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Persistent Hot Spot on Gallium Scan
May 29, 2001

Dear Doc, thanks for your help. I wrote you once before regarding this question but now have some more info. I was diagnosed with NHL from a biopsy of a node under my arm, it was completely removed. My baseline gallium scan showed one spot lighting up by my jaw. We assumed it was cancer. After three CHOP treatments we did followp scan and the same thing showed. My doctor then started to think it wasn't the cancer. She ordered an MRI of head and neck and said it showed absolutely nothing out of the ordinary and has concluded the spot is not cancer-thus I'm in remission. I am very uneasy about this since the spot "lit up". She's assuming it's a salivary gland just having some uptake. Can I trust this judgment? Should I be doing further tests? My main concern if that if it is cancer then it would seem the CHOP isn't working? Please help put my mind at ease.

Response from Dr. Dezube

You question is essentially what to do about a hot spot on a gallium scan despite a normal MRI scan. Although I agree with you that having a positive gallium scan is more worrisome than not having one, I do believe that your doctor is doing all the appropriate tests. If you are feeling otherwise well, I would recommend just following the spot-- getting a repeat gallium scan in about 3 months time (that's what I do with my patients in your same situation). If in 3 months, it is same or better, then I wouldn't worry about it. If in 3 months, it's worse, then I would consider having it removed. Although it may not please you to wait 3 months, I do NOT believe that waiting a little while will do you any harm. Sometimes these spots turn into something significant; more often than not, they do not. So I can perhaps put your mind at ease at least a wee-bit, though probably not completely. BD.

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