"and occasional tangible body macrophages and plasma cells"
that's okay because they are only occasional, so plasma cells are not the dominant cell as in Castleman's.
But if we wanted to get more complicated, we can notice the word "generally" in the cited paper: "Pathologically, it is generally of the plasma cell variant." So a node isn't always full of plasma cells in Castleman's - there is another type of Castleman's without all the plasma cells. Also, hepatosplenomegaly is not always present.
Castleman's isn't fully understood anyway. The excisional biopsy is necessary to distinguish.
The worst outcomes in Castleman's aren't necessarily the most probable outcomes. Castleman's is not even necessarily the most likely diagnosis. But it needs to be excluded.
Also, you have the pathologist's judgment of "mostly consistent with benign...". A judgment by a pathologist should always carry a lot of weight. However, it does say "mostly"' so a lymphoma is not 100% excluded but I'd say that the odds are still well in your favor on that.
Unfortunately, until the excisional biopsy everything has to do with odds and nothing is definite.
I have an appointment with surgical oncologist on 1/6. Will have an excisional biopsy.
I have an appointment with surgical oncologist on 1/6. Will have an excisional biopsy.
"FNA had high rates of false negative results. Do you think that might be the case here?"
No, because they did find things that are not typical - just not being lymphoma. They found multiplying lymphocytes, but not "monomorphous" ones which is what cancer would be. They also found stainable macrophages, which apparently are found in reactive (not-cancer) nodes.
"Castleman's disease"
Yes, you'd certainly want to make sure that has been ruled out. But they didn't find plasma cells, which are derived from but look different from lymphocytes. Also, that's why I'd asked about hepatosplenomegaly, which you say you don't have. But ask them for sure anyway.
"I am going to have them remove the entire node in my neck"
that sounds ideal to me
"...as it is pushing on my breathing tube."
that seems like all the justification they need to order the surgery. Also, examining a whole node will give clues that seeing only isolated cells doesn't provide.
Everything seems well on track for you. Let me know what happens.
"polymorphous lymphoid hyperplasia with scattered tingeable macrophages"
Hi, that's very good news for you, since both of those point to you not having lymphoma. What you have *looks* very much like lymphoma, especially with the nodes being huge. But it isn't lymphoma, so it can be said to be mimicking lymphoma.
So that leaves us wondering what you do have, with unfortunately possibly a long process of diagnosis still ahead of you. But your future seems much better than having lymphoma.
Maybe Rosai-Dorfman Disease, maybe granuloma.
http://theoncologist.alphamedpress.org/content/9/4/406.full
Is your liver or spleen enlarged or tender?
My lymph node in neck is now 3.2 cm. Before it was 1.1 cm.
I received the results of my FN aspirations on the neck. It said that I have polymorphous lymphoid hyperplasia with scattered tingeable macrophages. What does this mean? My doc is on holiday and no one can answer my this. It appears that both sides of cervical nodes contain this. My groin where there is a 4 cm node wasn't biopsied. Please help. Many thanks!
"in my chest also"
lungs?
"night sweats and low-grade fevers frequently... feeling more and more exhausted everyday"
that is not confined to cancer/lymphoma, it could be immune related
needle biopsies seem better at this point than excisional, unless the 4cm is causing problems from pressing on nerves etc. But be aware of 'false negatives' and the why of that.
"popped up at once"
let me clarify: did they each grow very quickly and then stop growing. They could have had that pattern independently of each other, but still each have the same pattern: quick growth then plateau. Is that what happened?
How does this change things?
This new info changes things more than a little. First and foremost, did the other nodes spring up very quickly and then level off so their size stayed mostly the same. If so that's good.
Secondly, what did the sonogram report of the neck node say?
Yes, keep me updated. This is not cut and dry by any means.
I will let you know how it goes when I get my results from the biopsy. Thank you so much!
Hi, the surgeon will almost certainly want to do the biopsy as soon as possible because of the 4 cm size. That's even more so if it's rounded instead of oval.
The main thing to keep in mind is that there are different kinds of non-Hodgkins Lymphoma. Ironically, the ones that grow the fastest can often be the most curable.
It's still somewhat possible that there is another cause, such as certain viruses or autoimmune conditions. The biopsy is the only way to be 100% sure. I'd ask the surgeon to tell you right after the surgery how things looked to the naked eye. That way you won't have to wait for a followup visit to get an idea of what is found.
Best wishes to you.