Ultrasound w/ Fine Needle Aspiration

I had one of those for an enlarged groin lymph node in March and tomorrow I am having 2 lymph nodes that have grown recently biopsied also using ultrasound guide (another in groin and one in armpit). In March the result was negative for melanoma. It was a very weird experience and I am not really looking forward to tomorrow's biopsies. For me, it hurt quite a bit once the needle was stabbing my lymph node. The doctor said some people feel it and some don't… guess I'm one that can feel it.

Hopefully you get good results, but, if you don't, just know there's a lot of support here and good treatment options. 

All the best,

I had one of those for an enlarged groin lymph node in March and tomorrow I am having 2 lymph nodes that have grown recently biopsied also using ultrasound guide (another in groin and one in armpit). In March the result was negative for melanoma. It was a very weird experience and I am not really looking forward to tomorrow's biopsies. For me, it hurt quite a bit once the needle was stabbing my lymph node. The doctor said some people feel it and some don't… guess I'm one that can feel it.

Hopefully you get good results, but, if you don't, just know there's a lot of support here and good treatment options. 

All the best,

I had one of those for an enlarged groin lymph node in March and tomorrow I am having 2 lymph nodes that have grown recently biopsied also using ultrasound guide (another in groin and one in armpit). In March the result was negative for melanoma. It was a very weird experience and I am not really looking forward to tomorrow's biopsies. For me, it hurt quite a bit once the needle was stabbing my lymph node. The doctor said some people feel it and some don't… guess I'm one that can feel it.

Hopefully you get good results, but, if you don't, just know there's a lot of support here and good treatment options. 

All the best,

Hi, 

Went through this in Nov 2015. 

Basically, they can feel a lymph node that might be involved.

 They want to test it for melanoma via FNA as this is simple and if it is positive then a SNB becomes unnecessary and would potentially complicate any surgery to comp!etely remove all the inguinal l ymph nodes  if you opt for that. 

The ultrasound can show the shape and size of nodes. There is a deal of variability in size. Nodes that are positive tend to be firm and painless. The scan shows if the node is vascularized..giving a tumour a blood supply to feed from. 

So , there are indicators from the view of the scan, the operator then takes fluid from the node to test for melanoma. They look at the cells under a microscope and the pathologist will comment on the appearance.. They are looking for spindle cells. The next tests are special stains of the aspirate … If it is positive for melanocytes via the mart 1 stain then this is positive for melanoma as these cells should not be in a lymph node. They may also test for S100 and comment on if the aspirate is bloody or clear.

At the end of the test the pathologist will comment and if it is mellanoma might say something like findings consistent with malignant melanoma.

I am very sorry if I am scaring you but I think you have already put some of the possible pieces of the picture together. I didn't want to believe my test results and had them explain how they were sure the result was positive . This was because I had just had a major surgery and had convinced myself that the timing meant the enlarged lymph nodes were related to that. Sadly this was not the case for me. Lymph nodes can be enlarged for a variety of reasons including infection but when melanoma is in the mix it must be taken seriously as a possible cause. Is your primary on the leg ? 

You will not know for certain until you get the lab results back.. But in order to take best advantage of that meeting  you might want to consider / research your likely options if it was positive.

There are choices.  Surgery to remove all the inguinal nodes.. as if one is palpable then the chances are there may be microscopic spread into the other draining nodes. But before surgery is planned you are likely to be offered a pet scan.. It is a combination of a ct scan superimposed with the scan of the uptake of radio active glucose. You need to fast before this test so that the cells that are using energy and growing are calling for glucose and fuel. This then gives your team more evidence of the likely spread. In my case ,it just showed the 3cm positive node. Because this node was large and high in the groin my 2nd opinion surgeon advised removal of pelviupelviucnodes too although not showing on pet scan. Pathology results showed one positive inguinal and one positive  pelvis although not detectable on pet scan results.Some of the other nodes were enlarged as they had developed a blood supply .

