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Radiologist vs Oncologist, how to find out whether infection or another metastasis
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Radiologist vs Oncologist, how to find out whether infection or another metastasis

› Forums › General Melanoma Community › Radiologist vs Oncologist, how to find out whether infection or another metastasis

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    • September 17, 2018 at 3:34 am
    MovingOn
    Participant

      I had a second batch of affected lymph nodes removed in late March of this year. Then my July 28th CT scans were interpreted by the radiologist as ‘likely metastasis’ around the same area (they are lymph nodes swollen to 1.7cm but still have the normal kidney bean shape rather than the rounded metastasis shape). My Oncologist thinks they are just infections and prescribed antibiotics for 10 days. Many of the inflamed areas went down but not the ones in the most concerning area. We are going to scan again at October 1st however, the previously inflamed areas have all puffed back up again because I finished the antibiotics 5 weeks ago. 

      I’m at a loss regarding how to find out what these inflamed lymph nodes really are (recurring infection from Opdivo or melanoma recurrence)? 

      Also, I feel like if my Oncologist can’t get things figured out (after 4+ months of this swelling) then I’m going to get a second opinion up in Los Angeles (2.5 hour car ride). 

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        • September 17, 2018 at 9:31 pm
        guynamedbilly
        Participant

          I'd be pressing for a fine needle biopsy if they are able to get to it.  As far as I know a biopsy is the only way to be sure.  I have no idea if they are able to do that with healthy lymph nodes.

          • September 19, 2018 at 3:35 pm
          jennunicorn
          Participant

            Does your oncologist consult with a tumor board? When things like this came up, my oncologist would bring this to the tumor board, a group of other melanoma oncologists, and get opinions from multiple great minds. I always found this wonderfully helpful, it's like having a second opinion without having to seek it. 

            I don't think melanoma affected lymph nodes would go up and down in size, but any lymph nodes that have stayed the same enlarged size I would ask about getting a fine needle aspiration for on top of getting second imaging in a couple weeks.

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