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Forum Name: Lymphoma

Question: Veiwing xrays for possible tumors


 jypsy_rose_lee - Sat Jan 14, 2006 11:09 pm

I was diagnosed with NHLI had it in my lungs.spleen and liver in veiwing my xrays I was interested in knowing how I can differentiate between what is a tumer and what is normal or is there a website that explains this? Thanks Mary
 Dr. Tamer Fouad - Sat Feb 18, 2006 4:00 am

User avatar Hello,

I hope your therapy is going well.

NHL could lead to several abnormalities in a chest x-ray. You may see round opacities in the center of the midline of the x-ray which could be due to hilar lymph node enlargement or a mediastinal mass.

It can also cause patches in the periphery of the lung fields which would be due to infiltration.

Some cases have bright white patches in the lower lung fields tapering upwards and this denotes fluid in the pleural sac (pleural effusion).

There may be other more rare presentations.

Best regards.
 jypsy_rose_lee - Thu Mar 02, 2006 10:20 pm

Thanks for the info regarding reading exrays,I had Lymphoma three years back,havn't been sick up until now,I srated having pains in my abdomin,that would radiate to my back with nausea.Doc gave me meds for a pelvic infection I havn't been able to git rid of the pain. My RBC is 3.77 hemiglobin is11.7 hematocrit is 35.0 lymph is 20.3 EOS is 7.9 lymph is 1.1 I knew these are low.My Potassium is 3.3 Chloride is 109 Albumin is 3.2 protein is 6.1.This was two months ago now I have constant cough,chest pains,fever,nuasea,weakness and a very hard time breathing.I was told a month and a half ago I have pnuemonia my exrays say examination of the PA andlateral veiws on 2/28/06 in comparison to the previous examination of 1/15/06 deminstrates soft tissue fullness in both hiler regions intervally increased from the previous examination,there is a right perhiler infilitrate also identified.These are secondary to pnuemonitis. I am still sick,I have been going to the hospital because,I have no insurance to pay up front.I have had pnuemonia for quite awhile now.I didn't have any symtoms when I had NHL before, just a knot on my neck.My platelet count is 236.I am just really worried.Thanks for any advice or info. Mary
 Dr. Tamer Fouad - Fri Mar 03, 2006 12:53 pm

User avatar Hello Mary,
I really cannot give you a decisive diagnosis over the internet. However, it does appear that your x-ray says pneumonia. Several things have to be taken into account here. Why do you have pneumonia? Is the pneumonia responding to therapy? Also, follow up both clinically and radiologically is recommended.

What about your LDH levels?
 jypsy_rose_lee - Fri Mar 03, 2006 5:58 pm

Thank you so much for responding,My LDH was 154 when it was checked two months ago at a different hospital.The hospital I'v been going to about three different times in the last month and ahalf hasm't checked it because it's not on my hemtoogy report that I had from my first visit two months ago 12/16/05 .I haven't had blood work done the last couple times I'v been to the hospital come to think about it.The doc just tells me I didn't have enough meds to finish off the pnuemonia,after listening to my lungs.I'v been letting them know about my past lymphoma.I don't know if it's assoiated or not but four months ago I was having pain in my abdimon that I still have that comes and goes.It radiates to back back and I git nauseated,doc said it was a pelvic infection,I figure since my LDH level was checked and it was 154 then there was nothing to worry about.Now I'v had pnuemonia with it that I cant git rid of. I just keep gitting meds after meds.This is awful I can't breath,my chest hurts,fever,nuasea and I sweat alot.Do youu think I should have them do another CBC and a LDH or will the LDH test be enough to show if it's cancer for sure? Thanks Doc. Mary
 Dr. Tamer Fouad - Sat Mar 04, 2006 10:34 am

User avatar Hello,

The problem with tests like LDH is they are notoriously not specific. It may help though. Have you discussed the possibility of a CT scan. Another radiological procedure is a PET scan although that is not usually available. PET scans can tell if you have an underlying malignancy or not.

Sorry, I know it seems a little late to ask this but could you provide your age and if you have any details on your previous illness (NHL), such as pathology report? stage? From what I gather your pneumonia has been with you since 15/1/2006?

