Non-Hodgkin's lymphoma - CAT scan showed a prominent pancreatic tail adjacent the gastric fundus

Follow up:

Hi,

This is in addition to the comments made by Dr Dennis.

What was the indication for you to have had a splenectomy in the first place? What were your signs and
symptoms at that time?

Currently, you are naturally worried if the new findings in the latest CT scan could possibly represent non
Hodgkins lymphoma (NHL)relapse.

MRI is superior to CT in detecting subtle soft-tissue pathology. However, in your case, MRI would not clinch
the diagnosis, nor provide much additional information to your oncologist. To prove or disprove the relapse of
NHL, a biopsy or a cytology study is needed.  

As far as imaging studies are concerned, I feel that you may consider getting a PET (Positron Emission
Tomography) scan done. Tumor cells concentrate more glucose than normal cells. In PET scanning, radio-labelled
glucose is injected into the patient. If tumor is present, it shows up as a metabolically active spot as it
has a higher concentration of radio-active glucose in it. 

Thus in your case, a PET scan, ot a combined PET-MRI or PET-CT may give additional information to your
doctor.

What is the size of the new lesion detected in the pancreatic tail on CT? Do you have any history of pancreas
pathology (like pancreatitis, diabetes, etc)? Do you take alcohol? 

Currently do you have any of these signs/symptoms: fever, weight loss, weakness, sweating, abdominal
discomfort, or any swollen lymph glands?

It would be advisable to get a complete panel of routine blood tests, including LDH level estimation.

I was initially getting a CT for kidney stones and a mass in my spleen was incidentally found which led to
splenectomy (per MD, too dangerous to biopsy).  The pathology results were B-cell non-Hodgkin's lymphoma.
 CT scans since then (12/2006 x every 4 months) have shown enlarged lymph nodes in groin, but these are
reduced on most recent CT.  However, "prominence of the pancreatic tail noted adjacent to the gastric
fundus is now present.  I rarely imbibe with alcohol and have not had pancreatic symptoms.

This question is open for comments.  Please share your opinion.

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