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Excisional biopsy today after pos FNA report rt groin

Stalyn's picture
Stalyn
Posts: 13
Joined: Oct 2013

After having a +FNA report of rt groin, my surgeon took out groin node immediately ( same week).

surgery went well & he tells my family it's benign but he has to send it off for path report. 

My question is, how would he know it was benign by looking? I thought lymphoma was dx By path report only???

any replies greatly appreciated. 

needadvice1911
Posts: 17
Joined: Oct 2013

I hope you're doing well.  I'm in a similar situation as you.  Just a few steps behind.  You will find the people here to be very strong and supportive.  I hope that all goes well and the path report comes back negative.  Just ou of curiosity, what lead to the FNA?  Did you have any symptoms leading up to this?  I ask because I have a node in right groin that has been enlarged for months.  Ultrasound says benign but it's still there.  After three months I went back for full blood work and new scans.  I'm awaiting results.  Just wondering what got your doc to suggest in the first place.

needadvice1911
Posts: 17
Joined: Oct 2013

I hope you're doing well.  I'm in a similar situation as you.  Just a few steps behind.  You will find the people here to be very strong and supportive.  I hope that all goes well and the path report comes back negative.  Just ou of curiosity, what lead to the FNA?  Did you have any symptoms leading up to this?  I ask because I have a node in right groin that has been enlarged for months.  Ultrasound says benign but it's still there.  After three months I went back for full blood work and new scans.  I'm awaiting results.  Just wondering what got your doc to suggest in the first place.

Stalyn's picture
Stalyn
Posts: 13
Joined: Oct 2013

My hip has been hurting for a long time. Then I noticed it felt like I pulled my groin, which I knew I didn't. 

So ultrasound showed enlarged node, not really big, but borderline. I think it measured 1.6 x1.0....as far as looking abnormal I don't know, that wasn't mentioned. Looked ok to  me. 

Had a CT scan which showed 3 enlarged nodes.....rest of abdominal Ct ok.

So I got a shot of rocephin & 7 days of antibiotics. N still there. Family dr was gonna pass the buck, So I bypassed him & made an appt w a local surgeon. he had an ultrasound machine there in the office and decided he would biopsy it then & there. He didn't look or act like he thought anything was wrong tho. So I was satisfied he was looking into it. 

7 days later I called the office n the nurse says, "there's a note on your chart to come back in n schedule excisional biopsy"

they done it 4days later (yesterday)

the surgeon told us the FNA showed possible lymphoma. But after excision he said it appeared benign to him. Would send it off though. 

from what I understand, pathology is only way to tell. ? 

 

Waiting for results. 

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 1039
Joined: May 2012

Stalyn,

Welcome to this Lymphoma Board. 

You are correct:  No doctor can "look" at a biopsy sample and know for certain if it is cancerous or not.  It is actually a pretty outrageous and irresponsible comment to make.  He might have a lot of experience, and there may be some objective differences in how a non-cancerous node looks verses a cancerous one, but he cannot say that with certainty.

Heck, many people here have had to undergo numerous biopsys and extensive testing to get the strain of lymphoma that they have diagnosed correctly. Many have related having been treated for the wrong lymphoma for some time, before subsequent tests got them on the right track.  This is NOT COMMON, but it does happen, and it demonstrates that cancerous lymphatic tissue requires careful lab analysis.

I do hope you are negative.  Your CT, fortunately, proves that if it is lymphoma, it is not very widespread at this point -- a good thing. 

Bless your results,

max

Rocquie's picture
Rocquie
Posts: 478
Joined: Mar 2013

Welcome to you, I am glad you found us. I can just imagine how you are feeling right now--really, I can. Waiting for test results is extremely nerve racking, especially when you have already been told some potentially scary news.

First of all I want to assure you that, if you do have lymphoma, it is very treatable and not like other types of cancer. So many advances have been made and lymphomas have been classified into so many catagories, with very targeted therapies for each type. I say this to warn about too much internet reading at this point.

My diagnosis was also in phases. Mine started with an "abnormal" chest xray which was ordered because I was having trouble breathing. That lead to a CT scan (of the chest area) which showed many enlarged lymph nodes. I was told, by my family doctor, because I also had many classic symptoms, that I had lymphoma. (I had no idea what that meant). A more extensive CT scan was ordered along with a needle biopsy which confirmed the diagnosis. That was the point I was referred to a Hemotologist/Oncologist and he ordered an entire (underarm) lymph node removed and biopsied.

That lymph node removal was not for diagnosis of lymphoma, per se, but rather to determine what type of lymphoma I had.

