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Changes in my spleen after transplant for lymphoma
Apr 20, 2002

Dr. Dezube,

I am one year out from high dose chemo/stem cell rescue for HIV non-Hodgkin's lymphoma (NHL). The last two CT scans over two months have shown spleen tissue inhomogeneity. Not a mass, according to radiologist. The size hasn't changed and the inhomogeneous tissue is at the top of the spleen. There is slightly enlarged spleen, but I have had this before. My oncologist is thinking it may not be NHL recurrence, but possibly some other HIV manifestation. I'm now scheduled for a needle biopsy. Any thoughts on what may be causing this inhomogeneity?

Response from Dr. Dezube

That's quite a saga in terms of you lymphoma and your stem call transplant. I agree with your oncologist in that the changes in your spleen may not necessarily represent recurrent lymphoma. A needle biopsy is reasonable, and indeed may be the most direct way at getting an answer. A gallium scan may also be helpful. If you were to be gallium negative, then the likelihood of reccurent lymphoma is quite small. If you were to be gallium positive, then this would indicate that something may be going on and that further testing is necessary. As for what can cause changes in the spleen-- many many things, including lymphoma as you mention, but also infection, inflammation, medications, and a whole variety of medical diseases. If you do find out what is causing these changes in the spleen, please write back and let me know.


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