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I Am Patient Of NHL Here Is My History, Is This Relapse Of Follicular Lymphoma?

Posted on Wed, 14 Dec 2022

Question: Dear Sir ,
I m patient of NHL my history is as follows :
23.11.2017 - Swelling seen on RHS Lymph Node ( IB & II Nodes ) .
19.12.2017 – Cervical Lymph Node Biopsy Done .
04.01.2018 - Histopathology Report Shows NHL - Follicular Lymphoma Gr III .
16-04-2018 – Pet Scan Done - A case of Follicular lymphoma presented with cervical adenopathy, now has received 4 # chemotherapy ( R - Chop ) (LD -25/3/2018) , FDG avid right level IB and II nodes noted 11 X 17 mm, SUVmax 21.45 ,
IMPRESSION –
Scan findings reveal, Hypermetabolic right cervical level IB and II nodes
No splenic and marrow involvement noted .
21-06-2018 - A case of Follicular lymphoma presented POST 4# RCHOP. PET/CT (13/04/2018) scan showed right level IB , II cervical nodes . Now post 6# R CHOP ( Last Done on 19.05.2018 ) Present scan is being done for evaluation of treatment response .
IMPRESSION
As compared to the previous scan dated 13/04/2018 Increase in metabolism with no significant change in size of right level IB, II cervical nodes Hypermetabolic soft tissue lesion noted in the right side of hard palate, is a new lesion needs clinical sos biopsy correlation
19-07-2018 - Submandibular Lymph Node Group Right-Biopsy :
Impression:
Relapse of Follicular lymphoma, grade 3a
25-07-2018 - Bone marrow biopsy .
Impression:
Uninvolved bone marrow .

Pl Suggest the further treatment & precautions to be taken .

Answered by Dr. Monish De (4 hours later)

Brief Answer:

R-CVP chemotherapy

Detailed Answer:

Hi,

I have gone through your history

Unfortunately you are having a relapse of follicular lymphoma, grade 3a in submandibular lymph node group right biopsy I would advsie you to go for R-CVP chemotherapy which includes the drugs rituximab, cyclophosphamide, vincristine, and prednisone

Consult your local doctor regarding it

But one good thing is that your bone marrow is not involved

Regards
DR Monish De
Oncologist

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Monish De (3 days later)

Dear Sir ,

Thanks for your valuable advice .

Regarding the further treatment ( NHL –FL – Probably II Stage ) & after Bone Marrow Test , I consult my Doctor & he advice me to take review from RT doctor , he also said that we have to go for Radiation Therapy . I am going to consult RT doctor on 01.08.2018 .

Your valuable reply is awaited .

Thanks & regards .

Answered by Dr. Monish De (5 minutes later)

Brief Answer:

External beam radiotherapy

Detailed Answer:

Hi

If the patient is unwilling for further chemotherapy then in relapsed follicular lymphoma external beam radiotherapy can be considered as an effective modality when integrated in a multimodality approach.

You can consult your radiation oncologist regarding it.

Regards
DR Monish De
Oncologist

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