I cannot speak about a surgeon telling you that a biopsy showed "possible lymphoma" but a lymph node "appeared benign".  I can only tell you what my own experience has been.

I will take a moment, however, to emphasize the importance of having someone with you for any and all discussions with doctors (and other medical professionals). Have them write things down. Also ask for copies of all reports, lab tests, pathologies, scans, everything. Everything. Don't be shy about asking. Or have your advocate ask. Or both. As patients, we are often scared and confused, or sedated, and it is very difficult to hear everything correctly, much less remember.

Even now, call the doctor's office and ask for copies of the reports you are worrying about.

Again, welcome to our group. You will find many caring people here who have been there too. Come here as much as you need to or want to.

Many hugs to you,

Rocquie

 

 

Stalyn's picture
Stalyn
Posts: 13
Joined: Oct 2013

I'm not exceptional at putting my thoughts into words, but to try n clear up my question here goes.............

lit is my understanding that fine needle aspirations (FNA) done in dr office can yield false negatives but not false positives. 

If you get a positive result, then they take out the whole node for staging. 

 

Is this right?

 

Rocquie's picture
Rocquie
Posts: 478
Joined: Mar 2013

Stalyn, I'm sorry I can't answer your question. I may be wrong, but I think you are making some sweeping generalities here. It seems to me that biopsies could be either false positive OR false negative. Pathologists are humans too and readings can sometimes be very close and difficult. It is not unusual to get second pathology opinions (I had 3). Pathologists themselves often ask for them.

And no, I don't believe the statement that the entire lymph node is removed after a positive biopsy is true either. Sometimes, lymphomas are in places where it is difficult if not impossible to surgically remove.

I really am so, so sorry that you are filled with so much worry on the weekend, when you can't get clarification. You can ask me anything you want and I will answer to the best of my ability and knowdedge.

(((Hugs)))

Rocquie

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 1039
Joined: May 2012

Stalyn,

The following is an academic, 59-page set of recommendations for the procurring and analysis of lymph node biopsies and specimens.  It is British, but US recommendations are most likely very similiar.  Since we discuss biopsy proceedures here quite frequently, it may be of interest to most of our members.  it is the most authoratative and detailed account on the subject that I could find.

The portions most relevant to your questin begin around page 6 in the document.

The most beneficial thing you can do at this point is trust your doctor, who by definition is an expert.  He or she will know how to interpret the results that come back.  Asking questions is good, but it has to be balanced with trust and confidence.    And a calm knowledge that you will be well.

max

http://www.bcshguidelines.com/documents/Lymphoma_diagnosis_bcsh_042010.pdf

GKH
Posts: 292
Joined: Jul 2012

I struggled with an uncertain diagnosis for almost two years. My blood has always looked good and my lymph nodes were were swollen but not greatly enlarged. Also my liver and spleen were marginally enlarged. Still I was sick and felt bad all the time. Then i had a golf ball sized lump on my shoulder. Surgery for that showed negative results but the handling was very suspect. The pathology request never mentioned cancer and simply said " verify cyst". I went to an onc who said I probably just had an infection.I had a PET scan but it was not definitive - marginally enlarged lymph nodes near my heart and kidneys with an above normal but not alarming SU value. After another 3 months of feeling awful I went to a surgeon and said " find out what this is". The plan was a laparscopic biopsy. I ended up on the table for 7 hours followed by 7 days in the hospital. Diagnosis was stage 4 FNHL with extensive scar tissue throughout my abdomen. Bone marrow biopsy showed  extensive bone marrow involvement (26%). Bottom line is please take charge, get a biopsy and learn the details. Your nodes are much more accessible than mine so it will be a breeze. My advice is get the details, find out if you have it and if so what type and get this most treatable form of cancer dealt with. If negative, start life with a fresh appreciation of good health. Either way you come out ahead.

Stalyn's picture
Stalyn
Posts: 13
Joined: Oct 2013

Wink

So much support here! thank you sooooooo much. 

Im gonna read the article today.  

Will keep everyone posted. 

 

# hugs

Stalyn's picture
Stalyn
Posts: 13
Joined: Oct 2013

Wink

So much support here! thank you sooooooo much. 

Im gonna read the article today.  

Will keep everyone posted. 

