Medical Forum / Diseases and Disorders / Cancer / June 2004
What is "lymphoma in bone"?
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Robin - 23 Jun 2004 09:06 GMT My brother is two years out from stem cell transplant, initial diagnosis Stage 4, aggressive non-hodgkins lymphoma. Over the last 3-4 mos., he's had cat scan, bone marrow biopsy, both of which had clean results, and bloodwork once a month (there's been a pattern of high red cell count, then low). He's been receiving epogen shots over the last few months because of frequent colds and flu.
He also has peripheral neuropathy was increased in duration and severity and since approx 4 mos ago, its every night, and during day, he calls it excruciating pain. Neurontin did not help. I have purchased him every gel and cream available, and recently a foot spa and shiatsu massager which helps somewhat but very temporarily. He is usually using both several times a day.
He's also been getting fevers. His oncologist ordered a Pet scan; results a higher index is showing which looks "suspicious". If my brother had another diagnosis, it might be due to that but since lymphoma is his only (known) diagnsis, the doctor suspects a recurrence. He will be ordering a cat scan and needle biopsy over the next couple of weeks.
He mentioned something about some indication of a different kind of lymphoma in the bone. This is what I'm writing to ask - what is lymphoma in the bone? In doing online research, leukemia is often mentioned. Is that what lymphoma in the bone is? I've been doing searches on symptoms of bone lymphoma but only come up with general early symtoms of lymphoma. Search results also include "....if lymphoma in bone is primary diagnosis, then...". What would "primary diagnosis" mean? That this is first diagnosis of any cancer, or the only one active?
If any of you had/have bone lymphoma, did you have symptoms of burning in bottoms of feet (ball of foot)? Deep ache in lower legs? leg cramps? Jaw and/or hand cramps? And pain in side of torso when turn to that direction? These are all the symptoms he's been having lately, along with fever.
would appreciate any feedback.
Robin
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J - 23 Jun 2004 11:22 GMT > <snipped> > [quoted text clipped - 15 lines] > > <snip> Hi Robin,
http://www.worldortho.com/database/etext/lymphoma_of_bone.html Malignant lymphoma of bone is morphologically similar to the lymph node counterparts ie Non Hodgkins or Hodgkins (rare). When malignant lymphoma is responsible for a bone lesion it may be -
1. A primary osseous lesion with no distant disease. 2. Multiple skeletal sites but no involvement of any soft tissue. 3. A bone lesion with involvement of other soft tissue sites eg spleen, liver, lymph nodes.
Primary osseous lymphoma is rare - 3% of bone tumours. In clinical cases of lymphoma, involvement of the bone is unusual but at autopsy 20% show bone involvement.
http://www.lymphomainfo.net/nhl/types/bone.html Primary Lymphoma of Bone Lymphomas can arise from most any lymphatic tissue (lymph nodes, spleen, thymus, mucosa associated lymphoid tissue (MALT)). It is hard to believe but the bones are an important part of the lymphatic process: the "B" in white b-cell is for cell maturation in the bone marrow. Lymphomas (Nonhodgkin's mostly, rarely Hodgkin's lymphoma) can start in the bone. These lymphomas are all quite rare, 3% of bone tumors. The lymphoma can be an aggressive one or an indolent form. These are not to be confused with lymphomas that have spread to the bone from other areas.
Lymphoma of bone strikes more men than women (4:3 ratio). They can occur at all ages but is rare in pediatric (childhood) patients. 20% of cases are adults in their 60s.
Symptoms The main symptom is localized pain which has been present for months if not years. The area of the primary tumor may be tender or swell. Fever and weight loss do not occur."
Robin - 23 Jun 2004 18:34 GMT > > <snipped> > > [quoted text clipped - 41 lines] > bone. These lymphomas are all quite rare, 3% of bone tumors. The lymphoma > can be an aggressive one or an indolent form. These are not to be confused
> with lymphomas that have spread to the bone from other areas. Regarding the sentence above - my brother has been in remission since stem cell transplant for 2 yrs. If he does have it in the bone now, does that mean its considered "primary" or that the lymphoma has spread to the bone from lymph nodes? BTW, thank you so much for researching this.
(You may have read my other posts about sister-in-law with recent breast cancer diagnosis, asking if lumpectomy and mastectomy are painful. This is my brother's wife). Both have brain disorders. I wonder what its like to live a charmed existence, or perhaps that's just a myth. Robin
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J - 23 Jun 2004 22:43 GMT > > http://www.lymphomainfo.net/nhl/types/bone.html > > Primary Lymphoma of Bone [quoted text clipped - 13 lines] > that mean its considered "primary" or that the lymphoma has spread to > the bone from lymph nodes? BTW, thank you so much for researching this. Thanks Robin, As Steph said lymphoma can occur anywhere in the body. If you read the above (further up), the B-cells are in the bone marrow, bone marrow is part of the lymph system, so it seems to be true that it spreads through the lymph system. So I would think since he was declared NED, if he does have it, it would be considered a recurrence, but I'm not an expert. And it's very confusing right now, because part or all of it could be neuropathy but perhaps something else is going on there.
When I was looking up muscle cramps, one web site mentioned lactic acid. I know lactic dehydrogenase LDH is involved in lymphoma somehow or one of the tests. (but I don't know if there's a connection between one and the other). I was going to suggest one of those sports drinks that resets the electrolytes, but I think that should be checked with his doctor first. I sure hope they find a way to help him feel better soon and get some answers for you all. I'll be thinking of you.
