MD NewslineMisdiagnosed with Migraines and Anxiety: Courtnie Liniewski’s Journey with Follicular Lymphoma

⚠️ Patient Narrative

Courtnie Liniewski described being physically active and feeling healthy before developing a constellation of symptoms that initially appeared unrelated, including severe intermittent back pain, unilateral hearing changes, chest discomfort, progressive fatigue, weight loss, night sweats, and neck swelling. Early emergency evaluation focused on stroke exclusion and migraine management, but her symptoms continued to worsen over subsequent weeks.

A later urgent-care evaluation prompted imaging that identified a mediastinal mass, leading to hospital admission and eventual diagnosis of lymphoma. The patient reported rapidly progressive disease that required chemotherapy initiation shortly after diagnostic workup and biopsy.

Clinical Communication Insights

• The patient described difficulty connecting multiple symptoms into a single clinical picture during the early diagnostic period.
• She felt overwhelmed by the amount of information delivered during initial oncology consultations, particularly while recovering from procedures and receiving pain medication.
• The interview highlighted the challenges patients may experience when attempting to absorb prognostic, treatment, and disease-specific information immediately after diagnosis.
• The patient emphasized the potential value of simplified educational tools, checklists, and staged information delivery during initial cancer consultations.

Survivorship and Quality-of-Life Considerations

• The patient reported substantial physical toxicity during six cycles of R-CHOP chemotherapy.
• She described ongoing psychological effects after treatment, including symptoms she later recognized as trauma and PTSD-related distress.
• Formal mental-health support was not pursued until years after treatment, despite significant emotional challenges during survivorship.
• The patient reported ultimately seeking a second opinion, which led to reassessment of aspects of her original diagnosis and renewed efforts to better understand her disease.