Lung Nodules/PET w/new findings

[Lorrie62]

Dr. Saini
I had the PET Scan and the 13 mm lung nodule had an SUV of 3.2.  The other two showed no uptake. However, there was mesenteric lymphadenopathy with SUV values of 8.1 to 8.6.  I had a dedicated CT scan of the abdomen on Friday and the largest nodal mass is 2.8 x 1.6 cm suggestive of Hodgkin's lymphoma.  Three of my doctors question this diagnosis for I have absolutely no symptoms of lymphoma.  I guess the next step will be a fine needle biopsy of the lymph node.  My questions are: 1) Can the lung nodule be benign at SUV of 3.2 and do you recommend a needle biopsy? 2) What can the lymphadenopathy be caused from if it does not prove to be lymphoma?  My CEA is normal.  Thank you again.

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Even if the lung and abdominal lesions are related to lymphoma, it still does not automatically make it stage 4 disease.
Lymphoma is treatable, and in most cases, curable.
Please do not worry, just wait for the histopathology and immunohistochemistry report of the biopsy specimen.
Good Luck!

[Lorrie62]

Thanks for your truthful response.  I have hypometabolic mesenteric as well as retroperitoneal lymphadenopathy.  No pelvic lymphadenopathy.  Speen normal.  No pancreatic mass.  No renal mass. No malignant hepatic lesion.  If the nodules in my lungs are indeed related to the lymphoma in the abdomen, would this be Stage IV lymphoma and is it treatable?  Thank you for all the time you take volunteering on this board and giving so many of us hope.
Lorrie62

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Yes, it is possible to have lymphoma without displaying the typical signs and symptoms.
Lung nodule with a fairly high SUV of 3.2 should not be assumed to be benign, especially when you have other nodes with even higher SUVs. We must assume that are caused by the same disease process as the abdominal nodes.
Lymphoma is an eminently treatable condition.
All the very best!