PET Scan Result Help

Portal Forums Cancer Basics Imaging Issues PET Scan Result Help

This topic contains 1 reply, has 2 voices, and was last updated by catdander forum moderator catdander forum moderator 2 weeks, 5 days ago.

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March 7, 2017 at 8:17 am  #1290283    

mcbenton

Good morning, everybody. My husband was recently diagnosed with Stage IIIB Hodgkin’s Lymphoma. His mother obtained a copy of the PET scan findings and is panicking over them, convinced that her son is actually Stage IV and that he needs a second opinion. I think she’s reading the results out of context. I’ll post as many of the line items as I can below.

Diagnosis: Hodgkin lymphoma of extranodal or solid organ site (HCC) [C81 .99 (ICD-10-CM))

Reference value mediastinal blood pool SUV (max) = 1.9.
Reference value liver parenchyma SUV (max) = 2.4.

Skull base/Neck: There is moderately intense abnormal FOG uptake within scattered bilateral level 3, 4, and
supraclavicular adenopathy (the largest single lymph node measuring 1.5 x 1.8 cm); SUV (max)= 6.0
consistent with metastatic neoplasm.

Chest: There is intense abnormal FOG uptake with in scattered left axillary/subpectoral adenopathy (the largest single lymph node measuring 1.0 x 1.5 cm); SUV (max)= 10.8 consistent with metastatic disease.

There is moderately intense abnormal FOG uptake throughout the mediastinum and hilar regions bilaterally
involving ATS nodal stations 1, 3, 2R, 2L, 4R, 5, 6, 7, 1 OR, 11 R, 1 OL, and 11 L (the largest single lymph node measuring 1.8 x 2.8 cm); SUV (max) = 6.5 consistent with metastatic disease.

Osseous structures: Bone scintigraphy is more sensitive for detection of osteoblastic metastatic disease and PET more sensitive for osteolytic lesions, suggesting the imaging modalities should be regarded as
complementary, and should not replace each other. Otherwise, no evidence of malignant glucose activity.

I think his mother is triggering on the words “metastatic” and “solid organ” in the findings. Am I safe in assuming that the diagnosis is correct and that the prescribed treatment (ABVD) is the right one in this case? (Note: there were other findings, but they were similar to the above. I ran out of space.) I’m hoping to talk her off the ledge, so to speak.

March 7, 2017 at 7:32 pm  #1290287    
catdander forum moderator
catdander forum moderator

Hi McBenton,

Welcome to Grace. I’m so sorry your husband is going through this as well as you and his mom. You’re right that a scan alone doesn’t tell the whole story. Enlarged lymph nodes don’t necessarily mean they are cancer. It’s quite normal for lymph nodes to become enlarged when fighting off disease.

I’m sorry this isn’t an appropriate venue in which to make suggestions of what a scan report means. The report would need to be put into context with other findings by an oncologist to make determinations about diagnosis.

I don’t think any of that matters because treatment is usually the same for stage III and IV including ABVD.

From cancer.org, “Stages III and IV…Doctors generally treat these stages with chemotherapy using more intense regimens than what is used for earlier stages. Although ABVD (for at least 6 cycles) can be used, some doctors favor more intense treatment with the Stanford V regimen for 12 weeks, or even the BEACOPP regimen if there are several unfavorable prognostic factors.”

https://www.cancer.org/cancer/hodgkin-lymphoma/treating/by-stage.html

It may come down to what your husband is most comfortable doing and that may include getting a second opinion to settle his mom’s worries. A 2nd opinion is really never a bad idea.

I hope he does very well with treatment.
All best,
Janine


My husband, 8/09 53 @ dx stage III squam nsclc R. pancoast tumor
Destruction of 3 ribs, touching brachial plexus.
6/09-8/09 2 core and 1 VATS undx biopsies. Open thoracotomy for 1 positive biopsy (unresectable)
9/09 Chemo/rads curative intent
11/09 MRI by pancoast specialist surgeon spine met found undiagnosed Rad to spine, Chemo continued thru 6 cycles
Tarceva maintenance 2/10
11/10 3cm tumor L lung, undx core bx w/collapsed lung. Gemzar, 12/10 through 7/12
NED 3/12, stop tx 7/12. Remains NED as of 9/16
Unanswerable question. Was it ever metastatic?

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