@babu123
Welcome to Mayo Clinic Connect. Ideally, a non-Hodgkin lymphoma patient will see a hematologist/oncologist who is experienced in the this treatment. Your physician should be able to give you guidance and refer you. Have you spoken to your doctor about who he or she would recommend?
Colleen Young, Connect Director | @colleenyoung | May 19 10:04am
Welcome, @babu123. Please note that Mayo Clinic Connect is a public form. I removed the medical form attached with your post because it contains personal identifying information. If you would like to consider a second opinion with Mayo Clinic experts, please submit a request here: http://mayocl.in/1mtmR63
I agree with @pmm. Your care will likely be transferred to a hematologist specializing in oncology.
Welcome, @babu123. Please note that Mayo Clinic Connect is a public form. I removed the medical form attached with your post because it contains personal identifying information. If you would like to consider a second opinion with Mayo Clinic experts, please submit a request here: http://mayocl.in/1mtmR63
I agree with @pmm. Your care will likely be transferred to a hematologist specializing in oncology.
@babu123
Welcome to Mayo Clinic Connect. Ideally, a non-Hodgkin lymphoma patient will see a hematologist/oncologist who is experienced in the this treatment. Your physician should be able to give you guidance and refer you. Have you spoken to your doctor about who he or she would recommend?
The doctor is telling you to choose yourself, only saying that you will need chemotherapy, but the doctor has not clearly said that chemotherapy will be given by an oncologist or a hematologist. I'm confused who would be better? Or what will be the next treatment?
@babu123
There are oncologists who specialize in disorders of the blood. That’s the doctor you need. The treatment required will be unique to your medical needs. There are different types of non-hodgkins-lymphoma so getting an accurate diagnosis is your first step.
Ideally, you should have a specialist hematologist/oncologist who is very experienced in the treatment of this disease. I would recommend going back to your doctor and asking for a referral to an experienced referral.
Here is some information from the Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/non-hodgkins-lymphoma/care-at-mayo-clinic/mac-20375691
Will you share a bit more about your local resources?
Thanks for your advice. In fact all diagnoses are complete. Active B-cell non-Hodgkin lymphoma. My immunohistochemistry report is the immunohistochemistry results
CD20: Positive, expansive and powerful.
PAX 5: Positive, diffuse and strong.
CD 3: Negative
CD 10: Positive
BCL 6: Negative
MUM 1: Negative
What 67: 50%
Comment:
Immunohistochemistry staining supports diffuse large B cell lymphoma, activated B cell type.)
Treatment and surgery were performed by ENT surgeons. He gave me a list of few doctors and asked me to select from it. The list includes radiology oncologists, clinical oncologists, hematologists, all of whom can provide chemotherapy. Is it really true? What kind of specialist do I need?
Thanks for your advice. In fact all diagnoses are complete. Active B-cell non-Hodgkin lymphoma. My immunohistochemistry report is the immunohistochemistry results
CD20: Positive, expansive and powerful.
PAX 5: Positive, diffuse and strong.
CD 3: Negative
CD 10: Positive
BCL 6: Negative
MUM 1: Negative
What 67: 50%
Comment:
Immunohistochemistry staining supports diffuse large B cell lymphoma, activated B cell type.)
Treatment and surgery were performed by ENT surgeons. He gave me a list of few doctors and asked me to select from it. The list includes radiology oncologists, clinical oncologists, hematologists, all of whom can provide chemotherapy. Is it really true? What kind of specialist do I need?
Hi @babu123 It is true that all of the doctors you mentioned can order chemotherapy. But because of your diagnosis with B-cell non-Hodgkin lymphoma the specialist you should choose is a hematologist oncologist. A hematologist oncologist is a doctor who specializes in treating cancers of the blood. They have extra training in the blood system, lymphatic system, bone marrow, and cancers.
Is there a doctor on your list that states they are a hematologist oncologist?
It is Doctor Title * MBBS, FCPS (Hematology)
* Specialist in blood diseases, blood cancer and bone marrow transplant
* Professor, Hematology)
Is he a hematologist oncologist?
At this point I ran into another problem - I did the immunohistochemistry at another lab and the lab report came back different. I have no B cell non Hodgkin lymphoma!
I am enclosing yesterday's report
- [ ]
- [ ] Soft tissue, left parotid (biopsy): 1. Chronic sialadenitis, 2. Reactive lymphadenitis.
- [ ] Microscopic description: Sections from the lymph node reveal partial effacement architecture by multiple large nodular proliferations of atypical lymphocytes having large vesicular nuclei, with on an average > 15 centroblasts /HPF admixed with centrocytes.