This made me stage 3. As usual I would recommend finding a melanoma specialist centre for treatment even if itmeans travel as they are likely tone more up to date and offer more expertise in the treatment and management of the disease. A centre running clinical trials might offer you newer treatments prior to Fda approval for this stage of disease  such as keytruda etc 

If your biopsy is negative, you will still have these issues to think about if the SNB is positive. I would research treatments for stage 3 melanoma so you are prepared in case you need the information  at a later date. Hope you don't…but until anything is confirmed or ruled out you are not under the time pressure that comes with knowing that something needs doing and the sooner the better . Not saying that the waiting isn't a time of anxiety and stress ..but maybe you canuse it to work out which questions you want to ask at your next appointment.I would also highlyhhighlyh recommend trying to distract yourself with doing things you enjoy in the meantime..a sort of two pronged approach..educate yourself for possible choices to come but try not to stress too much until things are confirmed. Whilst it is distressing to have your stage increased .. If that happens… Accurate staging means you get the most appropriate treatment for your actual stage of disease.

With the best of wishes

Deb

Hi, 

Went through this in Nov 2015. 

Basically, they can feel a lymph node that might be involved.

 They want to test it for melanoma via FNA as this is simple and if it is positive then a SNB becomes unnecessary and would potentially complicate any surgery to comp!etely remove all the inguinal l ymph nodes  if you opt for that. 

The ultrasound can show the shape and size of nodes. There is a deal of variability in size. Nodes that are positive tend to be firm and painless. The scan shows if the node is vascularized..giving a tumour a blood supply to feed from. 

So , there are indicators from the view of the scan, the operator then takes fluid from the node to test for melanoma. They look at the cells under a microscope and the pathologist will comment on the appearance.. They are looking for spindle cells. The next tests are special stains of the aspirate … If it is positive for melanocytes via the mart 1 stain then this is positive for melanoma as these cells should not be in a lymph node. They may also test for S100 and comment on if the aspirate is bloody or clear.

At the end of the test the pathologist will comment and if it is mellanoma might say something like findings consistent with malignant melanoma.

I am very sorry if I am scaring you but I think you have already put some of the possible pieces of the picture together. I didn't want to believe my test results and had them explain how they were sure the result was positive . This was because I had just had a major surgery and had convinced myself that the timing meant the enlarged lymph nodes were related to that. Sadly this was not the case for me. Lymph nodes can be enlarged for a variety of reasons including infection but when melanoma is in the mix it must be taken seriously as a possible cause. Is your primary on the leg ? 

You will not know for certain until you get the lab results back.. But in order to take best advantage of that meeting  you might want to consider / research your likely options if it was positive.

There are choices.  Surgery to remove all the inguinal nodes.. as if one is palpable then the chances are there may be microscopic spread into the other draining nodes. But before surgery is planned you are likely to be offered a pet scan.. It is a combination of a ct scan superimposed with the scan of the uptake of radio active glucose. You need to fast before this test so that the cells that are using energy and growing are calling for glucose and fuel. This then gives your team more evidence of the likely spread. In my case ,it just showed the 3cm positive node. Because this node was large and high in the groin my 2nd opinion surgeon advised removal of pelviupelviucnodes too although not showing on pet scan. Pathology results showed one positive inguinal and one positive  pelvis although not detectable on pet scan results.Some of the other nodes were enlarged as they had developed a blood supply .

This made me stage 3. As usual I would recommend finding a melanoma specialist centre for treatment even if itmeans travel as they are likely tone more up to date and offer more expertise in the treatment and management of the disease. A centre running clinical trials might offer you newer treatments prior to Fda approval for this stage of disease  such as keytruda etc 

If your biopsy is negative, you will still have these issues to think about if the SNB is positive. I would research treatments for stage 3 melanoma so you are prepared in case you need the information  at a later date. Hope you don't…but until anything is confirmed or ruled out you are not under the time pressure that comes with knowing that something needs doing and the sooner the better . Not saying that the waiting isn't a time of anxiety and stress ..but maybe you canuse it to work out which questions you want to ask at your next appointment.I would also highlyhhighlyh recommend trying to distract yourself with doing things you enjoy in the meantime..a sort of two pronged approach..educate yourself for possible choices to come but try not to stress too much until things are confirmed. Whilst it is distressing to have your stage increased .. If that happens… Accurate staging means you get the most appropriate treatment for your actual stage of disease.