Thank you.
 jypsy_rose_lee - Sat Mar 04, 2006 12:55 pm

Dear doc,
Again, thank you for your infomation, no need to apoligize. I am 40 years old, in 2000 I had a knot that developed on my neck,I started gitting sick with pnuemonia like symptoms,I went to the doctor"s office,was told I had pnumonia,They said the knot was from they pnuemonia settleling in my lypnodes.I begain to wonder though after about a month why the knot hadn't went away since I had been on antibiotics.I became persistant with the doctor to find out,they did xrays and a catscan and said I had stage 2 Anaplastic large B cell lymphoma in my lungs and neck.I only had 8 cycles of Chops one cycle every third week which wasn't so bad,compared to other people who had it found at a later stage.The symtoms then, before it was diagnosed weren't as debiliatating as these symptoms.I don;t recall having pain in my abdomin,back pain and nausea,I haven't had any swollen lympnodes,so that is why I'm hoping this is just pnuemonia,but still worried.I was told by someone who had non-hodgkins that a HDL test would show if there was reasons to suspect lymphoma. My exrays that I had two months ago didn't show anything but puemonia.Are pet scans very exspensive?I trust your advice and knowlege,Thank you Mary
 jypsy_rose_lee - Mon Mar 06, 2006 1:16 am

I'm sorry I forgot to ask you one more thing,I noticed on my hematology report it states smear review 1555 confirms auto-diff.
could you tell me what this may mean please.Thamk you so very much doctor. Mary
 jypsy_rose_lee - Thu Mar 09, 2006 12:36 am

Dear doc,
I don't beleive this,I still feel very sick,shortness fo breath is worse.I went to ER not needing another bill, they didn't do a CBC or exrays,they just said I didn't have enough meds to finish off the pnuemonia and gave me more.I have been trying to git some insurance.I'm still hoping this isn't lymphoma. Mary
 Dr. Tamer Fouad - Thu Mar 09, 2006 1:04 pm

User avatar Hello Mary,

I am sorry to hear you are still suffering. Please understand that it isn't impossible that your pneumonia is not responding because you aren't taking sufficient medication. This is a viable possibility.

I would suggest that you discuss the possibility of a CT scan with your doctor to resolve this issue. Unfortunately, your current symptoms do not point in a certain direction.

Best regards.
 jypsy_rose_lee - Fri Mar 10, 2006 11:43 pm

Dear Doc.Fouad
I started passing blood in my urine,amd my skin is yellow I went yesterday to a different hospital and had a ctscan done, I have cancer again,thay aren't sure what type but they beleive it is lymphoma it's in my lungs liver and possiblely my spleen,I have to start chemo tomarrow. Thanks a lot for advice.
 Dr. Tamer Fouad - Sat Mar 11, 2006 8:14 am

User avatar Good luck with the chemotherapy jypsy_rose_lee. I wish you a quick and uneventful recovery.
 jypsy_rose_lee - Mon Mar 20, 2006 2:18 am

Well Iam home safe and sick without my heaing.I would have deid had I not went to the other hospital. I had to be put on oxygen as soon as I arrived.I had stage four diffuse large B cell lymphoma.I had to have four straight days 24 hours aday of strong chemo{decadron,high-dose ara-c, and cisplatinum with rituximab] I went to an ear specialist and he said I have 75% irreversible hearing damage done to me.The oncoligist said it was from the ara-c but he said he only used 225 cc's or mg's
I will never listen to doctors again untill they rule out lymphoma first.The blood work I had the other day was abnormal on all counts the four times thst I saw these doctors,they only did blood work once and that was three months ago.Now I have to have a stemcell transplant. Mary
 jypsy_rose_lee - Mon Mar 20, 2006 11:07 pm

If anyone has had simular side affects from these type of chemo drugs,I'd really like to hear from you.My email at Outlook express isn't recieving mail for some reason.You can email me at jypsy_rose_lee@yahoo.com. Thanks
 Dr. Tamer Fouad - Tue Mar 21, 2006 1:04 am

User avatar Hello Mary,

I am sorry to hear that you've had a difficult experience with chemotherapy. Unfortunately, Ara C (Cytosar) can lead to nerve damage (neuritis) in rare cases. Its a known side effect that happens only rarely. This is just very unfortunate given all you have been through already.

We all truely wish you a quick recovery here at The Doctors Lounge.

Best regards.
 jypsy_rose_lee - Tue Mar 21, 2006 1:33 am

Thank you doctor for the kind words.It has been difficult to deal with,good thing I injoy using the computer because I can't hear the TV.

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