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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Follicular Lymphoma

Hi, I have been diagnosed with a follicular lymphoma in situ 2 years ago following a biopsy of an inguinal lymph node. CT/PET scans didn’t reveal anything and a bone marrow aspiration showed no sign of the cancer. I’m on a wait & see protocol but at this time the cancer is not considered to have declared itself as further oncogenic events have to take place. Whether they will or not is anybody’s guess. I was also sent to an immunologist because my IgG reading is low (latest was at 5.84). However I have been responding normally to vaccines and the immunologist didn t this was an issue. Further blood work showed an increased count in CD8 lymphocytes. Over the last year blood tests showed an unexplained augmented count of CD8. Although my CBC was within normal range (white blood cells at 5.20— normal range at 4.20-11.00), the CD4 CD8 Direct measurements were off. CD45CD3 Abs was within the normal range at 2064; the CD45CD3CD4 Abs was also within the normal range at 641. However the CD45CD3CD8 measurement was high at 1383. Ten month earlier, the results were somewhat similar with CD45CD3CD8 elevated at 1005. As a result of the elevated CD8 count, my CD4 CD8 ratio is now at 0.5 (it was at 0.6 10 months earlier). I have no infection (including HIV-AIDS, for which I have tested negative). In fact, I didn’t even get a cold this winter, which is rare for me (I live in Montreal, Canada). Currently my immunologist thinks the test results are faulty (2 faulty results in the same lab over a 10 month period seems stretching the law of probabilities, as far as I’m concerned, especially since the readings are more or less congruous). I’m nonetheless waiting for a third set of results — with a more detailed count to determine exactly which CD8 population is augmented. I m wondering whether the elevated CD8 count is worrisome. The probability that there would be an underlying T-cell cancer (leukaemia or T-cell lymphoma) seems low given my overall good health (I train 6 times a week, 3 times of weight training; 3 times jogging 6 km and have been doing it for years) and the fact that I’m already at risk for a B-cell cancer (follicular lymphoma) — let me put it this way: how unlucky can someone get at these things all at once!? But then again we never know… In any case, my immunologist also thinks such a cancer is unlikely at this juncture. But if so, what else could be causing these numbers?
Mon, 29 Oct 2018
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General Surgeon 's  Response
Hello,

Consult a hemato oncologist and get evaluated.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Shinas Hussain, General & Family Physician
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Suggest Treatment For Follicular Lymphoma

Hello, Consult a hemato oncologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician