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Dr. David
Dr. David, Doctor (MD)
Category: Oncology
Satisfied Customers: 45934
Experience:  Experienced Oncology Physician trained in New York City. I'm ready to help.
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I have hadscans in the past 3 months from constant abdominal

Customer Question

Hello I have had*****scans in the past 3 months from constant abdominal pain. Ive had a colonoscopy and endoscopy and they were both fine and found nothing abnormal. The one thing all of my ct scans have in common is enlarged mesentric lymph
nodes. Could this be a very early stage of lymphoma? They have stayed that way for 3 months and if I just had some type of infection they would have gone down by now. Ive had stool tests done and they havent found any bacteria or anything.
Submitted: 1 year ago.
Category: Oncology
Customer: replied 1 year ago.
in my newest scan from a few days ago they found slightly enlarged spleen
Expert:  Dr. David replied 1 year ago.

This is Dr. David

if the lymph nodes in your abdomen are not enlarging in size, then there is no lymphoma cancer in those lymph nodes.

lymphoma would cause lymph nodes to keep getting larger and larger.

where in your abdomen is your abdominal pain? upper abdomen or lower abdomen?

are you having constipation?

have they checked your stool for occult microscopic blood?

have you had testing to check for H Pylori bacteria in your stomach? or H Pylori antigen in your stools?

have you tried stomach acid blockers like nexium or protonix to see if this helps your pain

what medications are you taking?

Customer: replied 1 year ago.
I have been treated for h pylori and my endoscopy biopsy showed that it is gone. Stool occult test was negative too. The pain is almost always lower. If it was a very very early stage of lymphoma though would they grow more each time in only 3 months? Some of my CT scans say they are small non specific but some say predominant. What else could be causing these to always show up?
Customer: replied 1 year ago.
the scan actually have only been from july to now so not exactly 3 months
Expert:  Dr. David replied 1 year ago.

lower abdominal pain can be from ovarian cramps, bowel cramps, constipation, diverticulosis.

you could have inflammation of your bowels from IBS or colitis.

usually bad colitis will cause bleeding.

I doubt these lymph nodes are related to your abdominal pain.

have you had a pelvic transvagional ultrasound?

pelvic endometriosis can cause pain as well.

Customer: replied 1 year ago.
The pain is almost always in the right lower quadrant. Transvaginal ultrasound has been normal too. They also didnt see colitis when they did my colonoscopy. Do you have any idea why these lymph nodes always show up? on my more recent scan it said they were prominent and my spleen is now slightly enlarged.
Expert:  Dr. David replied 1 year ago.

I hope the colonoscopy went into your cecum and distal ileum. sometimes crohns disease can hide in the distal ileum

right lower quadrant can be from pain from diverticulosis or constipation or ovarian cyst.

it is normal for these lymph nodes to be seen in the mesentary of your bowels. they are there to filter lymphatic fluid which circulates

if you have bowel allergies like gluten sensitivity or lactose or milk or casein milk protein allergy or sensitivity, this can cause pain and cramps and diarrhea symptoms and loose stools and cause lymph nodes to be prominent.

Customer: replied 1 year ago.
ok yeah I have had all of the food allergies checked and they're normal. I'm currently waiting on my colonoscopy biopsy results so I will know for sure. Ovarian cysts have also never showed up on ultrasound or ct scan. My liver enzymes also went up significantly and then came back down to normal, do you think that has to do with anything relating to my mildly enlarged spleen? So its normal for these lymph nodes to always be visible on a ct scan and that theres no way this could be very early lymphoma?
Expert:  Dr. David replied 1 year ago.

viral infections like mononucleosis can cause spleens to enlarge and is a common viral infection in your age. it can be checked for by blood work.

a small gall stone or bile duct stone can cause your liver enzymes and bilirubin levels to temporary spike up and come back down after the stone passes.

yes, it can be normal for these lymph nodes to always to visible on scan.

you didnt' say if you had constipation.

you didn't report any medications you are taking.

I am 99.9% sure you don't have lymphoma.

Customer: replied 1 year ago.
ok I was tested negative for mono and had a HIDA scan which was normal. I dont really have constipation. I am taking Paroxetine HCL, Sprintec, Ferrous Sulfate, Vitamin D supplements, Prenatal Vitamins (not pregnant). I have iron deficency anemia from my periods. My hemoglobin is ok but all of my iron stores are very low could this cause the mildly enlarged spleen? I was just concerned cause I heard that can be related to lymphoma.
Customer: replied 1 year ago.
The spleen can be related to it is what i meant
Expert:  Dr. David replied 1 year ago.

why are you taking paroxetine? for depression? or for excessive anxiety symptoms?

are your periods heavy?

how intense is this abdominal pain you are having on a scale from 0-10

do you have it all the time? once in a while?

iron supplements can cause constipation.

most enlarged spleens are not related to lymphoma.

Customer: replied 1 year ago.
anxiety and yes they are. Anywhere from 1-10 depending on the day and a few days before this ct scan I had intense pain where my spleen is. Can the very low iron stores cause a mildly enlarged spleen? Ive also noticed the past few days im very bloated and I have a bowel movement everyday but its hard to pass sometimes and when it does pass its yellow. Is it safe to take magnesium citrate? Between the colonoscopy and antibiotics ive taken for h pylori I'm not sure if cleaning out my gut again is a good idea cause I may not have many good bacteria left.
Expert:  Dr. David replied 1 year ago.

how large is your spleen?

you are constipated if you are needing magnesium citrate.

your abdominal pains are most likely from constipation in your right lower quadrant

your pain behind your spleen is most likely from inflammation of your stomach from gastritis and excessive stomach acid.

you need to take probiotics if you have taken antibiotics in the past.

you don't have lymphoma.

Customer: replied 1 year ago.
They didn't say exactly how large I think they said mildly large. But it never was before and when I had the pain it hurt with deep breathes. Could that be from my very low stored iron? Since I don't have mono or any kind of infection I don't know what else it could be.
Expert:  Dr. David replied 1 year ago.

anxiety can cause it to hurt with deep breaths.

so can asthma.

your spleen size can be normal for you

it is not from lymphoma.

your anxiety symptoms can cause abdominal pain as well.

Customer: replied 1 year ago.
My ferritin also went from 12.6 To 11 in the past few weeks is there something wrong with my spleen that's making it drop?
Expert:  Dr. David replied 1 year ago.

that change of ferritin is not significantly different

you need more time for your iron supplements to build up your iron levels.

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Customer: replied 1 year ago.
Ok so can my low iron cause the enlarged spleen?
Expert:  Dr. David replied 1 year ago.

these two things are unrelated.

and this doesn't mean you have lymphoma.

Customer: replied 1 year ago.
ok also when the lymph nodes were prominent my liver functions were very elevated but then went back to normal in a few weeks, and now my spleen is enlarged. isn't that another sign of lymphoma though? What would be the next/simplest least invasive way to diagnose lymphoma?
Expert:  Dr. David replied 1 year ago.

enlarge spleen by itself is not enough to be a sign of lymphoma.

your anxiety symptoms are severe

you have had 5 CT scans already.

you don't need more scans.

you don't have lymphoma.

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