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Possible lymphoma

I was referred to a liver specialist when two lesions were found on the right lobe of my liver via ultra sound and I had abnormal LFT.  By the time my referral came through, I had had to give up due to fatigue, severe nausea, severe sweating, night sweats (which seem to have settled)and temp raising.  My Consultant performed many scans including CT of the liver but could not identify the lesions (cyst?).  Eventually after being admitted into hosopital twice she decided to look for possible lymphoma.  I have no raised lymph nodes ( shown by CT of chest, abdomen and pelvis)but the last CT showed an enlarged spleen.  Bloods are normal agin except for raised ESR 50?  She has referred me to a Haemoloigist at another hospital and has mentioned possible lymphoma.  My concern is that if I have no raised lymph nodes how do they diagnose this, what do they biopsy?  I am so ill now I am in bed most of the time (I have a partner and 3 children) any over exertion at all produces terrible sweats and sometimes dizziness.  I ahve constant nausea and upper abdominal pain.  My doctor has also hinted that my symptoms may be caused by depression!  My depression is caused by my symptoms!  I am also waiting for the results of a MRI scan of the liver.  I feel so ill now that I'll be relieved when they finally diagnose something but I upset and confused.  Can you have lymphoma just in your spleen??

Many thanks for any help
3 Responses
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233190 tn?1278549801
MEDICAL PROFESSIONAL
It is possible to have lymphoma limited to the spleen.  You have had a pretty good evaluation already, with the multiple CT scans.  

There are cases where the lymphoma may not be detected by the CT.  It can also be present in the bone - where it may not be picked up on the CT scan.  If this is suspected, a bone scan can be considered.

If lymphoma continues to be considered, you can discuss a PET scan - which is a more thorough imaging study.  This can be discussed with the hematology referral you are seeing.  

I would settle on depression as a diagnosis only if every other organic disease is ruled out.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b
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Avatar universal
lymphoma can indeed involve only the spleen. Also, if the liver lesions can be confirmed, they could be biopsied using a guided needle. Seeing a hematologist seems a good choice.
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Avatar universal
Thank you for your reply but can you give me a wee bit more information.  I'm aware you cannot make a diagnosis but please tell me, what if the liver leisions cannot be detected as on the CT scan (only on 1st uss?) what do they biopsy?  Surely not the spleen as it has a tendency to bleed?  How can they diagnose lymphoma when I have all the symptoms but only the enlarged spleen to test??  I know it good I'm seeing a haemolotolgist(sic) but in the meantime I'm worried sick?  If they cannot test for it then what?

Thank you

Mrs Rogers
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