for sure whether or not it is cancer or not.
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