My Son

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Karen Lynn - 23 Mar 2004 02:13 GMT

Hello Everyone,

I am the mother of a 40 yr. old son who last Friday was diagnosed with
Diffuse Large B Cell Lymphoma (DLBCL). He has a very large tumour in his
abdomen, aggressive, that is obviously growing daily--obvious to any one who
knows him. He also has a lump on his left elbow and a spot on his nose that
had previously (a few months ago) been diagnosed as basal cell carcinoma.

He has had a PET scan, a CT scan, a Gallium scan, blood tests and is having
a bone marrow aspiration on Thursday at Princess Margaret Hospital in
Toronto. They will start chemo this week too. No mention of radiation.

The oncologist describes his NHL as "intermediate". I've done lots of
research on the net to try to get the facts about the disease, but, as you
know, it's difficult to understand some of the terminology. I'd appreciate
some/any advice, and in particular, answers to these questions. Can anybody
help? The Dr. hasn't indicated any 'stage' but...

1) "the Ann Arbor staging system. In this system, a lymphoma's stage is
shown by the Roman numerals ranging from I to IV. The letter "B" is added
after the Roman numeral if the person has B-symptoms, such as fever, night
sweats, or weight loss." The Dr. said that my son is a "B", but he doesn't
exhibit *any* of these symptoms. His only symptom is pain (tumour pressing
on a nerve) which he is barely controlling with Tylenol 3s. Doesn't this
mean that his cancer should be classified as "A"?

2) Terminology:
What do these terms mean?
Intermediate-grade
Lymphoblastic
Primary effusion lymphoma
Serum lactate dehydrogenase (normal versus elevated) I understand that
this is determined by a lumbar puncture, but this has not yet been suggested
by the Dr.
Histiocytes
Immunoblastic
B-cell markers CD19, CD20, and CD22
Three major B-cell entities: centroblastic (CB), B-immunoblastic (B-IB),
and B-large cell anaplastic (Ki-1+), now termed anaplastic large cell
[CD30+], [B-ALC].

Thanks very much from anyone who knows more than me, many of you I'm sure.

Karen

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Sharon - 23 Mar 2004 02:03 GMT

"Karen Lynn" wrote in message
This may help explain a little better:
http://pleiad.umdnj.edu/hemepath/diffuse_large/diffuse_large.html

And this:
http://www.cmj.hr/index.php?P=2561

> 2) Terminology:
> What do these terms mean?
> Intermediate-grade

Includes diffuse, small, cleaved cell lymphoma and diffuse, large,
noncleaved cell lymphoma. These are more aggressive than low-grade
lymphomas, but they respond better to anticancer drugs.

> Lymphoblastic

Pertaining to the production of lymphocytes.

> Primary effusion lymphoma

http://www.thebody.com/Forums/AIDS/Cancer/Archive/lymphomas/Q148878.html

> Serum lactate dehydrogenase (normal versus elevated) I understand that
> this is determined by a lumbar puncture, but this has not yet been suggested
> by the Dr.

This is about children, but it may help:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?holding=npg&cmd=Retrieve&db=Pu
bMed&list_uids=10944136&dopt=Abstract

> Histiocytes

http://cancerweb.ncl.ac.uk/cgi-bin/omd?query=histiocytes

> Immunoblastic

http://cancerweb.ncl.ac.uk/cgi-bin/omd?query=immunoblastic+lymphoma

> B-cell markers CD19, CD20, and CD22

http://www.cancerresearch.org/antibodies2002/tomas_tedder.html

http://www.pathologyoutlines.com/cdmarkers.html#CD19

> Three major B-cell entities: centroblastic (CB), B-immunoblastic (B-IB),
> and B-large cell anaplastic (Ki-1+), now termed anaplastic large cell
> [CD30+], [B-ALC].

http://www.slz.nl/hora/protocol/appendices/nhlclas.htm

--
Take Care, Sharon Lane
http://www.rare-cancer.org

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Larry - 23 Mar 2004 04:01 GMT

Karen,

Unfortunately, I can't answer many of your questions. But:

1. I thought that any test that had "serum" in front of it was taken
from the blood (Serum Lactate DeHydrogenase or LDH).
2. The following characteristics:

B-cell markers CD19, CD20, and CD22
Three major B-cell entities: centroblastic (CB), B-immunoblastic (B-IB),

> and B-large cell anaplastic (Ki-1+), now termed anaplastic large cell

[CD30+], [B-ALC].

Will likely only be known either from biopsy of the tumors, bone marrow
biopsy, or biopsy of an affected lymph node. When they do the bone
marrow biopsy, ask the doctor if he will be doing a "cell-marker
analysis". It is also known as an Immunohistochemistry or
immunophenotyping. It requires the taking of additional samples from the
bone marrow so ask before. These are all techniques for identifying the
surface markers or antigens that exist on the cells within the bone
marrow (or within the tissue where the biopsy was taken from).

If I'm not mistaken:

Lymphoblastic
Immunoblastic

are adjectives that describe the morphology of the cells (or how they
look under the microscope). So this also would require either a biopsy
or bone marrow biopsy ... but they can be ascertained simply by
describing the way the cells look as opposed to conducting the special
testing mentioned above ... which requires finding the biochemical
markers in the cells.

Hope this helps.

Larry

> Hello Everyone,
>
[quoted text clipped - 40 lines]
>
> Karen

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Steph - 23 Mar 2004 04:54 GMT

> Hello Everyone,
>
[quoted text clipped - 40 lines]
>
> Karen

Karen,
take this list along and ask the oncologist, who is the only one with the
info needed to answer. The lactate dehydrogenase is measured on blood, not a
lumbar puncture.

NHL is a potentially curable disease, and he's being treated at one of the
best Centres in the world.

But ask the oncologist

Reply to this Message

Karen Lynn - 23 Mar 2004 07:06 GMT

Thank you so much Sharon, Larry and Steph. It's a great relief to get advice
and support from those who have first hand experience of cancer (or their
advocates). I'll follow your advice to the best of my abilities. The picture
is getting clearer.

Karen

> Hello Everyone,
>
[quoted text clipped - 40 lines]
>
> Karen

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