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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for lymphoma

my daughter 18 years old is under going biopsy investigation for suspected lymphoma,doctor gangadharan of lake shore hospital suspects the case started 12-15 months back, she had skin allergy and was undergoing ayurveda treatment from kottakkal for last 13 months, what tratment or course of action you recommend doctor, blood tst showed esr89 and crp90, chest xray showed shadows, mri scan result showedmultiple rounded soft tissue lessions in lung field and central necrosis
Tue, 16 Jan 2018
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Oncologist 's  Response
Hello,
In short lymphoma can be considered as cancer of lymphatic glands. It has different types and treatment is different as per different type.Also there are many conditions that can mimic lymphoma. Most common and most prevalent in Indian setting is Tuberculosis. So getting a appropriate diagnosis is most important when we are suspecting lymphoma.
In a 18 year old girl with long history(as per your doctor), high ESR and CRP and lung shadows there are 2 most important possibilities.
1. Hodgkins Lymphoma
2. Tuberculosis
In such cases what I do is to
1. Take proper history regarding duration of symptoms and TB contacts
2. Good general examination
3. Lymphnode bipsy with PCR/Staining for AFB as well as IHC for lymphoma
Once a lymphoma is confirmed on biopsy. Treatment will depend on its type and how advance it is (Stage)
So in your daughters case if we take it as hodgkins lymphoma,It is one of the most curable lymphomas in children. Though it will be stage IV as she has lung nodules. The initial chemotherapy for hodgkins is standard all over the word which is ABVD (4 chemotherapy drugs). What I do is give 2 cycles of chemotherapy and assess response with PET after 2 cycles. And then decide whether to give 6 or 8 cycles.
I hope this answers your query. If you have any other questions I am happy to answer.
Thank you
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Suggest treatment for lymphoma

Hello, In short lymphoma can be considered as cancer of lymphatic glands. It has different types and treatment is different as per different type.Also there are many conditions that can mimic lymphoma. Most common and most prevalent in Indian setting is Tuberculosis. So getting a appropriate diagnosis is most important when we are suspecting lymphoma. In a 18 year old girl with long history(as per your doctor), high ESR and CRP and lung shadows there are 2 most important possibilities. 1. Hodgkins Lymphoma 2. Tuberculosis In such cases what I do is to 1. Take proper history regarding duration of symptoms and TB contacts 2. Good general examination 3. Lymphnode bipsy with PCR/Staining for AFB as well as IHC for lymphoma Once a lymphoma is confirmed on biopsy. Treatment will depend on its type and how advance it is (Stage) So in your daughters case if we take it as hodgkins lymphoma,It is one of the most curable lymphomas in children. Though it will be stage IV as she has lung nodules. The initial chemotherapy for hodgkins is standard all over the word which is ABVD (4 chemotherapy drugs). What I do is give 2 cycles of chemotherapy and assess response with PET after 2 cycles. And then decide whether to give 6 or 8 cycles. I hope this answers your query. If you have any other questions I am happy to answer. Thank you