Diagnosed with SLL and kidney cancer in 2016. CT of lung 1/2018 and PET/CT 3/9/18 from ears to thigh shows lung nodules doubled in size and number in 7 weeks with SUV uptake of 8.8 on the 14 mm nodule. Also 2 thyroid nodules 23 mm and 12 mm with intense FDG uptake. (2014 biopsy of 5mm thyroid nodule determined to be benign with increased lymphocytes). Also 1.7 cm on pelvis. Just wondering if anyone has seen CLL or Sll behave like this because I am hoping for this versus metastic kidney cancer.
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Judyanne
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Hi Chris, The surgeon wanted to do a node biopsy but the RCC specialist and I thought best to wait 7 weeks and do followup scan to see if growing which they have in size and number. She is planning to do biopsy of pelvis if mri looks cancerous and if doesn’t look cancerous biopsy the lungs. Response on kidney site is biopsy useless because can get false negative. However, I can avoid the surgery if biopsy is positive. I am concerned now though with how fast growing. Do you think I should go for the node re-section?
The 7 weeks have passed. Now going to do mri soon and needle biopsy of pelvis or lung. My ldh is always low, currently 85. Didn’t even think about Richters. Only enlarged node doctor can feel is spleen. Thank you. May need to do node re-section to get good answer.
There was a study recently looking at using PET and specifically SUV levels as a dignostic tool for transformation.. previous studies suggested an SUV on a node greater than 5 should trigger a biopsy, but the new study felt that 10- 12 range had a greater likelihood of transformation...
RT is very unlikely then, if you are feeling OK.. there is extra nodal.. outside the node Richter's, as in my case... and I presented with high normal LDH... its something to discuss with your hemetologist, who I hope he is in the loop currently...
Thank you. RCC specialist is going to call CLL specialist re: coordination for treatment of 2 different cancers and I will see my hematologist in 10 days and update him. Thanks for mentioning Richters.
Therefore, an interval increase in the standardized uptake value (SUV) in a nodal adenopathy raises the suspicion for RT, especially if above 5 SUVmax, and should be further investigated for histopathologic correlation. Furthermore, FDG-PET/CT serves the additional purpose of guiding the biopsy by identifying intensely metabolically active nodes that are more likely to demonstrate RT.
I don’t know how you do it all. I hope being on the other cancer site is helping you. I bet you are probably one of the most knowledgeable ones on the other site too. Thanks for the info.
No I'm totally ignoring the adenocarcinoma with the hope it will stop metastasising... actually I can't be treated for it at the moment, so no point in worrying about it...
I have CLL. My thyroid nodule was cancer so it had to all Be removed. Waiting to find out what the very tiny something in my lung was on my last scan. CLL does beget other cancers. We just have to keep monitoring ourselves. Xxx
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