Pet scan with lymph node activity

Hi -- sorry to hear about the scan that was anything other than a slam dunk of no activity.  I've been on a year long adventure with PET scans, node measurement comparisons, and SUV upticks, etc., etc.  Mine ultimately resulted in  relapsed Hodgkins recently, but it sure took a while to get here.  The Covid situation slowed the process down a lot, and my version of HL is fairly indolent, so my doc was not in a rush to get to biopsy mode in case my PETs were actually just showing an infection or something that would resolve itself.  

It's not fun, and can wear on you and loved ones mentally.  If I have any worthwhile advice it would be to not "borrow trouble" by going down the mental path of worst case scenarios.  Just take it as it comes.  It's easier said than done, but if you can compartmentalize the Relapse Anxiety to a space in your head that you can visit from time to time, but not stay too long, like a trip to the in-laws or the dentist, you'll be happier in the long run.  Ultimately if you have faith in your oncologist, keep that faith and resist the urge to go down the rabbit hole of reading research studies online (if you have a tendency to do such a thing, which unfortunately I do). 

And, if this turns out to be a relapse, just remind yourself that there are a lot of treatment options out there and you'll have a extremely high likelihood of getting rid of it again!  But, I really hope that's not the case!! 

I'm an ENT nurse that works for a practice where we do ultrasounds and fine-needle biopsies about twice a month on lymph nodes, and other neck masses.  Just as others have said it is not a given that it is a relapse.  The majority are not cancerous. the score you gave is mildly suspicious.  During the ultrasound, the ENT physician should talk you through the process and tell you what they see.  If a fine-needle biopsy is warranted then they will numb the site with lidocaine (stick and burn) (normally done in the office).  They will normally make four needle passes to retrieve a good sample.  You will feel pressure, but normally the nurse or tech with the physician can give you a hand to squeeze.  That is one of my jobs.  Normally 5-7 business days for biopsy results.  Although depending on the workload of the lab (COVID) it could take a few days longer.  It is good that you are going in with your imaging disc.  Possible infection, you might need a different antibiotic, but the ENT will be able to address that for you.  Please know that I will be lifting you up in prayer. Please keep us updated after the ultrasound/fine-needle biopsy. 

Whatever is going on, these results do not shout 'lymphoma.' Far from it. Item #1, 'mildly enlarged', could be a lot of things. Item #2 means that there is a bit of thickening or swelling in the rear of your throat. Item #3 is 100% irrelevant to lymphoma. I doubt that most ENTs would order a biopsy based upon these results, but a patient can usually insist.

Hi,

Sorry to read your news... You say you were diagnosed with MZL "a while ago" - when was that, and were you ever treated for it? If I try to read in between the lines here, I would assume that you were treated with single-agent Rituximab so far.

If the new biopsy report only says "findings suspicious for B-cell lymphoma", it is possible that your oncologist will request another biopsy for more precise results before making any further moves.

As regards treatment this time, with the tumor being in your nasopharynx (did they biopsy your adenoids?), your oncologist may well opt for chemotherapy followed by some radiotherapy and possibly prophylactic  intrathecal methotrexate as well.

Do let us know how things go next Thursday.

PBL