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Anaplastic large-cell lymphoma in breast. History of abnormal cell in pap smear. Did PET and CT, Next?

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OBGYN, Gynecologic Oncology
Practicing since : 1984
Answered : 99 Questions
I am 29yrs, F. ALCL was found in my breast (implanted breast, over 10 years ago. Not PIP implants) after aspirating 200mls fluid. I have been regularly aspirating approx 200mls fluid since this finding & waiting to have my implant surgically removed. I have a history of abnormal cell findings from pap smear. I have had 6 pregnancies, 1 live birth, 1 ectopic, 1 D&C and 3 miscarriages ranging over the past 10 years. I am extremely fit and live a very healthy lifestyle (as organic as possible). Non drinker, non smoker.

My PET/CT results state
- the ovaries are bulky, however, demonstrating physiological FDG uptake.
- bilateral collections of axillary nodes (chest). The larger nodes have central fatty hila, measuring 16mm

My questions are:
I am told that physiological uptake in ovaries occurs around the ovulatory phase of mentruation. I have a long cycle (7wks, 5days). This PET/CT was taken 2 weeks in (a few days after menstruation ceased). I was far from my ovulatory stage. The radiographer did not ask what stage of my cycle I was in. Prior ultrasound imaging of my ovaries did not show any masses or bulkiness. I have been referred to lymphoma clinic however the wait will be many weeks or months and I am anxious to know if the uptake of FDG could be due to lymphoma?

RE the axillary nodes, is this anything to be concerned about?

Posted Mon, 15 Apr 2013 in Cervical and Ovarian Cancer
Answered by Dr. Manjunath L Ramarajapalli 20 hours later

Thanks for the query.

I went through the details with diligence and my comments are as follows:

1. ALCL might involve lymph nodes. The axillary lymph nodes may be related to ALCL.

2. Abnormal pap findings should be further investigated to rule out any pathology.

3. The bulky ovaries and FDG uptake also need to be investigated. It is difficult to conclude about the nature of the pathology based on the information presented. Whether or not this is related to lymphoma / is a concern can be commented only by further evaluation.

I understand you have a waiting period to consult your doctor. However I would advise you to consult your oncologist to learn the nature of problem after evaluation.

I hope this information has been useful. Let me know if you need clarifications.

Good luck
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