 

# hugs

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 1039
Joined: May 2012

GKH,

Your path to diagnosis is interesting. My new neighbor has been through a similiar struggle.  He had enlarged nodes in various areas, and went to a variety of non-oncologists for close to a year and was put on various antibiotics. None believed him to have cancer, but he went to an oncologist in the same practice where I was a patient, and was sent for a CT.  When the results came back, the oncologist told him she was sure he had lymphoma, at least Stage 3, but she sent him for a biopsy, which came back negative.  She also did a bone marrow test, which was also negative.  He has been in a "wait and see" pattern since, and I believe she has him come in once every six months.  It must be almost worse not knowing than having a definitve diagnosis.

My case was crystal clear from day one: The surgeon took a golf-ball sized node out of my armpit, and the results clearly showed exactly what type of HL I had.

max

girliefighter's picture
girliefighter
Posts: 206
Joined: Mar 2013

Stalyn,

I know that my FNA showed possible cancerous cells, but the ENT seemd slightly unconcerned until he did the biopsy of the entire swollen node...But i can tell you he was 100% honest with me in telling me that his knowledge on cancer wasn't that vast, he was a Ear, Nose and Throat specialist not an oncologist, so please bear in mind that this surgeon specializes in removing or repairing body parts and organs not diagnosing diseases. well, unless he has xray vision...lol...

see the fine needle aspiration is such a small sample size that it could or could not contain cancer cells in it while you could or could not have it, they could easily get a small sample from any of us on here who do have cancer and it may show no cells in that tiny area.

keep your chin up and we will hope for the best

XXXOOO

Carie

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 1039
Joined: May 2012

Stalyn,

After going through and reading the article today, I must agree with Carie's observations here.  The article mentions two or three times that aspiration biopsies are frequentily not accurate, usually because they do not contain a sufficient tissue sample.  This is especially true in rare cancers, or cases where more than one cancer strain is involved.  I was very interested, in that it specified my rare strain of cancer as one that is most commonly got wrong with a limited tissue sample.

It does appear that usually if a sample is insufficient or corrupted, the pathologist will be aware of that himself,  and will tell the oncologist that the test was inconclusive.  On the other hand, if the pathologist comes back and says that the strain is clear and that their is no ambiguity, then I would guess that the test was suitable and sufficient, but I would ask the doctor those questions. 

max

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 1039
Joined: May 2012

 

Heard anything yet, Stalyn ?

Stalyn's picture
Stalyn
Posts: 13
Joined: Oct 2013

FNA report 10/8/13 

says "small mature lymphatic cells" noted in mono ssheets

 

excisional biopsy 10/18/13

says "benign findings"

 

i am NOT at all "OK" with these 2 conflicting reports!!! ???.

I have had MDAnderson retrieve them. One of their physicians has sentoot to medical director. 

Hope to hear something Monday. 

 

anybody gone thru this????

 

Stalyn's picture
Stalyn
Posts: 13
Joined: Oct 2013

FNA report 10/8/13 

says "small mature lymphatic cells" noted in mono ssheets

 

excisional biopsy 10/18/13

says "benign findings"

 

i am NOT at all "OK" with these 2 conflicting reports!!! ???.

I have had MDAnderson retrieve them. One of their physicians has sentoot to medical director. 

Hope to hear something Monday. 

 

anybody gone thru this????

 

Stalyn's picture
Stalyn
Posts: 13
Joined: Oct 2013

No word still from md Anderson. 

Its been a long weekend. 

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 1039
Joined: May 2012

In all honesty, Stalyn, anyone who got your request at Anderson is most likely on the Links today, getting in some golf, or on the lake.  Few medical people anywhere worry about patients on the weekends, unless they are on duty somewhere.  This is probably especially true of staff asked by a third party for a second opinion. It will be on their back-burner.

Also, most likely they will send their analysis to your doctor, not you directly.  The good news is that at this point, no news is neither good nor bad.

I read what you forwarded regarding the earlier results, and could not readily see how they "disagreed."  The statement about  "small mature lymphatic cells" does not indicate cancer, that I am aware of, but let me stress that I have no medical training. The lymphatic system is ALWAYS full of lymphatic cells, of course.

I hope you hear something promptly Monday morning.  And I hope it is all "benign" in conclusion, again.

max

needadvice1911
Posts: 17
Joined: Oct 2013

Stalyn,

how are you?  I hope all is well.  Have you ever heard back from the doctors on what your diagnosis is?  I hope is clear on any cancer.

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 1039
Joined: May 2012

I heard from Stalyn a week or two ago that his tests all came back benign.  All results show no cancer.  I suppose he has moved on, which is understandable. 

Bless him !

 max

GKH
Posts: 292
Joined: Jul 2012

Your friends situation is exactly why I always encourage second and even third opinions.

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