With the best of wishes

Deb

Hi, 

Went through this in Nov 2015. 

Basically, they can feel a lymph node that might be involved.

 They want to test it for melanoma via FNA as this is simple and if it is positive then a SNB becomes unnecessary and would potentially complicate any surgery to comp!etely remove all the inguinal l ymph nodes  if you opt for that. 

The ultrasound can show the shape and size of nodes. There is a deal of variability in size. Nodes that are positive tend to be firm and painless. The scan shows if the node is vascularized..giving a tumour a blood supply to feed from. 

So , there are indicators from the view of the scan, the operator then takes fluid from the node to test for melanoma. They look at the cells under a microscope and the pathologist will comment on the appearance.. They are looking for spindle cells. The next tests are special stains of the aspirate … If it is positive for melanocytes via the mart 1 stain then this is positive for melanoma as these cells should not be in a lymph node. They may also test for S100 and comment on if the aspirate is bloody or clear.

At the end of the test the pathologist will comment and if it is mellanoma might say something like findings consistent with malignant melanoma.

I am very sorry if I am scaring you but I think you have already put some of the possible pieces of the picture together. I didn't want to believe my test results and had them explain how they were sure the result was positive . This was because I had just had a major surgery and had convinced myself that the timing meant the enlarged lymph nodes were related to that. Sadly this was not the case for me. Lymph nodes can be enlarged for a variety of reasons including infection but when melanoma is in the mix it must be taken seriously as a possible cause. Is your primary on the leg ? 

You will not know for certain until you get the lab results back.. But in order to take best advantage of that meeting  you might want to consider / research your likely options if it was positive.

There are choices.  Surgery to remove all the inguinal nodes.. as if one is palpable then the chances are there may be microscopic spread into the other draining nodes. But before surgery is planned you are likely to be offered a pet scan.. It is a combination of a ct scan superimposed with the scan of the uptake of radio active glucose. You need to fast before this test so that the cells that are using energy and growing are calling for glucose and fuel. This then gives your team more evidence of the likely spread. In my case ,it just showed the 3cm positive node. Because this node was large and high in the groin my 2nd opinion surgeon advised removal of pelviupelviucnodes too although not showing on pet scan. Pathology results showed one positive inguinal and one positive  pelvis although not detectable on pet scan results.Some of the other nodes were enlarged as they had developed a blood supply .

This made me stage 3. As usual I would recommend finding a melanoma specialist centre for treatment even if itmeans travel as they are likely tone more up to date and offer more expertise in the treatment and management of the disease. A centre running clinical trials might offer you newer treatments prior to Fda approval for this stage of disease  such as keytruda etc 

If your biopsy is negative, you will still have these issues to think about if the SNB is positive. I would research treatments for stage 3 melanoma so you are prepared in case you need the information  at a later date. Hope you don't…but until anything is confirmed or ruled out you are not under the time pressure that comes with knowing that something needs doing and the sooner the better . Not saying that the waiting isn't a time of anxiety and stress ..but maybe you canuse it to work out which questions you want to ask at your next appointment.I would also highlyhhighlyh recommend trying to distract yourself with doing things you enjoy in the meantime..a sort of two pronged approach..educate yourself for possible choices to come but try not to stress too much until things are confirmed. Whilst it is distressing to have your stage increased .. If that happens… Accurate staging means you get the most appropriate treatment for your actual stage of disease.

With the best of wishes

Deb