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Dr. Andrew Rynne

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What does this CT scan regarding diffused large B cell lymphoma indicate?

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Dr. Monish De

Oncologist

Practicing since :2004

Answered : 1645 Questions

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Posted on Wed, 20 Aug 2014 in Blood Disorders
Question: Greetings

I was diagnosed with Diffused Large B Cell Lymphoma in 2013 February. I went through the following treatments:

(1) 6 cycles of CHOP-R and in addition they gave 3 doses of methotroxate chemo (March 2013)

(2) ICE, BEAM followed by Stem Cell Transplant (November 2013)

(3) 20 doses of Radiation. (March 2014)



Latest CT scan report as of XXXXXXX 15 2014 is shown below.

According to my hematologists they have nothing more to do and I have less than one year to live!

I would very much appreciate if anyone could suggest any new drug therapy or alternative therapy that could save my life

-------------------------------------------------------------CT scan report on XXXXXXX 16 2014-----------------------------

ABDOMEN AND PELVIS:

HEPATOBILIARY SYSTEM:

Liver: Unremarkable

Gallbladder / ducts: Unremarkable

Pancreas: Unremarkable

GASTROINTESTINAL TRACT: Colonic and duodenal diverticulosis.

GENITOURINARY SYSTEM:

Adrenals: Bilateral new adrenal masses as follows:

1. Right, image 22:14 mm

2. Left, image 19:50 mm

Kidneys / Ureters: Bilateral new renal masses as follows:

1. Right, image 34:22 mm

2. Left, image 22:21 mm

Urinary Bladder: Unremarkable

Prostate : Unremarkable

LYMPHATIC SYSTEM:

Spleen: Unremarkable

Lymph nodes: Residual but improved lymphadenopathy. Comparison is made

to diagnostic CT from January 8, 2014. The conglomerate retroperitoneal

index node on image 35 measures 30 x 57 mm (prior 52 x 75 mm) V 171" (9 0

PERITONEUM, RETROPERITONEUM & MESENTERY: There is a small amount of free

fluid. There is a new retroperitoneal/perinephric mass, on image 34

measuring 39 mm.

VESSELS & OTHER: Unremarkable

BONES / BODY WALL: Unremarkable

IMPRESSION:

1. Mixed response in the abdomen. There are bilateral new adrenal and renal

masses as well as a new left perinephric mass, most likely progressive

lymphoma. However, the pre-existing retroperitoneal lymphoma demonstrates

some improvement.

2. No convincing thoracic lymphoma. The right upper lobe groundglass

pulmonary nodule is stable compared to the most recent study. Recommend

continued followup.

3. Left thyroid nodule or cyst. Recommend evaluation with ultrasound.
doctor
Answered by Dr. Monish De 1 hour later
Brief Answer:
Alisertib, Everolimus

Detailed Answer:
Hi

Since you are having bilateral new adrenal and renal masses as well as a new left perinephric mass, suggesting progressive Diffused Large B Cell Lymphoma and you have been treated previously with different chemotherapy regimens some new drugs which are under clinical research like Alisertib, Everolimus and Bortezomib can be tried in your case.

Hope i have answered your query.

Regards
DR De




Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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