> (You may have read my other posts about sister-in-law with recent breast > cancer diagnosis, asking if lumpectomy and mastectomy are painful. This > is my brother's wife). Both have brain disorders. I wonder what its > like to live a charmed existence, or perhaps that's just a myth. Well, I think it's a myth, because when we "dig deeper" with people, we find out that many people have troubles (money, health, kids, jobs etc). However, it's a shame that so many health troubles are in your family. They're very fortunate to have you looking out for them and inquiring on newsgroups about their health issues. But you take care of you too. ok? Hugs J
Robin - 24 Jun 2004 05:24 GMT > > > http://www.lymphomainfo.net/nhl/types/bone.html > > > Primary Lymphoma of Bone [quoted text clipped - 56 lines] > Hugs > J Hi J, Thank you so much. It's interesting that you mentioned it could be neuropathy, because that's what I'm thinking. He just had a bone marrow biopsy about 1 month ago, all was ok. But his neuropathy has gotten progressively worse. His oncologist feels 50/50 chance its lymphoma recurrence. He also told my brother that, if recurrence, because he's 2 years past stem cell transplant, that he can be treated with medication and perhaps chemo. If there had been a recurrence shortly after stem cell transplant, he wouldn't have been able to receive the treatments he would if it happens now. Again thanks. Will keep everyone posted. Robin
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J - 24 Jun 2004 08:31 GMT > <snip> > Hi J, [quoted text clipped - 3 lines] > progressively worse. His oncologist feels 50/50 chance its lymphoma > recurrence. Well what's it going to take to know? More tests or time and then more tests? Somethings got to be done about his neuropathy. Poor guy, he sounds like he's in quite a bit of discomfort. Maybe somebody (one of his doctors) has to review his meds and see what they can do with that. Or maybe palliative care (hospice) could have a look at his file and his meds and make some practical suggestions?
> He also told my brother that, if recurrence, because he's 2 > years past stem cell transplant, that he can be treated with medication > and perhaps chemo. Well, that's good news to hear Robin.
> If there had been a recurrence shortly after stem > cell transplant, he wouldn't have been able to receive the treatments he > would if it happens now. Again thanks. Will keep everyone posted. Okay, thanks, will watch for your update, J
Robin - 24 Jun 2004 18:27 GMT > > <snip> > > Hi J, [quoted text clipped - 5 lines] > > Well what's it going to take to know? Cat scan and Biopsy scheduled over the next two weeks.
> Somethings got to be done about his neuropathy. Yes. That's why his oncologist ordered the Pet scan, at least that's what he told my brother to not alarm him (he has a brain disorder and scares easily). His oncologist told me a couple of months ago that something's "fishy", meaning monthly blood test results, my brother's various symptoms of frequent colds/flu/fever. That's why he had bone marrow biopsy a month ago, came out clean. Could that biopsy have missed something that is now showing up in Pet scan? His doctor said that because my brother was tolerating the biopsy well, he got in there real good to get a good sample. That's why I'm thinking (and hoping, of course) that this is neuropathy, or some other condition yet undiagnosed rather than recurrence.
Poor guy, he sounds like he's
> in > quite a bit of discomfort. > Maybe somebody (one of his doctors) has to review his meds and see what they > can do > with that. He's not on any meds related to cancer/red or white cells. Most are related to brain disorder and anxiety, blood pressure and cholesterol. The only new med and/or change took place 4-5 mos ago switching from Lexapro (antidepressent/anxiety) to Effexor.
> Or maybe palliative care (hospice) could have a look at his file and his meds > and > make some practical suggestions? That's an idea.
Robin
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Steph - 24 Jun 2004 02:21 GMT > > > <snipped> > > > [quoted text clipped - 49 lines] > that mean its considered "primary" or that the lymphoma has spread to > the bone from lymph nodes? BTW, thank you so much for researching this. Almost certainly this is recurrent, rather than new.
> (You may have read my other posts about sister-in-law with recent breast > cancer diagnosis, asking if lumpectomy and mastectomy are painful. This > is my brother's wife). Both have brain disorders. I wonder what its > like to live a charmed existence, or perhaps that's just a myth. > Robin J - 24 Jun 2004 08:08 GMT > "Robin" <robinxjoy@yahoo.com> wrote in message > > <snip> [quoted text clipped - 10 lines] > > Almost certainly this is recurrent, rather than new. Thanks Steph, I can see your message. Not sure if Robin can or not. J
Robin - 24 Jun 2004 18:27 GMT > > "Robin" <robinxjoy@yahoo.com> wrote in message > > > <snip> [quoted text clipped - 14 lines] > I can see your message. Not sure if Robin can or not. > J I saw it. Robin
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J - 23 Jun 2004 11:41 GMT > My brother is two years out from stem cell transplant, initial diagnosis > Stage 4, aggressive non-hodgkins lymphoma. Over the last 3-4 mos., he's [quoted text clipped - 32 lines] > that direction? These are all the symptoms he's been having lately, > along with fever. It's hard to know what is going on there, Robin. We'll watch for your updates and hope it isn't a recurrence. Hugs J
Steph - 23 Jun 2004 16:22 GMT > My brother is two years out from stem cell transplant, initial diagnosis > Stage 4, aggressive non-hodgkins lymphoma. Over the last 3-4 mos., he's [quoted text clipped - 36 lines] > > Robin Lymphoma can set up shop anywhere. Lymphoma in bones is not uncommon in aggressive NHL. It isn't leukaemia.
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