- [ ] Immunohistochemistry (IH-811/24):
- [ ] IC is done on the Lymph node section. The following immunophenotype is noted-
- [ ] • CD20
- [ ] : CD10
- [ ] • BCL6
- [ ] : cyclinD:
- [ ] • •
- [ ] CD23
- [ ] Ki67
- [ ] : Positive in the neoplastic follicles and the focally in
- [ ] the inter-follicular area
- [ ] : Positive in the inter-follicular area
- [ ] : Positive in the neoplastic follicles and focally in the
- [ ] inter-follicular area
- [ ] : Negative
- [ ] : Negative in the large nodules
- [ ] : Negative
- [ ] : Negative in the large nodules
- [ ] : Positive cells are mostly confined in follicular centers
- [ ] Comment: Lymph node (biopsy): Though BCL2 is negative the morphological and other IHC findings are suggestive of Follicular lymphoma, Grade 3
- [ ] Note: BCL2 may be negative in grade 3 follicular lymphoma. Please correlate
- [ ] with molecular studies for follicular lymphoma
What do I do now? I went to the hematologist mentioned above, he asked for a sample test review and a PET scan. Am I on the right track? Will it be too late to take my treatment? Cancer will not spread? I am confused! What should I do?
@babu123
Here in the United States a hematologist who specializes in blood cancer and is trained in that area would be a hematologist/oncologist. If you have a blood cancer or a precursor to a blood cancer, then that would be your guy or gal.
You need physician guidance to know what your next steps should be. Your physician should answer all of your questions and you have some very good questions.
As a patient forum, you will find that there are people who have similar lab results, but we are each unique in presentation, symptoms, and treatment.
Do you have the opportunity to consult with your physician and ask these pertinent questions?
@babu123
Here in the United States a hematologist who specializes in blood cancer and is trained in that area would be a hematologist/oncologist. If you have a blood cancer or a precursor to a blood cancer, then that would be your guy or gal.
You need physician guidance to know what your next steps should be. Your physician should answer all of your questions and you have some very good questions.
As a patient forum, you will find that there are people who have similar lab results, but we are each unique in presentation, symptoms, and treatment.
Do you have the opportunity to consult with your physician and ask these pertinent questions?
Let me tell you a bit about the past — I had a little swelling on my face near the left ear for the past two years, there was no pain, but from last month it started swelling under the throat, so I went to the ENT specialist. Before the operation, the ENT surgeon said that it was a lymph node tumor. After the operation, I found out that it was not a tumor, but lymphoma. Soft tissue, left parotid samples were sent to 2 laboratories for biopsy and the reports were different, 2 samples were immunohistrochemstry and the reports were also different, one showed B cell non-Hodgkin lymphoma, the other one showed follicular lymphoma, I have added two reports earlier. Last week I went to the hematologist, he said that after analyzing my physical symptoms, he thought it could not be B cell non-Hodgkin lymphoma, so he asked to send the sample to a neighboring country for review and advised me to take PET scan and treatment until the report comes. But I am afraid that I will get the right treatment?
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@babu123
Welcome to Mayo Clinic Connect. Ideally, a non-Hodgkin lymphoma patient will see a hematologist/oncologist who is experienced in the this treatment. Your physician should be able to give you guidance and refer you. Have you spoken to your doctor about who he or she would recommend?
-
Like -
Helpful -
Hug
2 ReactionsWelcome, @babu123. Please note that Mayo Clinic Connect is a public form. I removed the medical form attached with your post because it contains personal identifying information. If you would like to consider a second opinion with Mayo Clinic experts, please submit a request here: http://mayocl.in/1mtmR63
I agree with @pmm. Your care will likely be transferred to a hematologist specializing in oncology.
-
Like -
Helpful -
Hug
1 ReactionThanks a lot
-
Like -
Helpful -
Hug
1 ReactionThe doctor is telling you to choose yourself, only saying that you will need chemotherapy, but the doctor has not clearly said that chemotherapy will be given by an oncologist or a hematologist. I'm confused who would be better? Or what will be the next treatment?
@babu123
There are oncologists who specialize in disorders of the blood. That’s the doctor you need. The treatment required will be unique to your medical needs. There are different types of non-hodgkins-lymphoma so getting an accurate diagnosis is your first step.
Ideally, you should have a specialist hematologist/oncologist who is very experienced in the treatment of this disease. I would recommend going back to your doctor and asking for a referral to an experienced referral.
Here is some information from the Mayo Clinic.
https://www.mayoclinic.org/diseases-conditions/non-hodgkins-lymphoma/care-at-mayo-clinic/mac-20375691
Will you share a bit more about your local resources?
