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Treated for mantle cell lymphoma. CT scan showed spleen of 6-7mm low density. Worrisome

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I have been in remission with Mantle Cell Lymphoma after stem cell xplant 5 yers ago. I have no symptoms, but on a routine followup CT scan recently, a new 6-7mm low density of the spleen was evident. There is no pain, bleeding, associated with this and the radiologist reports that the small dimensions of this lesion are such that the etiology and significance of are uncertain.

The physician explaining these results indicated this was very worrisome. The location and depth are such that a biopsy are not possible. The next step will be a pet scan, followed likely by a recoomendation of spleen removal, if there is sugar uptake. I have had similar lesions in the past ,
cysts on the liver whixh were unidentified but stable or disappeared. I'm not sure why ths newcomer is so upsetting and wonder if physicians or patients with similar CT results/experience and could comment. This is the first time I've been really scared about my disease.I am 60+.

Thx for any help-

Posted Sat, 10 Nov 2012 in Cancer
Answered by Dr. Indranil Ghosh 2 hours later
Thanks for writing in.
It is good that you have been doing so well after treatment for mantle cell lymphoma including a transplant. Relapse after 5 years is quite uncommon but not impossible.
A splenic lesion is quite worrisome but as it is below a cm we can not do any needle biopsy or fine needle aspiration. We can certainly do a PET-CT but with such a small lesion it is unlikely to pick up anything. If that shows anything I would agree with the plan of spleen removal but if nothing comes up then we may just wait and watch with maybe a scan after 2-3 months.
Overall I think that the possibility of a relapse in this scenario is quite low.
Hope I have answered your query. I will be available for further follow-up queries, if any.
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