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What Does My PET Scan Report Indicate?
Question: Hi I have 3 x mediastinial lymph nodes in my chest that are enlarged. A following pet scan showed intense activity in this area and my adenoids and tonsils and the ano-rectal area. Moderate activity in the bones. They removed and biopsied one tonsil but it came back as normal except for tonsilitis (I wasnt even sick!). They just did a bone marrow biopsy - also normal. All blood tests have been normal - including flow cytometry - except for Beta 2 microglobulin which was 2.2 on 10th dec (normal level her in aus is 2.0) and XXXXXXX to 2.6 on 31st dec. I have been very tired this year and have had problems taking a deep breath for 6 months or so. Lungs and lung function, spirometry all normal. I am having a colonoscopy next week. And doctor has said they will biopsy one of the enlarged lymph nodes. All of the talk has been around lymphoma with the possibility of sarcoidosis, however a blood test they ran that might indicate this was negative. Is there a possibility that this could be lymphoma with all blood tests except the beta 2 essentially normal?
Brief Answer:
Biopsy is advisable
Detailed Answer:
hi,
The history you elaborated doesn't indicate towards a specific disease.
The biopsy of mediastinal lymph node will be a better idea. This will give you the diagnosis.
Pet scan is not specific for cancer. As you said bone marrow is normal so it should not be multiple myeloma.
Some pathology is there likely inflammatory.
Feel free to ask further.
Biopsy is advisable
Detailed Answer:
hi,
The history you elaborated doesn't indicate towards a specific disease.
The biopsy of mediastinal lymph node will be a better idea. This will give you the diagnosis.
Pet scan is not specific for cancer. As you said bone marrow is normal so it should not be multiple myeloma.
Some pathology is there likely inflammatory.
Feel free to ask further.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Your answer doesn't really help??? The enlarged lymph nodes were found on a chest CT whilst looking at another issue. The only other symptoms I had spoken to my GP about were fatigue, feeling like I was unwell (aches and pains), chest tightness and feeling like I couldn't take a deep breath. I have otherwise been well. The oncologist asked me about: night sweats - I am very hot at night and sleep with a fan on even in winter. Weight loss - yes I have had some unintentional but not a great deal. Itchiness - yes but I thought it was psoriasis. Chest pain and tightness and fatigue are very bothersome. Biopsies have been done of a tonsil and bone marrow - both normal. Only blood results that are abnormal are BETA 2. The posibilities we have been given are sarcoidosis and lymphoma with lymphoma the more likely in our doctors opinion. My question is - is lymphoma a possibility with largely normal blood tests (except Beta 2) and normal bone marrow results????? Or is sarcoidosis more likely in your opinion? A lymph node biopsy will be done anyway as I mentioned. The PET scan results indicated as I mentioned: INTENSE activity in chest area and associated lymph nodes and also adenoids and tonsils (tonsil later ruled out as tonsilitis) and INTENSE activity in ano-rectal area (colonoscopy next week) and moderate activity in bones. I believe this question requires much more than the brief answer you just gave?
Brief Answer:
thoracic lymph node biopsy if they are significantly enlarged.
Detailed Answer:
Dear madam,
I can understand that you are in a difficult situation.
There is some pathological process going on in your body, that we have to find out.
... Yes, lymphoma is a possibility. in initial phase of lymphoma blood tests are normal, even beta 2 microglobulin. the doctors there did bone marrow because there is rise in microglobulin. a normal bone marrow biopsy rules out an aggressive variety of cancer - multiple myeloma and also stage 4 of lymphoma.
If you or any of your family member has visited south asian countries, tuberculosis is another diagnosis.
Sarcoidosis or silicosis are also in line.
There are 3 ways of thoracic lymphnode biopsy - mediastinoscopy, thoracoscopy or open surgery. an easy option is EUS guided FNAC (Fine-needle aspiration cytology) from lymph node.
The largest lymph node should be biopsied. so please tell me the size of the lymph nodes.
I personally feel that it should not be cancer, but a systemic inflammatory process involving many lymphoid organs in body. steroids may help you.
Have you done the thyroid tests? few endocrine diseases may cause such symptoms.
feel free to ask further.
thoracic lymph node biopsy if they are significantly enlarged.
Detailed Answer:
Dear madam,
I can understand that you are in a difficult situation.
There is some pathological process going on in your body, that we have to find out.
... Yes, lymphoma is a possibility. in initial phase of lymphoma blood tests are normal, even beta 2 microglobulin. the doctors there did bone marrow because there is rise in microglobulin. a normal bone marrow biopsy rules out an aggressive variety of cancer - multiple myeloma and also stage 4 of lymphoma.
If you or any of your family member has visited south asian countries, tuberculosis is another diagnosis.
Sarcoidosis or silicosis are also in line.
There are 3 ways of thoracic lymphnode biopsy - mediastinoscopy, thoracoscopy or open surgery. an easy option is EUS guided FNAC (Fine-needle aspiration cytology) from lymph node.
The largest lymph node should be biopsied. so please tell me the size of the lymph nodes.
I personally feel that it should not be cancer, but a systemic inflammatory process involving many lymphoid organs in body. steroids may help you.
Have you done the thyroid tests? few endocrine diseases may cause such symptoms.
feel free to ask further.
Above answer was peer-reviewed by :
Dr. Raju A.T
Thyroid is normal. No cough or lung issues on imaging and all respiratory tests normal. I haven't travelled out of the country nor have I been exposed to any toxic dusts or chemicals. Only other thing really was a big change in bowel habits, no blood. Mucous and intermittent constipation and dihorrea. We do have colon cancer in my family so was referred to hospital but was still on waiting list. After intense activity seen in that area on Pet scan, colonoscopy has been booked for next week.
Am I able to get a second opinion please.
Am I able to get a second opinion please.
Brief Answer:
colonoscopy and lymphnode biopsy will complete the workup
Detailed Answer:
hi madam.
sorry for the delay.
my personal experience says that it should not be a colon cancer.
its more likely a picture of a systemic inflammatory response. such response occurs in autoimmune diseases usually. in such cases steroides are useful, but to be taken after your doctor's advise.
to rule out cancer completely colonoscopy and biopsy of thoracic lymphnode is needed.
you did not mention the size of thoracic lymph node.
feel free to ask further.
colonoscopy and lymphnode biopsy will complete the workup
Detailed Answer:
hi madam.
sorry for the delay.
my personal experience says that it should not be a colon cancer.
its more likely a picture of a systemic inflammatory response. such response occurs in autoimmune diseases usually. in such cases steroides are useful, but to be taken after your doctor's advise.
to rule out cancer completely colonoscopy and biopsy of thoracic lymphnode is needed.
you did not mention the size of thoracic lymph node.
feel free to ask further.
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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