Mysteries of the Human Body: Weird Groin Lumps Edition
February 6, 2018 10:02 AM   Subscribe

hey everyone so i'm back at it again with the groin questions, thanks and sorry, YANMD. I got a suspect lymph node biopsied and it ended up not being cancer, which is good. But it also wasn't an infection, and may not have been a lymph node at all. The surgeon isn't really sure what it is or what's caused it. Any guesses?

So I got a CT scan, which found some 'solid and cystic appearing lesions,' most between 1 and 2 cm in size, some of which were presumed to be lymph nodes, and a few others (larger in size) identified as cystic/hypodense regions. One of these was biopsied. The mass itself turned out to be liquid and lacking in structure, and collapsed when they tried to remove it, so it's unclear whether it was a lymph node at one time that went necrotic and liquified, or just a... weird mass of goo? (They did culture the goo. Nothing grew.)

This was the most visible and painful of the lumps, and the skin around it had also turned red, so I'm happy it's gone, but I'm a bit concerned that no one seems to know what caused it. The diagnosis they went with was an abscess, but the pathology report found no evidence of infection. They found fibroadipose tissue with necrosis and chronic inflammation, but I don't have any history of trauma or injury in that area, and there was no infection.

The surgeon's answer was 'idk bodies do things' (though phrased more elegantly), and while I can't argue the truth of that, it's a bit odd. Plus I still have a lump that is similar in size to the last and feels similar in constitution located just above the biopsy incision (about 2cm), which didn't get biopsied. The surgeon checked it out today at the post-op visit, and wasn't really sure what it could be. It's definitely not post-surgical swelling, though. It was present before and was on the CT scan.

I have a follow-up in a month, with instructions to come in sooner if the second lump gets painful or red, but the surgeon sincerely doesn't seem to know what the thing was or is. (This isn't his specialty, although tbh I don't know what specialty this would be.) Any ideas?
posted by halation to Health & Fitness (8 answers total)
Most surgeons I have encountered are very job-oriented: something needs to be removed and they remove it. You should go see an internal medicine specialist, who will be more able (and more interested) to help you figure out the actual cause of this problem.
posted by ubiquity at 10:22 AM on February 6, 2018 [5 favorites]

Read about hidradenitis suppurativa and see if it sounds familiar*.

I have it, and the location, description of the structure of the lumps & the fact they're painful sound very familiar. Being filled with lots of weird nebulous goo is definitely true for me.

If it does sound familiar, you probably want to see a dermatologist.

*Caveat that applies to all skin diseases on the internet: the image returns from a google search will be very extreme examples of the disease.
posted by terretu at 10:39 AM on February 6, 2018 [2 favorites]

Came in to suggest hidradenitis suppurativa, too--I've had it in the past and it sounds very familiar to both your and terretu's descriptions. I ended up having to see a specialist to get a big network of it removed and ever since then I've been pretty lucky--I might get one every few years but they're isolated and taking antibiotics makes them go away.
posted by stellaluna at 11:05 AM on February 6, 2018 [1 favorite]

Re: hidradenitis suppurativa -- the peculiar thing is that there aren't any papules/pustules -- no surface skin irritation at all, no suppuration. No opening or head to the nodule. No evidence of tunneling or chambers, either. Just a pair of deep-under-the-skin lumps, both roughly the size of a butter bean. Quite hard when palpated, so it's weird that the biopsied one collapsed like a lava cake, because it didn't feel squishy at all. (I was not conscious for this, but evidently it was kind of a 'surprise! unexpected goo in biopsy area!' sort of a situation.)

I was referred to the surgeon by my internist, and they're in the same practice, so I've messaged my doctor and am hoping he'll eventually have a thought too -- but it's a busy flu season and he's probably slammed, and the weird lump isn't an emergency, it's just... a lump, and weird.
posted by halation at 11:36 AM on February 6, 2018

I would consult with a dermatologist. Take the biopsy info with you if you can.
posted by purple_bird at 1:16 PM on February 6, 2018

Uterine tissue can spread inside your pelvis and swell along with your cycle.
posted by littlewater at 1:52 PM on February 6, 2018 [1 favorite]

A Liposarcoma of the Groin?
posted by Morpeth at 3:04 PM on February 6, 2018

I'd get another opinion from a different kind of doctor or another internist, particularly if you're worried about it. For what it's worth, I have had a bump near my ear and it appears to be nothing at all. It's just there and my doctors don't know why but say it's nothing. I've chalked it up to a big lymph node. I make sure the size hasn't increased and it hasn't. Shrug.
posted by AppleTurnover at 3:08 PM on February 6, 2018 [2 favorites]

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