Oncology (General Cancer)/Length of Diagnosis Process


In 2011 I was diagnosed with stage 1 papillary thyroid cancer.  I had a complete thyroidectomy and I underwent RAI that same year with a follow up in 2012.  In 2013 my doctor told me I was cured (although they would continue the bloodwork and do sonograms as needed).  Sonos of my lymph nodes done in 2012 & 2013 noted that my lymph nodes (bilateral) were morphologically normal in appearance although one (in 2013) was at the upper levels of normal in terms of size.

Late last year I noticed some swelling in my neck with occasional pain.  In December I came down with Bronchitis and was on antibiotics for 5 days.  Since I was still occasionally having pain, I went back to my doctor.  He ordered a neck and chest CT.  Chest came back fine but the neck came back with increase in size and number of zone 2 lymph nodes.  My thyroid bed is clear.  The report suggested that I have a MRI with contrast.

My questions are as follows:  what does morphologically normal mean?  I realize that I'm going to need more testing but I'd like to know, approximately how long does it generally take to complete whatever testing process there is to determine what is going on?  The process with my thyroid took about 4 months.

Thank you for taking the time to answer my questions.

Lymph nodes can be more dense than normal, can have abnormalities within them, and can be infiltrated by fat, which makes them less dense.  All of these would be morphologic abnormalities. Sometimes a lymph node is enlarged, but no other abnormalities are noted.  If you were my patient, I'd want to move things right along, because I think there's a good chance you have something else going on.  An MRI is fine, but eventually you will have to have a lymph node biopsy.  You might have a lymphoma or chronic lymphocytic leukemia. Disease of the lymph nodes can generally be managed successfully and frequently cured.  A papillary thyroid cancer, stage I, treated as you've been treated, is unlikely to be the cause of the lymph node enlargement, although it is within the realm of possibility.  Hope this helps.  

Oncology (General Cancer)

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Donald Higby, M.D.


I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.


I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

American Society of Clinical Oncology

New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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