Lymphocytes on CBC

I have been anemic my whole life. I cannot get the McH (shape i understand) in range.

My hemoglobin was perfect higher then ever been but things still low.

Drs think I have lymphoma cancer. This is only thing off. Has a ct scan for other issue and ct showed lymphomatic system all enlarged with Legions in spleen and nodules in lungs. He says looks like either lymphoma or saracosis.

I'm following as I have the same question. I'm being worked up for cutaneous T-cell lymphoma after three years of increasing lesions on my back, torso, arms and legs but I've had chronic "idiopathic" lymphopenia (off the low end of the scale) for years. I always thought lymphoma showed high lymphs?

Evidently not I was basically told that nothing on the CBC tells them
U have cancer. I have been anemic my whole life up until the last six months. My life sites have been on the bottom end so I keep telling them. How could I possibly have lymphoma?

I was diagnosed with a B-cell lymphoma (DLBCL) and have reviewed my lymphocytes and lymphocyte% from the hospital bloodwork at diagnosis prior to the first chemotherapy. Both numbers were below normal range. Biopsies of the tumors and a spinal tap in the hospital were needed to diagnose the lymphoma (I had tumors in the brain and other organs).

I see my oncologist for a follow up next week so will ask about the low lymphocyte values with active lymphoma. I will add an additional comment here if there is anything informative to contribute from my doctor.

May I ask what your first reasons or symptoms you had that brought them to do ct scan? I'm still in process of diagnosis of whatever is going on with me. I also have normally been anemic my whole life but currently keep red blood cells in unusually high numbers for me and I have been having very low white blood counts and most recent was lymphocytes were below normal and I believe Leukocytes were low also. I'm still learning what all of the technical terms count for. I really only understood a few things under the normal"CBC" tests. Just curious what brought you to this point of of you can share your story. Thank you.

I'm interested in your story also. I have many wierd skin subnormal now lasting almost 2 years. I have low white blood cell and below normal lymphocytes. I'm still in process of diagnosis; but the growths/rash/lesions are also on my back front torso and even my face. I thought I was dealing with rosacea on my face but I've never had a many spots nor on both sides. Any help or sharing of your story start would be greatly appreciated. I did try to locate your original story but unable to find. Thank you again.

Thanks for sharing your story. What led your team to do a spinal tap? I've only had blood testing (flow cytometry for T cells and B cells) which all came back normal. I've had TCR testing of skin biopsies, one of three showed monoclonality (which can be a sign of lymphoma) and I'm waiting on a fourth. I have lots of neurological symptoms in addition to the skin stuff so I've wondered about doing a spinal tap to check for nervous system involvement.

I have sarcoidosis (cardiac w/pacemaker) which is an inflammatory/autoimmune disease. It sometimes goes hand in hand with lymphoma (and other diseases) because the body is in a constant state of inflammation which makes it susceptible to other illnesses (including cancer.) I started getting dime-sized red sores on both shoulders about three years ago which have since spread to all over my back with a few on my arms, legs and stomach, one on my face and one on my lower lip. I've had eight skin biopsies which all (except one) came back as probable lichen planus, an idiopathic autoimmune skin disease. (I don't believe that is correct because LP normally is in sun-exposed areas, is a bumpy purple/red rash, shows up on wrists and ankles first, and is very itchy. My spots don't meet any of those requirements.) The eighth biopsy came back as pigmented purpuric dermatosis (instead of LP.) Both PPD and LP can mimic cutaneous T-cell lymphoma so it must be ruled out. I'm now waiting for TCR testing on the PPD biopsy sample.

I'm trying to get in to rheumatology because my research shows my symptoms could fit Lupus, Rheumatoid Arthritis, Amyloidosis and Cryoglobulinemia as well CTCL. I have lots of neurological issues, brain fog, severe fatigue, joint and muscle pain, vision changes in addition to the skin lesions (one of which was biopsied a year ago and still hasn't healed.)

Hi @jmhilde61 -

So sorry to hear you are experiencing issues. I hope the information below will help to explain why the diagnostic process included a spinal tap in my situation as part of attempting to diagnose CNS lymphoma. Hopefully your medical team will evaluate your neurological issues in the best way for your symptoms and be able to treat them.

My brain and body scans showed multiple tumors but the brain tumors were in inoperable locations for biopsy. So the spinal tap was done instead to try and collect cancerous cells in the cerebral spinal fluid.
The doctors explained to us before the spinal tap that it was a very low percentage that they would collect cancerous cells this way but they felt it was important enough to attempt.

So although the spinal tap was used as an alternate diagnostic test it did not actually yield cancerous cells for diagnosis in my case. Fortunately, the doctors were able to accurately diagnose the Diffuse Large B-Cell Lymphoma (DLBCL) from the tumors located elsewhere in my body.

The other factor that helped the doctors feel confident that the brain tumors were also this same lymphoma was the immediate reduction of all of the neurological symptoms I was experiencing after a very large dose of prednisone. Large doses of prednisone are included in one of the chemotherapy treatments (R-Chop) for DLBCL.
So my actual treatment plan alternated cycles of the Matrix treatment for the brain tumors with cycles of the R-Chop treatment for the body tumors.

Wishing you all the best with your diagnosis and possible treatments.

I asked my hematology oncologist about why the lymphocyte values in bloodwork can appear low in active lymphoma. He did not have a simple answer for this other than the lymphocytes become mutated in lymphoma and can crowd out the normal lymphocytes. These abnormal lymphocytes accumulate to cause the tumors in lymphoma.
Below is a link to video and written article from Mayo Clinic that explains some of this.

Excerpt from the Mayo Clinic article:
Like all cancers, lymphoma is the result of mutations in DNA that instruct the cells on how to grow, and the cells often grow out of control and live longer than they should. These disease cells then continue to multiply at a rapid rate, producing more disease cells. These particular DNA mutations affect lymphocytes, which accumulate in the lymph nodes and other parts of the lymphatic system to form tumors, crowding out healthy tissue and limiting its ability to function.
https://www.mayoclinic.org/diseases-conditions/lymphoma/multimedia/vid-20522470