What Do The Following Blood Test Report Indicate?
my mother she is 68 years now.In 2010 she was diagonsed with NHL B large grade grafe in stage 4 .she had undergone 8 cycles of RCHOP CHEMOTHARPY.Afer 6 cycles per ct was done and its clear and after that 2 more cycle also given for precautnary measure.After that she is under observation, but due to cancer her L5 AND L4 IS COLLAPSED for that she is not able to sit and walk.then after that she undergo the decomprasdion of nervers surgery from collapsed l4 &l5 in 20!2.after that she is able to sit for sometime and able to walk some steps with support but still companing of and on in thighs specially in night.but no pain in back or spine area only compaing in thighs outer side w0e did lasr PET CT in 2016f eb (report attached) there is nothing.all well.her regular routine blood test have been on 26 july2017 (report attached) but lymphoctes are on higher side we are little worried on that because its never seen in past.kindly advice
Can't see the reports
Thanks for your query.
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This is suggestive of increased lymphocytes
This report is concerning. The total leucocyte count is 14000 with 70% lymphocytes which makes the total lymphocytes close to 10000. Their appearance is also not normal, with presence of smudge cells. This picture is suggestive of chronic lymphocytic leukemia. If the patient had small cell lymphoma earlier, then this could well be a recurrence. Small cell lymphoma and chronic lymphocytic leukemia are basically same.
But then you mentioned that previously she had large cell lymphoma. Then the present manifestation can't be explained by a recurrence. It may be the unlikely event of a new disease.
I recommend getting the current blood picture reviewed by an expert hematopathologist, in conjunction with the previous biopsy. We can also do flow cytometry analysis on blood to get the exact current diagnosis.
Hope this helps.
I could not find the attached discharge summary
However, if it's clearly diffuse large b cell lymphoma, then it can't explain the current blood picture. The previous biopsy and current blood picture should be reviewed by an expert and flow cytometry done, as I mentioned earlier.
yes it is large B cell
You should definitely review the old biopsy, if the slides/blocks are available. And the flow cytometry on current blood is a must. That will give the clear diagnosis. Even if it is confirmed as chronic lymphocytic leukemia, no immediate treatment may be required if she is otherwise alright.
Because it does not improve survival
Chronic lymphocytic leukemia (CLL) is an indolent disease, very unlike diffuse large B cell lymphoma, which is aggressive. Hence, unless it is causing any symptoms like fever, weight loss, low hemoglobin, low platelets, etc, there is no benefit in immediate treatment. Rather we wait till it causes any problems. Years may pass without treatment.
These are likely not related
Most likely these are unrelated issues and can benefit by topical skin preparations and laxatives respectively.