Friday, May 21, 2010

Is This a Lymphoma?

For the past month an a half I have had an enlarged left supraclavicular lymph node (about the size of a golf ball). The doctor has done blood work that confirmed A: no infection viral or bacterial in my body B: severe anemia C: my wbc is 3.1 D: I have billirubin in my urine along with protien and E: my liver function is awlful. I have for the past 4 days spiked a temp of about 102 every evening. I had a chest xray and ct of my neck done today confirming the large large node....


I have also recently had biopsies done of my whole gi tract during endoscopy with no malingancies in my gi tract.


Anyone have any experience with this?

Is This a Lymphoma?
Keep pressing the docs until you get some answers. Have you had a course of antibiotics? If antibiotics didn't phase it, it could be a problem. There are many things that cause lymph nodes to swell, but you need to know for sure. Any itching? Night sweats? Weight loss?


Here is the best info:


http://www.leukemia-lymphoma.org/hm_lls


Best wishes
Reply:yes most likly i am sorry to tell you that go to your family doctor so that they can send you for a chest x ray that will tell
Reply:Im not to familiar with lymphoma but i know its a cancer. A few weeks ago my lyphnode was about the size of a golf ball also after a week or two it went down. The doctor told me it was just a mild infection. But you should deffinatley go see some other specialists. 2nd opinions dont hurt.





**GOODLUCK**GODBLESS**
Reply:The only way to determine if it is Lymphoma, is to have a biopsy of the node, and a PET scan to see if there are other infected nodes
Reply:You are at the unfortunate place where Drs (and yourself) know something is wrong but haven't found out exactly what the problem is yet. You will need to have a CT scan, probably a PET scan, probably a biopsy and certainly more bloodwork before a definitive diagnosis is made. The time spent doing all this will suck and may seem like an eternity but should be complete in 2-3 weeks.





I will tell you that I have a close friend who recently was having all the symptoms of cancer including fevers, night sweats, cough and enlarged mediastinal lymph nodes on CT scan. Even his oncologist suspected advanced cancer. Finally, after a broncoscopy it was determined that he had sarcoidosis, a systemic autoimmune disease. Yes it was a serious ailment but certainly not the same as having cancer. The message here is to try and not waste time on the "what ifs". Concentrate on asking the right questions, making sure the diagnosis process is going as quickly as possible and keeping your spirits up so you will be ready to deal with whatever the problem might be. good luck
Reply:I have searched out this topic, did a little trimming here an there I hope it will informative to understand the nature of your disease:





About 58,870 new cases of non-Hodgkin lymphoma (NHL) will occur this year in the United States.





Lymphoma is a general term for a group of cancers that begin in the lymphatic system.





Lymphomas, including Hodgkin lymphoma, result from an injury to the DNA of a lymphocyte. Scientists know that the damage to the DNA occurs after birth and, therefore, is acquired rather than inherited. The damaged DNA in one lymphocyte produces a malignant change that leads to the uncontrolled and excessive growth of malignant lymphocytes. The accumulation of these cells results in tumor masses in lymph nodes and other collections of lymphatic tissue in the body.





Lymphomas generally start in lymph nodes or collections of lymphatic tissue in organs like the stomach or intestines. Lymphomas may involve the marrow and the blood in some cases. Lymphocytic leukemias originate and are most prominent in the marrow and spill over into the blood. They occasionally spread and involve the lymph nodes.





Non-Hodgkin lymphoma is the sixth most common cancer in males and the fifth most common cancer in females in the United States. The age-adjusted incidence of non-Hodgkin lymphoma rose by 76 percent from 1975-79 to 2002-03, an annual percentage increase of 2.6 percent.





Age-specific incidence rates are 2.9/100,000 at ages 20-24 for males and 1.9/100,000 for females. By ages 60-64, they are 51.2/100,000 for males and 38.4/100,000 for females.





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Non-Hodgkin Lymphoma Symptoms and Signs


In most cases, patients seek attention because of the appearance of swollen glands in the neck, armpits or groin. These swollen lymph nodes are mostly painless. They are present for several weeks before attention is directed toward them. They are unresponsive to treatment with antibiotics.





