Suggest treatment for chest pain,shortness of breath and swollen neck lymph nodes
Patient: Age:47 Height:5 8 weight: 135 Sex: Male - I have been having lung pain with Shortness of breath, swollen lymph node/s above right collar bone, Pale face color, some weight loss (10 pounds in last 2 months), odd headaches and woozee feeling, with ongoing low blood sodium (136 down to 125) for the past 2 years. I have had 3 chest CT s. First 2 showed mild lymph node swelling (no masses or malignancy) with the 3rd showing what the radiologist called residual thymic tissue with it s own blood supply (Not present on first 2 CT s). 3rd CT also showed inflammation of Rugal folds, Dodoneum, with contracted Gallbladder, and partially collapsed stomach. Have smoked 1 pack for 35 years (but am quitting due to the above symptoms and chest pain). My Primary Care says that my CBC is fine, CT s show nothing significant and other deficiencies aren t serious (low Vitamin D, elevated CRP, Elevated RH Factor) so it can t be anything serious and to quit smoking change my eating habits (I don t really eat badly). Symptoms have become substantially worse over the last several months. I know what it sounds like and I am worried due to worsening symptoms. Is there anything that stands out given the tests and other items above? Thank You for your time Doctor: Hello Thanks for posting at HCM. I see here that you underwent multiple CT scans, blood tests. But you have not mentioned anything about the lymph nodes which you have above your collar bone or in the chest. havent you ever been adviced a lymph node biopsy? I recommend a lymph node biopsy or aspiration from the collar bone lymph node under USG guidance. The aspirate can be sent for further tests. In view of your symptoms like shortness of breath, weight loss and swollen lymph nodes, tuberculosis must be ruled out. Please go ahead with a biopsy from the lymph nodes. Wishing you good healthRegards