Question My dad was diagnosed with non Hodgkin Lymphoma in 2011 done well with chemo & was doing really good until about a month ago ~shortness of breath ,chest pain radiating into his back. After CT SCAN PET scan was ordered ~ It showed Evidence of extensive tumor involvement. Active bilateral hilar & mediastinal lymph nodes with multiple hypermetabolic lung nodules in the chest with multiple bilateral pulmonary nodules too numerous to count.
At least 4 small hypermetabolic lesions in his liver.
Enlarged & hypermetabolic bilateral adrenals
a skeletal lesion at L3.
The largest lung lesion measure 2cm but most were considerably smaller.
Can you break this down ,could it be anything else than Lung cancer?
Answer We have to consider if it is his non Hodgkin lymphoma that has come back. After all most of the tumor volume seen is in his lung hilar and mediastinal lymph nodes. And it is also more likely that his known tumor gives more problems than that a new tumor has appeared. If not a lymphoma then of course a lung cancer is one of the other possibilities that has to be considered though as far as I can understand from your description no obvious primary lung tumor is seen. A mediastinal biopsy may be possible in order to get the diagnosis. If a lymphoma extensive chemotherapy - if possible - is most probably needed.
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