Patients may experience loss of appetite and weight loss, along with nausea, vomiting, indigestion and abdominal pain or bloating. Sometimes a feeling of fullness may be present, the result of an enlarged liver, spleen or abdominal lymph nodes. Pressure or pain in the lower back, often extending down one or both legs, is another fairly common symptom. Other symptoms include itching, bone pain, headaches, constant coughing and abnormal pressure and congestion in the face, neck and upper chest.





General symptoms may include feeling tired, having a flu-like syndrome or aching all over. Fatigue may be the result of anemia. Others experience night sweats and some may have recurring high-grade or constant low-grade fevers. Since all these symptoms are common to many illnesses, from minor ailments to serious disorders, the correct diagnostic procedures must be performed in order to confirm or rule out the diagnosis of lymphoma.





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Non-Hodgkin Lymphoma Staging


(determining the extent of disease)


After the diagnosis is confirmed, the extent of the disease is determined. This is called "staging." The blood and the marrow are examined. Blood cell counts assess if anemia or low white cells or platelets are present or if lymphoma cells are in the blood. Examination of the bone marrow can detect the presence of lymphoma cells, as well. Other tests include: imaging studies of the chest and abdomen using CT or MR imaging to detect enlarged lymph nodes, liver, spleen, or kidneys.





Measurements of blood chemicals and other constituents look for chemical evidence of other organ involvement, such as liver or kidney dysfunction, and indicate whether immune globulins made by lymphocytes are deficient or abnormal.





A spinal tap (lumbar puncture) and/or imaging of the brain or spinal column may be required when the type of lymphoma or the patient's symptoms suggest the central nervous system (brain or spinal cord) might be affected. When all of the tests are completed, the physician determines the areas involved using the evidence at hand.





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Factors Influencing Treatment


Six major factors are used to determine whether treatment should be initiated immediately after diagnosis. Some of the sub-types of NHL progress at a more rapid pace. The selection of treatment may differ from one treatment facility to another.





1. Type of Lymphoma


The first factor is the class of lymphoma. More than thirty subtypes of specific lymphomas or closely related lymphocytic leukemias have been categorized. To simplify this classification, many oncologists group the various subtypes into whether, on average, the lymphoma is growing very slowly (low-grade) or progressing very rapidly (aggressive).





2. Stage of the Disease


The second consideration is the distribution of the lymphoma.





Stage I signifies the lymphoma can be detected in one lymph node area or in only one organ outside of lymph nodes.


Stage II indicates the involvement of two or more lymph node regions, which are near to each other, for example all are in the neck and chest, or in the abdomen.


Stage III represents the involvement of several lymph node regions in the neck and chest and abdomen.


Stage IV is used if there is widespread involvement of lymph node areas and organs such as lungs, liver, intestines and bone.





3. Cell Type


The third consideration is whether the lymphoma cells are most closely related to T cells, B cells or NK cells. This distinction is determined by the use of immunophenotyping or by molecular diagnostic techniques. These tests measure special features of the cells, which distinguish them as one or another of these three lymphocyte types. The aggressiveness or drug responsiveness of the lymphoma can be deduced, in part, from these measurements.





4. Extranodal involvement


The fourth consideration is whether organs outside of lymph nodes are involved as the approach to therapy is often affected. If the brain, liver or bones are involved, for example, the approach to treatment should consider these areas outside the lymph node.


5. Age


Advanced age of the patient (over 60) and concurrent medical conditions are also important considerations.





6. Body Reaction


The presence of a body reaction to lymphoma also influences the approach to treatment. Factors such as fever, exaggerated sweating and weight loss over 10 percent of body weight, referred to as B symptoms, are important findings. The designation A (as opposed to B) signifies the absence of these three findings.
Reply:Your case sounds a lot like mine. I too had the enlarged lymph glands, when removed with no malignancies I was sent to a hematologist and he did a bone marrow and was very good. He diagnosed me at that time with AIHA. I also went to the Mayo Clinic and it was confirmed that I have AIHA. My suggestion to you is to see a hematologist. You have the classic symptoms of AIHA.

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