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re: repost - Please? B-cell lymphoma
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re: repost - Please? B-cell lymphoma

Breast lump (left side) visible on the skin, deep thickness on ultrasound, with extending toward back/underarm area. Breast lump excision performed, margins not clear per path report.
Initial path report: "dense lymphoid infiltrate composed of B and T cells that involve the skin and underlying superficial adipose tissue. Differential dx:reactive lymphoid hyperplasia and lymphoproliferative disorder. However, given the dense, deep nature of the infiltrate, we recommend re-biopsy." Biopsy sent on to another institution, report: Dx: "Atypical lymphoid infiltrate consistent with low-grade B Cell lymphoma of the extranodal marginal zone type with predominance of lambda-expressing plasma cells." - (oncologist recommended 5 weeks radiation after receiving this report). All set to do this...then another report comes in from another institution: "Mixture of CD20+ b cells and numerous CD3+/CD5+ T Cells, Bcl-2 is difficult to interpret ecause of large number of T cells. By outside report there is an increase in lambda+ plasma cells but these slides not available for our review". "Not sufficient evidence for dx of lymphoma, and suspect this lesion may represent a particularly florid cutaneous lymphoid hyperplasia." They also suggested nipple-related infections, but the lesion was back underneath the arm extending a bit onto the breast itself, no where near the nipple. This institution (3rd) received no clinical information, nor all the slides.
So, question is, what to do now? Oncologist is of the wait and watch idea...which now I'm nervous about.
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Hi, I can't be of much help to you with your test resultsbut I do know that a watch and wait approach for Lymphoma (non-hodgkins) is normal practice. My husband has low grade Lymphoma and is presently on the watch and wait approach although initially he did have surgery.  I would ask your oncologist WHY you have contradictory reports, henceforth treatment options.  Generally oncologists are quite understanding as a diagnosis of Lymphoma is not like having the flu is it! Try and get some clarification. You need to know for your own peace of mind and of course your health. Please come back and let us know how you go on. Take Care Chris
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Avatar_n_tn
Thank you so much for both your replies.  Crystaly, I'm quite certain it's difficult for you to "watch and wait" along with your husband, I wish you both well.  Being in the "gray-zone" is very nerve-wracking.

B Johnson, I'm so glad you posted your comment, sounds like you are of medical background and very knowledgable.  I am indeed seeking out a 2nd opinion, and have an appointment the end of May.  

Thanks to both of you for your support, it is much appreciated.
If you have any other thoughts on this, please do let me know...I'm in the process of collecting all reports, films, etc., for the 2nd opinion.

Take care,
V
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