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Biopsy and CA-19 test done. Diagnosis as lymph node. Feeling pain and discomfort. Is it cancerous?

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I had a EUS last week because of CA-19 TEST. The first test was done in March and that came in at 108, second test in May and that came in at 117 and third test was in August and that was at 122. The Cytopathology Report
Three biopsies were done and on the report for Diagnosis it said Lymph node 11mm liver portal(fine needle aspiration). Microscopic Interpretation: Paucicellular smears predominantly show a mixed population of small and large Lymphocytes arranged in sheets, groups, and singly. The background consists of GI contamination and blood elements. thin prep concurs.
I have no idea what this means and if I need to see a specialist or any medication should be prescribed? Please let me know what to do and could the CA19 be coming in higher then normalthat might have been caused by trauma because I was in a car accident (rear ended) that caused a lot of pain and discomfort because of seat belt and large uterine fibroids that I have? Please let me know because I need to know if I have a problem with my pancreas or my liver and id it is cancerous.

Thank you
Posted Fri, 2 Nov 2012 in Cancer
 
 
Answered by Dr. Pavan Kumar Gupta 5 hours later
Hello
Thanks for the query
CA19-9  is a tumor marker that is used primarily in the management of pancreatic cancer.

Guidelines from the American Society of Clinical Oncology discourage the use of CA19-9 as a screening test for cancer, particularly pancreatic cancer. The reason is that the test may be falsely normal (false negative) in many cases, or abnormally elevated in people who have no cancer at all (false positive). The main use of CA19-9 is during the treatment for pancreatic cancer to see the response of treatment.
CA19-9 can be elevated in many types of gastrointestinal cancer, such as colorectal cancer, esophageal cancer and hepatocellular carcinoma. Apart from cancer, elevated levels may also occur in pancreatitis, cirrhosis, and diseases of the bile ducts. It can be elevated in people with obstruction of the bile ducts.

Your accident has nothing to do with your high levels of CA 19-9.
Whatever biopsy report you have sent doesn't reveal much since it is not complete report.Please send the complete report.
The high levels of CA19-9 do give suspicion of malignancy but there can be various other non malignant causes for this.
Have you got any CT abdomen done?
Why was CA 19-9 done?
Why was EUS done?
Any other investigation done ?

There is no need for any medication at the moment since the diagnosis is not confirmed.

Basically you should be seen by a surgical Gastroenterologist for proper evaluation and management.

Please do revert to me for further discussion with more informations.
Best of luck
Thanks
Above answer was peer-reviewed by
 
Follow-up: Biopsy and CA-19 test done. Diagnosis as lymph node. Feeling pain and discomfort. Is it cancerous? 14 hours later
Hello Dr,


I had a EUS upper scope and they also want me to do a colonoscopy, the Cytopathology report that I had a 11mm lymph node Paucicellular smears show mixes population of small and large lymphocytes arranged in sheets, groups, and singly. Background consists of GI contamination and blood elements, thin prep concurs.

I dont understand the report and if I need to be on antibiotics?
The EUS was done following the CT, the reason why all this ever got started is because of all the pain and swelling I had and still have in my abdominal area. The DR did a physical and ordered a ca19 on me also. Please let me know what the GI contamination and large lymphocytes mean.

Thank you
 
 
Answered by Dr. Pavan Kumar Gupta 1 hour later
Hello,
 Recognition of gastric or duodenal epithelial contaminants can be essential to avoid misinterpretation during cytological evaluation of the specimens.
This simply means that sample for biopsy has been taken correctly.
Large lymphocyte doesn't denote anything of it's own.
Your biopsy report is inconclusive and as such doesn't tell anything specific.
There is no need to take any antibiotics.

Your doctor is right in ordering a colonoscopy also,because high CA19-9 is found in colo rectal cancers also and these cancers can be detected by a colonoscopy.
Thanks.
Above answer was peer-reviewed by
 
Follow-up: Biopsy and CA-19 test done. Diagnosis as lymph node. Feeling pain and discomfort. Is it cancerous? 5 hours later
Thank you so much Dr. XXXXXXX I was under the impression that since the report stated that background consists of contamination and blood elements that that would be an infection. The paucicellular smears with the small and large lymphocyte is nothing to worry about also? please reply


Thank you Dr. XXXXXXX and I will keep you posted
 
 
Answered by Dr. Pavan Kumar Gupta 1 hour later
Hello
In simple term,your report is inconclusive and hence needs more evaluation.
Thanks
Above answer was peer-reviewed by
 
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