-
Like -
Helpful -
Hug
1 ReactionThanks for your advice. In fact all diagnoses are complete. Active B-cell non-Hodgkin lymphoma. My immunohistochemistry report is the immunohistochemistry results
CD20: Positive, expansive and powerful.
PAX 5: Positive, diffuse and strong.
CD 3: Negative
CD 10: Positive
BCL 6: Negative
MUM 1: Negative
What 67: 50%
Comment:
Immunohistochemistry staining supports diffuse large B cell lymphoma, activated B cell type.)
Treatment and surgery were performed by ENT surgeons. He gave me a list of few doctors and asked me to select from it. The list includes radiology oncologists, clinical oncologists, hematologists, all of whom can provide chemotherapy. Is it really true? What kind of specialist do I need?
Hi @babu123 It is true that all of the doctors you mentioned can order chemotherapy. But because of your diagnosis with B-cell non-Hodgkin lymphoma the specialist you should choose is a hematologist oncologist. A hematologist oncologist is a doctor who specializes in treating cancers of the blood. They have extra training in the blood system, lymphatic system, bone marrow, and cancers.
Is there a doctor on your list that states they are a hematologist oncologist?
-
Like -
Helpful -
Hug
2 ReactionsIt is Doctor Title * MBBS, FCPS (Hematology)
* Specialist in blood diseases, blood cancer and bone marrow transplant
* Professor, Hematology)
Is he a hematologist oncologist?
At this point I ran into another problem - I did the immunohistochemistry at another lab and the lab report came back different. I have no B cell non Hodgkin lymphoma!
I am enclosing yesterday's report
- [ ]
- [ ] Soft tissue, left parotid (biopsy): 1. Chronic sialadenitis, 2. Reactive lymphadenitis.
- [ ] Microscopic description: Sections from the lymph node reveal partial effacement architecture by multiple large nodular proliferations of atypical lymphocytes having large vesicular nuclei, with on an average > 15 centroblasts /HPF admixed with centrocytes.
- [ ] Immunohistochemistry (IH-811/24):
- [ ] IC is done on the Lymph node section. The following immunophenotype is noted-
- [ ] • CD20
- [ ] : CD10
- [ ] • BCL6
- [ ] : cyclinD:
- [ ] • •
- [ ] CD23
- [ ] Ki67
- [ ] : Positive in the neoplastic follicles and the focally in
- [ ] the inter-follicular area
- [ ] : Positive in the inter-follicular area
- [ ] : Positive in the neoplastic follicles and focally in the
- [ ] inter-follicular area
- [ ] : Negative
- [ ] : Negative in the large nodules
- [ ] : Negative
- [ ] : Negative in the large nodules
- [ ] : Positive cells are mostly confined in follicular centers
- [ ] Comment: Lymph node (biopsy): Though BCL2 is negative the morphological and other IHC findings are suggestive of Follicular lymphoma, Grade 3
- [ ] Note: BCL2 may be negative in grade 3 follicular lymphoma. Please correlate
- [ ] with molecular studies for follicular lymphoma
What do I do now? I went to the hematologist mentioned above, he asked for a sample test review and a PET scan. Am I on the right track? Will it be too late to take my treatment? Cancer will not spread? I am confused! What should I do?
@babu123
Here in the United States a hematologist who specializes in blood cancer and is trained in that area would be a hematologist/oncologist. If you have a blood cancer or a precursor to a blood cancer, then that would be your guy or gal.
You need physician guidance to know what your next steps should be. Your physician should answer all of your questions and you have some very good questions.
As a patient forum, you will find that there are people who have similar lab results, but we are each unique in presentation, symptoms, and treatment.
Do you have the opportunity to consult with your physician and ask these pertinent questions?
-
Like -
Helpful -
Hug
2 ReactionsLet me tell you a bit about the past — I had a little swelling on my face near the left ear for the past two years, there was no pain, but from last month it started swelling under the throat, so I went to the ENT specialist. Before the operation, the ENT surgeon said that it was a lymph node tumor. After the operation, I found out that it was not a tumor, but lymphoma. Soft tissue, left parotid samples were sent to 2 laboratories for biopsy and the reports were different, 2 samples were immunohistrochemstry and the reports were also different, one showed B cell non-Hodgkin lymphoma, the other one showed follicular lymphoma, I have added two reports earlier. Last week I went to the hematologist, he said that after analyzing my physical symptoms, he thought it could not be B cell non-Hodgkin lymphoma, so he asked to send the sample to a neighboring country for review and advised me to take PET scan and treatment until the report comes. But I am afraid that I will get the right treatment?
-
Like -
Helpful -
Hug
2 Reactions