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What Does My PET Scan Report Indicate?
Question: Have asked before but now have new updated information:
Enlarged mediastinal lymph nodes.
Pet scan shows "intense activity" in this area and in colon area. Moderate activity in bones.
LDH and all blood tests normal.
Blood tests suggesting sarcoidosis. Normal results.
Beta 2 microglobulin XXXXXXX from 2.2 to 2.6 in 3 weeks but apparently no cause for concern.
Night sweats, weight loss, difficulty taking a deep breath, chest pain, bone aches and feeling very fatigued and generally unwell for a few months.
Tonsil and bone marrow biopsies normal. Colonoscopy and biospy normal.
Lymph node biopsy to come.
CT scan yesterday reported:
There is aertopulmonary, pre vascular, proximal and distal paratracheal lymphadenopathy and enlarged hilar lymph nodes. Compared to the recent study the hilar lymph nodes and subcarinal lymph nodes are more prominent. No pericardial or pleural effusion. No axillarly adenopathy. No breast lesion in the area surveyed. No pulmonary nodules or mass. No bronchiectasis or inserstitial lesion.
The oesophagus is normal and the adrenal glands are normal. No bone lesion.
I am wondering if you can suggest to me what else this could be aside from Lymphoma. Or indeed if it could likely be lymphoma without any indicators coming up in the blood or other biopsies?
Enlarged mediastinal lymph nodes.
Pet scan shows "intense activity" in this area and in colon area. Moderate activity in bones.
LDH and all blood tests normal.
Blood tests suggesting sarcoidosis. Normal results.
Beta 2 microglobulin XXXXXXX from 2.2 to 2.6 in 3 weeks but apparently no cause for concern.
Night sweats, weight loss, difficulty taking a deep breath, chest pain, bone aches and feeling very fatigued and generally unwell for a few months.
Tonsil and bone marrow biopsies normal. Colonoscopy and biospy normal.
Lymph node biopsy to come.
CT scan yesterday reported:
There is aertopulmonary, pre vascular, proximal and distal paratracheal lymphadenopathy and enlarged hilar lymph nodes. Compared to the recent study the hilar lymph nodes and subcarinal lymph nodes are more prominent. No pericardial or pleural effusion. No axillarly adenopathy. No breast lesion in the area surveyed. No pulmonary nodules or mass. No bronchiectasis or inserstitial lesion.
The oesophagus is normal and the adrenal glands are normal. No bone lesion.
I am wondering if you can suggest to me what else this could be aside from Lymphoma. Or indeed if it could likely be lymphoma without any indicators coming up in the blood or other biopsies?
Brief Answer:
Mediastinal LN Biopsy with IHC is the key. Stop Metformin
Detailed Answer:
Hi. I am an oncologist of several years experience and have been dealing with lymphoma day in and out.
From what I understand, you have a number of constitutional symptoms and enlarged mediastinal lymph nodes.
The possibility of this being lymphoma is quite low based on the entire clinical picture. However the only way to be certain is a biopsy from the lymph nodes which I suppose has been done. I would also suggest that you get immunohistochemistry (IHC) done on the removed lymph node for lymphoma. This will additionally confirm or rule out lymphoma. It is more accurate than normal biopsy studies. This can be done at any standard laboratory on the sample that has already been removed or its blocks.
Another possibility is a chronic infection such as tuberculosis which can present in this manner although it is not so common in your country. It is still possible due to the growing Asian population there. This will also get confirmed on the biopsy.
If the biopsy conclusively says that it is not lymphoma and does not show any other infectious disease such as tuberculosis, then the next most plausible explanation for your symptoms would be side effects of Metformin that I noticed you are on. All these symptoms can occur with Metformin. I would suggest you change this medication to another in consultation with your doctor.
I hope this answers your questions conclusively. If you have no other questions then I request you to rate the question and close the thread.
Thank you.
Mediastinal LN Biopsy with IHC is the key. Stop Metformin
Detailed Answer:
Hi. I am an oncologist of several years experience and have been dealing with lymphoma day in and out.
From what I understand, you have a number of constitutional symptoms and enlarged mediastinal lymph nodes.
The possibility of this being lymphoma is quite low based on the entire clinical picture. However the only way to be certain is a biopsy from the lymph nodes which I suppose has been done. I would also suggest that you get immunohistochemistry (IHC) done on the removed lymph node for lymphoma. This will additionally confirm or rule out lymphoma. It is more accurate than normal biopsy studies. This can be done at any standard laboratory on the sample that has already been removed or its blocks.
Another possibility is a chronic infection such as tuberculosis which can present in this manner although it is not so common in your country. It is still possible due to the growing Asian population there. This will also get confirmed on the biopsy.
If the biopsy conclusively says that it is not lymphoma and does not show any other infectious disease such as tuberculosis, then the next most plausible explanation for your symptoms would be side effects of Metformin that I noticed you are on. All these symptoms can occur with Metformin. I would suggest you change this medication to another in consultation with your doctor.
I hope this answers your questions conclusively. If you have no other questions then I request you to rate the question and close the thread.
Thank you.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Brief Answer:
Early biopsy. Metformin probable cause. LNs insignificant if biopsy normal.
Detailed Answer:
Hi.
Thank you for your query.
It would be prudent to get the biopsy done earlier if possible for two reasons. One, you will remain worried till the biopsy report comes. Second, if it is lymphoma then the treatment will get delayed by that much. However, if it is not possible only to get the biopsy done earlier, then there is no option but to wait.
Metformin will not cause enlarged lymph nodes but it can produce all your other symptoms. If the biopsy does not show lymphoma or infection, then they are non-specific and to be ignored. This can happen in a number of individuals. Then we just need to cater to your symptoms which can be explained by metformin usage. These symptoms can occur any time during metformin usage particularly after prolonged use.
I hope that clears your doubts. If you don't have any further questions, kindly rate the question and close the thread.
Early biopsy. Metformin probable cause. LNs insignificant if biopsy normal.
Detailed Answer:
Hi.
Thank you for your query.
It would be prudent to get the biopsy done earlier if possible for two reasons. One, you will remain worried till the biopsy report comes. Second, if it is lymphoma then the treatment will get delayed by that much. However, if it is not possible only to get the biopsy done earlier, then there is no option but to wait.
Metformin will not cause enlarged lymph nodes but it can produce all your other symptoms. If the biopsy does not show lymphoma or infection, then they are non-specific and to be ignored. This can happen in a number of individuals. Then we just need to cater to your symptoms which can be explained by metformin usage. These symptoms can occur any time during metformin usage particularly after prolonged use.
I hope that clears your doubts. If you don't have any further questions, kindly rate the question and close the thread.
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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