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What Does My Lab Test Report Indicate?

Posted on Mon, 28 Aug 2017

Question: Dear sir
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

Answered by Dr. Deepak Sundriyal (18 minutes later)

Brief Answer:
Hello dear. She requires evaluation

Detailed Answer:
Hello dear. I have gone through the details. So as per reports, she has lymphocytic predominance with smudge cells, which is a feature of chronic lymphocytic leukemia. She requires a bone marrow evaluation abd flowcytometry for that. Please donot worry as even if it turns out to br leukemia, complete treatment is possible.
Thanks and regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Deepak Sundriyal (54 minutes later)

is any treament is in emergency or we have to wait

Answered by Dr. Deepak Sundriyal (7 minutes later)

Brief Answer:
Hello. No emergency

Detailed Answer:
Hello. There is no emergency. You can wait.
Thanks and regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Deepak Sundriyal (41 minutes later)

sir she has a history of NHL B GRADE LYHPOMA is it possible ahe has again suggered with leukeimia .she was in remmision period from last 7 years. and in 2003 she had done spleenoplasty also but that time also we did biopasy of spleen which is removed but we didnt get any sign at that time too but suddenly we know in 2010 she had nhl deases and now again leukemia suspect.kindly guide

Answered by Dr. Deepak Sundriyal (25 minutes later)

Brief Answer:
Hello. It may be possible

Detailed Answer:
Hello. It is rare but possible. So please get the workup done.
Thanks and regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Deepak Sundriyal (44 hours later)

dear sir
we did flow cytometry test as adviced in normL blood thru vail kindly check reports and advice

Answered by Dr. Deepak Sundriyal (12 minutes later)

Brief Answer:
Hello. She requires a petct.

Detailed Answer:
Hello again.

So there is a discordance as results show a leukemic phase of marzgnal zone lymphoma. Usually dlbcl does not changes to marginal zone lymphoma.
A petct is required to look for other sites of disease and if present, a biopsy is highly advised.

Thanks and regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Deepak Sundriyal (2 days later)

DEAR DOCTOR AS ADVICED BY YOU WE DID PET CT TODAY BIT NO EVEDENCE OF ANY DEASES IS SEEN KINDLY CHECK ATTACH REPORT AND ADVICE

Answered by Dr. Deepak Sundriyal (1 hour later)

Brief Answer:
Hello dear. Chemotherapy is required

Detailed Answer:
Hello dear. So depending upon the reports, chemotherapy may be required if she has any loss of weight, fever, repeated infections or anemia or low platelets. Otherwise, she can wait.
Thanks and regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Deepak Sundriyal (1 hour later)

Hi, I have provided some attachments. Please review them.

Answered by Dr. Deepak Sundriyal (6 hours later)

Brief Answer:
Hello. Petct is normal

Detailed Answer:
Hello dear. As the petct is normal, in my opinion observation will be the best strategy. Regular monthly follow up is required. However, i wish to see the original biopsy and ihc report of diffuse large b cell. Lymphoma, the initial. One.
Thanks and regards

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Above answer was peer-reviewed by : Dr. Nagamani Ng