Please Note: Due to volume considerations, not all questions can be answered. Questions most likely to be answered will be those of general interest to a broad group of visitors to this forum. Questions pertaining to a specific case; requests for diagnosis, medical advice, or second opinion; or requests for opinions about untested alternative therapies will generally not be answered.
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Intermediate grade NHL
Jul 27, 2003
Dear Dr. Dezube,
I have a history of Intermediate grade NHL. After chemotherapy, there was
complete remission. Once again, after eight years, I have a few enlarged
lymph nodes in my neck. I am in a peculiar situation wherein the opinions of
two independent well known expert pathologists differed on lymph-node
biopsy, one stating it to be Reactive
and the other as Low-grade NHL. PETSCAN was performed and it indicated a lot
of activity on the lymph nodes. I am told that the PETSCAN can only indicate
that the lymph-nodes are diseased but it may not be in a position to tell
whether it is malignant. Am I right? Tuberculosis has already been ruled
out.
I am terribly confused. I dont have any other clinical symptoms as fever,
weight-loss, night-sweat etc.
What do you advise?
-Sinm
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Response from Dr. Dezube
It's always very difficult when expert pathologists do not agree.
Occasionally we send slides to a third pathologist experienced in the field
of lymphoma. However, that has the potential of adding more confusion.
Sometimes we do very specialized studies (called "flow cytometry") which can
only be done if your surgical specimen was processed differently than
routine processing. Soemtimes when all is said and done, you are still left
with two differing opinions. In general, in such situations, the most
prudent course of action would be to sit tight and see what happens. If you
do have lymphoma, in time you will know. If you do NOT feel comfortable
sitting tight without receiving treatment, you may be a candidate for
rituximab therapy. Rituximab is an antibody which homes in on lymphoma
cells. It typically does not have side effects and could potentially mop up
any remaining lymphoma cells. However, many might feel that rituximab is a
bit of an overkill in this setting. So there is just no one single answer
to your question. You don't state if you are HIV positive or negative. It
would be good to have this info. Good Luck. BD
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