Hello ! I’m very worried, over the past 3-4 months my son has been struggling with odd symptoms. Night sweats, very itchy hands and extreme fatigue. Sometimes when he stands up he gets a bit dizzy. He has been having some abdominal pain especially when he leans over, we went to the hospital and they did an abdominal USS to rule out appendicitis and it was normal other than enlarged lymph nodes of “unknown significance” (probably because they were ruling out appendicitis). 
His blood work looks normal, his blood protein is at the very upper limit of normal should be below 78 and it’s 79. 
He has had enlarged lymph nodes on his neck area for 3 months but the hospital said they would follow up in another few months if we are still worried…

We are worried ! We feel he is just not right, can’t settle or shake the feeling something is not right… we went for a private neck scan today and the results have NOT reassured me at all. What does this mean and where do we go from here ? 

Reports states - 

several appear heterogeneous and subtly cystic/ necrotic. There is subjective evidence of clustering/ matting. Some nodes are tender to transducer pressure.

Thyroid & Salivary Glands: Appear normal in size and echotexture. No focal lesions.

CONCLUSION:

High-Risk Bilateral Cervical Lymphadenopathy:

Multiple nodes exceed 10 mm in the short axis, with the largest measuring 18x14 mm.

Pathological Morphology: Transformation from oval to rounded structures (Solbiati Index < 2) with evidence of central necrosis (cystic changes) and nodal clustering.

Systemic Correlation: Findings are highly concerned for a lymphoproliferative disorder (e.g., Lymphoma) or a chronic granulomatous process

(e.g., TB), especially given the reported night sweats and pruritus.

Urgent

RECOMMENDATION:

This patient requires an urgent referral to Pediatric Oncology/Hematology.

A biopsy is likely required for a definitive diagnosis.