Help! A lymphosarcoma.

[Natashka]

To the expert to the oncologist. Some time back at my wife below a clavicle has appeared something like neplshoj shishki. On reception at the surgeon it has been declared, what is it *quot; ??Oo?*quot; and it or he can be removed easily. One and a half month ago he has been removed. Thus a tissue have not given or not remote on the analysis. Two weeks the wound did not heal normally. After a while on a thorax have appeared similar shishki. The surgeon was quiet, but I have become nervous, have asked a direction in onkodispanser, there at survey have found out the increased lymphonoduses on a body and the right jaw. While handed over analyses for operation on a biopsy the beginning vision spoils. On MRT tumours in gajmorovyh and eye sinuses were found out. Has handed over a biopsy, but result only in 7 days. Today have made a cytology, the assumption the O-cellular lymphosarcoma. In urgent hospitalization have given up, having told or said, that the histology is necessary. What to do or make and what us waits?

[OlegD]

The m-yes, process of involving enough big, success will depend on sensitivity of a tumour to himio-and (possibly) radio-therapies. Under the description it is similar, on extranodal NK/T-cell lymphoma, but nevertheless it is desirable to see exact tsitozakljuchenie.

[irina 1]

Has handed over a biopsy, but result only in 7 days. Today have made a cytology, the assumption the O-cellular lymphosarcoma. In urgent hospitalization have given up, having told or said, that the histology is necessary. Yes, for exact diagnostics dimfosarkom histochemical research of a tumoral tissue is necessary histological, and also. Specify an opportunity *quot; O?ON??u*quot; the analysis (let and paid) as in most cases such analysis can be made for 2 days.

[AquaMarina]

In general that if is the assumption which has been proved enough prinalichii of a cytology, on limfomu (limfosarkoma-the out-of-date term), is meaningful at that time while the histology and immunogistohimija is done or made, and it where that week and will turn out, to make researches on stadirovaniju - KT trunks, a scintigraphy skleta, US, MRT (in connection with presence of disturbances of vision). And also obshcheklinicheskie for revealing possible or probable contraindications to HT-an electrocardiogram, EhoKG, a clearance of a creatinine, isotope renografiju (whenever possible). All these researches are necessary at any limfome as NHL and Hodzhkina. Their well-timed carrying out will truncate an interval from diagnostics prior to the beginning of therapy, that at times is not unimportant.

[LVE]

In general that if is the assumption which has been proved enough prinalichii of a cytology, on limfomu (limfosarkoma-the out-of-date term), is meaningful at that time while the histology and immunogistohimija is done or made, and it where that week and will turn out, to make researches on stadirovaniju - KT trunks, a scintigraphy skleta, US, MRT (in connection with presence of disturbances of vision). And also obshcheklinicheskie for revealing possible or probable contraindications to HT-an electrocardiogram, EhoKG, a clearance of a creatinine, isotope renografiju (whenever possible). All these researches are necessary at any limfome as NHL and Hodzhkina. Their well-timed carrying out will truncate an interval from diagnostics prior to the beginning of therapy, that at times is not unimportant.



Many thanks. Today has received tsitoanaliz there is more detailed description of a picture of disease.

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The morphological picture is made mainly with average and fine tumoral lymphoid cells, an abundance of leptons (otshnurovannye sites of a cytoplasma-is characteristic for limfom), in a plenty meet cells more largly promlimfotsitov the wrong form of kernels, sinuous, cerebriform structure or frame of distribution of a chromatin. (similarly to cells sezara-??O?NOa), macrophages. The given morphological picture bole all corresponds or meets limfome. It can be as:

1. The Fungoides mycosis (syndrome Sezari (O-cellular limfoma))

2. The Leukemid

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In pridachu to all at it or her a tumour in a head which press on muscles of an eye and besides on the right eye has arisen and any tumour all over again she develops was yellow color, the oculist has told or said, what is it from a liver, and now she red.

Information MRT.

The -resonant tomography of a brain in axial (1, 2), face-to-face (1) and saggitalnyh (1) sections with thickness of sections of 6,5 and 4 mm with use contrasting (Omniskan, 15,0 in \in) is spent.

On the received tomograms shift of median structures or frames, lateralnyh ventricles are not present asymmetry. Subarachnoid spaces are expanded in parietooccipital areas, mainly on a course of sulcuses. The size lateralnyh ventricles at a level of bodies - 5 mm, back horns 9. At pravogozadnego horns are a small perifocal edema.

On the right in a frontal sinus of the phenomenon of a frontal sinusitis, eats elements polipoznyh growths which grasp also the left sinus. The last extending downwards on an ethmoidal labyrinth from both parties or sides reach or achieve both gajmorovyh sinuses, the left half of basic sinus. In an ethmoidal labyrinth, alongside with polipoznymi growths there is a liquid component which also is marked or celebrated and in the basic sinus. polipoznye growths are more expressed in a labyrinth at the left. At carrying out of research with use of the orbital program spravo retrobulbarno there is a volumetric education which under characteristics of a signal reminds a tissue which is being in face-to-face, gajmorovyh sinuses and as in an ethmoidal labyrinth and the basic sinus. Volumetric education being retrobulbarno on the right pushes aside an optic nerve medially, moves apart the bottom straight line and lateralnye muscles of an eye.

The same nodal educations, in the sizes 8,5 and 4 mm are available retrobulbarno at the left by the bottom part of an eyeglobe. A lobby and back chambers of an eye without nodal includings or incorporations. The site similar described retrobulbarno, is available in a depth or strata of a temporal muscle on the right. Its or his sizes of 21*10 mm. At introduction of a contrast preparation there is its or his moderate uniform accumulation in volumetric educations which carry out sinuses and settle down retrobalbarno.



Proceeding from this additional information you can that nibud advise.

[DESUK]

Nevertheless it is not bad to make immunogistohimiju, except for that it is necessary to make a puncture of an osteal brain (from trez points), a lumbar puncture with research of a liquor, in addition to the set forth above researches. And more quickly to begin a chemotherapy. ?-cellular limfoma from adults demands an intensive chemotherapy. : to achievement remissii-allogenic transplantation.

Your wife has native brothers or sisters? There Is a probability, that they can be donors.

[SpezEvgeny]

Nevertheless it is not bad to make immunogistohimiju, except for that it is necessary to make a puncture of an osteal brain (from trez points), a lumbar puncture with research of a liquor, in addition to the set forth above researches. And more quickly to begin a chemotherapy. ?-cellular limfoma from adults demands an intensive chemotherapy. : to achievement remissii-allogenic transplantation.

Your wife has native brothers or sisters? There Is a probability, that they can be donors.



That is required from the donor, in what degree and as procedure is made.

Biopsy have given or remote on a histochemistry, but it again time, have told or said that about one week, and hours tick...

[ajgerim]

Begin obsledvanie (sm.vyshe) it will save time.

As to the donor, the estimation of its or his compatibility-HLA an identification all over again is spent, at concurrence at the donor after carrying out of special procedure - mobilization stvolovyh cells (a short: to deduce or remove these cells from an osteal brain in perefericheskuju 0 spend a fence of these cells from a blood on a special separator - procedure painless and safe. These cells replace to the patient instead of killed together sopuholevymi cells of its or his osteal brain.