In situations like yours, where the combination of symptoms such as persistent lymph node swelling, night sweats, neurological symptoms, and lingering concerns about lymphoma or paraneoplastic syndromes arises, thorough evaluation can indeed be essential. It’s understandable to have concerns about conditions such as neurolymphomatosis or paraneoplastic syndromes given the tests you’ve undergone. Although both are rare, lymphoma can occasionally present with neurological symptoms if it affects the nervous system directly (neurolymphomatosis) or through paraneoplastic processes. However, the normal hematological evaluations, imaging, and absence of overt signs of malignancy in your lymph nodes and other tests points against lymphoma at present. The negative neurological work-up, including the EMG and MRI, helps exclude significant nervous system structural pathology, though it doesn’t necessarily rule out all potential neurological origins.
Given the complex symptomatology, it may be valuable to consider further diagnostic avenues or expert consultations, possibly in neurologic or rheumatologic clinics. Regarding the cervical and lumbar MRI findings, while they might contribute to some of your symptoms through nerve impingement, they don’t fully align with the systemic symptoms like night sweats or arm and leg weakness. Your neurologist’s suggestion to consult with an orthopedist could address whether any musculoskeletal or spinal anomalies might explain part of your symptoms, especially concerning the leg and arm.
If possible, seek a comprehensive review from a neurologist specializing in neuroimmunology or neuro-oncology or a rheumatologist to explore the possibility of rare neurological involvement or an autoimmune process contributing to your symptoms. It’s encouraging that your main investigations have ruled out immediate red flags, but given your ongoing symptoms, continuation of follow-ups and perhaps seeing specialists with expertise in rare syndromes could bring further insight and peace of mind. Keep monitoring your symptoms and any new issues that might arise, and ensure you continue communicating clearly with your healthcare providers about your evolving condition.
Hi Doctor, thanks for your reply. Other symptoms have appeared over the last week (every day): loss of appetite, nausea, abdominal pain and slower digestion. Is this related to neuropathy? Thanks again.
Hi, I understand why you’re worried, but based on all the tests you’ve already done, lymphoma, neurolymphomatosis, or paraneoplastic syndrome are extremely unlikely.
Your ultrasounds, CT scan, CBC, LDH, ESR/CRP, beta-2 microglobulin, and hematology reviews are all normal, these would usually show clear abnormalities if lymphoma were present.
Your symptoms fit much better with: -Post-viral neuropathy / small-fiber neuropathy (common after viral fevers, and EMG can be normal early) -Lumbar disc protrusions (L4–L5 and L5–S1) causing leg weakness, burning, foot symptoms -Possible nerve irritation + anxiety after a prolonged illness
What you should do next:
1. MRI of the spine WITH contrast (this is the right test to fully rule out nerve infiltration).
2. Repeat EMG after 6–8 weeks (early EMG can be normal).
3. Neurology follow-up for post-viral neuropathy or radiculopathy.
4. Blood tests: Vitamin B12, Vitamin D, TSH, HbA1c.
Your symptoms are real, but with all normal cancer-related tests, this is almost certainly a benign nerve issue, not lymphoma.
Feel free to reach out again.
Regards, Dr. Nirav Jain MBBS, DNB D.Fam.Med
Hi Doctor, thanks for your reply. Other symptoms have appeared over the last week (every day): loss of appetite, nausea, abdominal pain and slower digestion. Is this related to neuropathy? Thanks again.
Hello dear See as per clinical history the tests are not in support of either paraneoplastic syndrome or lymphoma or cancer However if you are having doubt get following tests done and share with neurologist/orthopedic surgeon Lems or anti-achr Anti-ma2 Pet scan Gaba-b Mri / ct scan Emg Muscle biopsy Please share the result with orthopedic surgeon or neurologist for better clarity Also, In addition please share clinical pic for confirmation Regards
Hi Doctor, thanks for your reply. Other symptoms have appeared over the last week (every day): loss of appetite, nausea, abdominal pain and slower digestion. Is this related to neuropathy? Thanks again.
Hello dear Thanks for the kind response See directly they are not related with the nerve involvement but to see the chances of any advancement, you need to get in person consultation with neurologist. Kindly get complete clarification in person with concerned physician Regards
Hello Massimo By going through your history and evaluation of your health status I must say that nothing to Worry about . It’s not lymphoma nor its paraneoplastic syndrome . Don’t always believe on Google. It’s better to be postive and go for better evaluation. I am suggesting you following treatment as follows- Neurobion forte - once a day after food for 30 days Amoxicillin 625 - once a day after food for 7 days Gabapin nt - once a day after food for 7 days
Nothing to Worry and be positive. You will get fine soon. And consult be further after 7 days
Thank you
Your tests, imaging, clinical course, and physical findings all strongly exclude lymphoma. Your symptoms are far more consistent with a post-viral neuropathy + lumbar disc irritation.
You have been appropriately worked up. Nothing in your history points toward cancer.
You are dealing with a real problem, but not a dangerous one.
Hi Doctor, thanks for your reply. Other symptoms have appeared over the last week (every day): loss of appetite, nausea, abdominal pain and slower digestion. Is this related to neuropathy? Thanks again.
