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Large b cell lymphona - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Cancer
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3356 Questions
Doctor :   Hi
User :   I have been diagnosed with diffuse large b cell lymphona
Doctor :  
Doctor :   Pleeas proceed
Doctor :   OK
Doctor :   Please give me more details about you and your problem
User :   I have a few results
User :   still need to do the pt scan
User :   and likely the bone marrow biopsy
User :   my blood work came back normal
User :   ldh level was normal
Doctor :   Good
User :   i met with the radiology oncologist
User :   she did an exami
User :   didn't find any other inflamed nodes
Doctor :   Perfect and good to hear
User :   I was diagnosed after an submanibular extration/biopsy
Doctor :   Did they remove the lymph node
User :   I'm look for things to hang my hat on
Doctor :   completely
User :   no, they didn't know it was that at the time
User :   they took the gland out, though
User :   it was not extranodial
User :   it blacked the gland and caused it to swell - a lot
User :   i'm trying to determine the likelihood this is XXXXXXXX stage (1 or 2)
User :   is there any indicators
Doctor :   Looks to be stage 1
User :   I know we won't be SURE until the scan
Doctor :   However the histopathology biopsy readings are important
Doctor :   hence the doctor who is following you should be able to say the staging
User :   what is that?
Doctor :   Biopsy reading
User :   the original from the biposy taken from the gland?
Doctor :   yes
User :   they didn't tell me?
User :   why would you guess?
User :   so you are saying they should know the know the stage from the original biopsy?
Doctor :   yes
Doctor :   The stage of the disease is told by the following things
Doctor :   1) Clinically the size of the tumor, and the bilaterality
Doctor :   2) Biopsy finding
Doctor :   3) CT scan if it has spread to other parts
Doctor :   4) Immunohistochemistry
Doctor :   Diffuse large cell lymphoma should be treated by Chemotherapy
Doctor :   Is it given to you?
User :   I asked about the size, the Dr. said it was hard to tell because it (some word I never heard of) when they examined it)
User :   I haven't been given the treatment regiment yet
User :   I should mention, I feel fine, still run, can do everything I did before
User :   no unexplained weight loss
User :   no feever
Doctor :   Ok
Doctor :   what is your age?
User :   48
User :   If I where a 3 or 4, would you expect me to have other symptoms?
Doctor :   No
Doctor :   It cannot be
Doctor :   In majority of the cases the presentation of such kind of lymphoma is after its initial spread
User :   sorry, i don't understand what this means? can you explain?
Doctor :   By the time the person comes to the doctor and the doctor investigates the person , the findings are already spread locally to other parts
Doctor :   This is in majority cases and not all
User :   so you think it has yet to spread based on what I've told you?
User :   I undeerstand, I know this can be tricky
Doctor :   Was not an MRI done?
Doctor :   CT scan done?
Doctor :   They say about the spread
Doctor :   The doctor would have told you if they were done
User :   Now MRI, id have ann altra sound done a few weeks ago. The dr. that it was a stone
User :   I had a ct scan of my abdomen about seven/eight months (for something unrelated) it came back clean
Doctor :   Ok
User :   the dr. also did a bladder wash to check for cancerous cells and that came back clean - same time as the ct scan
User :   I assume this is good news too?
Doctor :   yes
User :   I know this is an agressive form of cancer, but I don't know how fast it can spread to other areas
User :   I discovered the small lum about 10 weeks ago. under my chin, what is the likihood that this is where is started?
Doctor :   I have no clue about the stage yet.
Doctor :   If it is diagnosed with DLBCL
Doctor :   Why did he not start on chemo?
User :   yes it was
User :   I still have more tests
User :   should they start right away?
User :   I have a pt scan next week
Doctor :   I think they are waiting for PET scan
Doctor :   before chemo
User :   that is one reason i'm worried
Doctor :   as the chemo can cause problems of good diagnosies
User :   it takes so long to get started
User :   i don't want it to spread while we are waiting
User :   I have been on clindimycin and another antibiotic for a week, due to a post operative infection
Doctor :   yes
Doctor :   It is usual practice to put on antibiotics
Doctor :   Let us see the scan results
User :   It was okay at first, but I now have cramps and a tighening in the back righ under my ribgage
User :   the dr. said it would be okay to stop taking the antibiotics becasue the culture didn't show any biacteria
User :   I am worried about the pain in my back
User :   is this a place where lymphoma generally shows up?
User :   are you there?
Doctor :   yes
Doctor :   No
Doctor :   Abdominal pain, lump in the neck are the common early findings
Doctor :   Where is the biopsy done ?
Doctor :   Neck is it not?
User :   yes, the gland was in the neck
User :   as I said, she checked my other nodes and didn't feel anything abnormal
User :   I only have a few more questions
Doctor :   Ok
Doctor :   So there is no bilaterality
User :   Based on everything I've told you, do you still think I'm likely a one or two?
Doctor :   Good toknow
Doctor :   Yes
Doctor :   One or two
User :   stage one or two
Doctor :   I cannot specifically say that
Doctor :   You can ask an Oncologist here
Doctor :   I am only a GP
User :   I'm not asking for a guaranntee
Doctor :   and he can have better answer
User :   just your opinion?
User :   I know the real answr come with more testing
Doctor :   Two
User :   what makes you think two?
Doctor :   Given the presentation is most often late
User :   late?
User :   and what presentation are youu referring to? I don't understand the term in that context
Doctor :   Lump in the neck is your presentation
Doctor :   but your age is not older
User :   I see.
User :   So typically this type of lymphoma doesn't start in the neck?
Doctor :   Why do you bother too much about the ppt, given the prognosis is same for both of them
Doctor :   and the treatment is also the same
Doctor :   sorry about the stage*
User :   your right
Doctor :   It starts in the neck
User :   no, it is what it is....
Doctor :   You have typical clincal picutre
Doctor :   Chemotherapy for 3 to 6 cycles
Doctor :   once every 21 days
Doctor :   If required radiotherapy
User :   final question
User :   How long would you feel comfortable, if you were me, to get started with the chemo?
User :   at this point I can't start for two or three weeks
User :   I was diagnosed a week ago
Doctor :   I would stop all the work and head towards the chemo centre
User :   was sent to the radiotherapy oncologist and now have an appointment with the medical onglist
Doctor :   and finish the cycles as early as possib;le
User :   I want to start now
User :   Does this seem slow to you?
Doctor :   Chemo is done by med onco
User :   yes
User :   I met with him monday
Doctor :   so you can approach him when you meet him
User :   i want a second opinion, do you recommend that?
User :   I know it mightl delay things by a couple of days
Doctor :   If you med onco delays the inception of treatment
Doctor :   then you should go for that
Doctor :   But I am sure they know it better what is a delay
Doctor :   I think they are not seeing it seriously
Doctor :   because it is a single small lump which is much less in size
User :   good've been very helpful...thanks
Doctor :   Pleasure speaking to you
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