Questions

justme78 · New User Joined: 02 Jul 2008 Posts: 2

I am a 29 year old male and I am sure there are plenty of posts here like this and I am trying hard not to self-diagnose but I had an FNA on Monday to rule out Lymphoma and the what-if is driving me nuts. I had a Neck/Chest CT that came back clear with the exception of one lymph node in my neck that is swollen to about 3cm. The Radiologist said it looked "reactive but was "inconclusive". They also did a bunch of blood work that came back negative. I have had no symptoms except for the swollen node for the past three weeks. I had a pretty nasty case of STREP Throat about 10 weeks before the lump appeared and my Doctors think it may just be a reaction to that but wanted to test it due to the size and characteristics (whatever that means).

I am not sure if anyone has had a similar experience or insight but I was doing some research and I was wondering whether a CT scan can be used as a diagnostic tool and why would the doctor do an FNA when he didn't seem to concerned after the CT scan. Also, I was reading that there may be a link between infections and lymphoma. I was wondering if it was only certain infections that increase your risk for lymphoma. Any references would be appreciated. Thanks and sorry for the long rant.

Mark

ChemoMan · Posted: Thu Jul 03, 2008 4:02 pm Post subject: Re: Questions

Hi

I had an almost identical experience. It eventually took over 6 months to get a diagnosis. The complicating factor was a bad cold I had about 6 weeks prior to the nodes swelling. The nodes were very big and mushy which was atypical. I had a biopsy on my underarm nodes and that came back inconclusive. It wasn't until more nodes came up in my neck, very firm this time, that another biopsy found DLBCL. The first Biopsy was in August the second at the end of December. (2007)

CT scans are of limited use in diagnosis. The only sure way is by excisional biopsy. Until you have that biopsy you will never really know for sure. To make a definite diagnosis the pathologist needs the whole node. As far as the characteristics he was probably referring to the hardness of the node. A very hard node is a bad sign usually.

Don't panic , it could be nothing. It is usual to watch and wait for a short time with these things as well, so don't be alarmed if the doctor seems to be wasting time. Good luck mate Smile

get back to us if it is serious

Cheers
_________________
Age 51
Diffuse Large B cell Lymphoma
Stage 2a
Finished six cycles of R chop 21 26th May 2008
Officially in remission 9th July 2008

justme78 · New User Joined: 02 Jul 2008 Posts: 2

Thanks for the reply. I got a call from my doctor today (Its Monday here in Asia) with the results of the FNA and I am a little confused (and concerned).

The quote from the biopsy report (paraphrasing from the phone conversation cause I didn't actually see the report) was "Atypical. Insufficient specimen for diagnosis". The call was from my reg Doc and not the Doctor who took the sample, but he said they will probably repeat the FNA. When I asked about an excesional biopsy he said they probably wouldn't do it since the lymphadenopy is localized and I don't have any symptoms. Unfortunately, I have to deploy for a month (I'm in the military) so its probably gonna be a while before I can repeat the FNA so thats not gonna help my stress level any.

When I asked about the "atypical" phrase my Doc said not to worry about because it could mean many things, and that all my blood work and CT scans were normal/negative. Although I am little confused how it can be "atypical" but an "insufficient specimen". Is this the same as inconclusive?

Hopefully, it goes away and I don't have to worry about it. Chemoman, I am curious how long was it until the other nodes starting swelling after you noticed the initial one?

Thanks again for the information.

Mark

ChemoMan · Posted: Mon Jul 07, 2008 11:59 pm Post subject: Re: Questions

[quote="justme78"]Thanks for the reply. I got a call from my doctor today (Its Monday here in Asia) with the results of the FNA and I am a little confused (and concerned).

The quote from the biopsy report (paraphrasing from the phone conversation cause I didn't actually see the report) was "Atypical. Insufficient specimen for diagnosis". The call was from my reg Doc and not the Doctor who took the sample, but he said they will probably repeat the FNA. When I asked about an excesional biopsy he said they probably wouldn't do it since the lymphadenopy is localized and I don't have any symptoms. Unfortunately, I have to deploy for a month (I'm in the military) so its probably gonna be a while before I can repeat the FNA so thats not gonna help my stress level any.

When I asked about the "atypical" phrase my Doc said not to worry about because it could mean many things, and that all my blood work and CT scans were normal/negative. Although I am little confused how it can be "atypical" but an "insufficient specimen". Is this the same as inconclusive?

Hopefully, it goes away and I don't have to worry about it. Chemoman, I am curious how long was it until the other nodes starting swelling after you noticed the initial one?

Thanks again for the information.

Mark[/quote]

Hi Mark,
That's exactly what I got with my FNA. The surgeon waited about another month then took the node out, mainly because it got bigger. His description was a few nodes had matted together but it did not look like lymphoma as it was mushy and infected looking. It came back as reactive. The node in my neck came up between 2 to 3 months after that EB, and I noticed it immediately. This would have been about 5 months after the FNA. The nodes under my arm never settled after the first EB and by this time those that were left were huge and growing fast. One cervical node taken with the second EB, small and hard, this time positive for NHL.

My treating specialist seems to think that I had NHL with the first EB, but he did not discount the fact that it switched between the first and second EB's. I never had any other symptoms apart from swelling of my left arm caused by the tumors in my armpit and that was late in the piece.

If the node is still enlarged, I would push for an EB , but that's only my humble opinion and in my case only Smile

This would be after a decent wait of course . They don't hurt if you have a good surgeon, and you are back on you feet that day.

Cheers and good luck
_________________
Age 51
Diffuse Large B cell Lymphoma
Stage 2a
Finished six cycles of R chop 21 26th May 2008
Officially in remission 9th July 2008

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