On 10/20/2008
zk_at wrote:
My mom has non-Hodgkins lymphoma and has been treated with chemo and Mabthera.
She also had thyroid cancer over 30 years ago and had her thyroid removed as well as neck dissection (removed a muscle and some nodes)
She had a PET Scan to follow up on her chemo. the scan showed great results on her lymph nodes.
however, they found something in the Foramen Magnum area (sp?). She lives outside the US, so I will do my best to translate and would love any indication on what this may be.
It says there is high uptake of FDG, soft tissue round process in the Foramen Magnum area, 1.7 cm in diameter. it causes substantial pressure on the spinal cord's inner part (or something like this). There is also moderate FDG uptake in both lungs "Ground Glass" and in the node about 1.5 cm in the "lung gate (??) on the right. This might be due to chemotherapy (the lung gate thing)
Any insight on this will be great. Her Dr. is especially concerned with the neck. Is it likely cancer? I really don't know what any of this means and am very curious.
I will try to answer your questions.
The foramen magnum (literally "big hole") is the opening in the skull where the spinal cord becomes the brain stem, and also arteries go thru to nourish the brain. Soft tissue uptake of FDG around the foramen magnum could indicate inflammation/swelling from the chemo, infection, or involvement by NHL. Could actually be involvement of the outer lining of the spinal cord. Yes, regardless of what the cause, this can cause significant pressure on the spinal cord. If your mom has not had a recent MRI of the brain, she should ask about having one done.
As for the lungs, "ground glass" possibly means the appearance of diffuse scattered clumps of cells or very tiny granules that are picking up the FDG - appears on the scan just like ground glass would look. Again, this could be inflammation or infection, or NHL involvement. The "lung gate" probably was reported as a lingulate node (a node positioned in the lingula of the left lung - a small-tongue like projection at the base off the lung near the sternum.) I do not know why the report would say it was on the right, unless the node actually is in the right lung but directly across from the lingula, and they were saying lingulate just in referring to that position. Possibly the node might be on the right side of the lingula. The location of the node is not of big concern, but rather the fact that there is increased uptake could indicate inflammation, infection, or NHL involvement.
If the dr is especially concerned with the neck, it sounds like he/she suspects this is spread of the NHL, or possibly recurrence of the thyroid cancer. (30 years is a VERY long time for cancer to reappear, but it has happened to others.) Again, if your mom has not had a brain MRI, would be good for her to ask about it - important to establish if she has any brain involvement.
Also, I would expect that the dr might be wanting to step up treatment - quite probably steroids, possibly more chemo? The fact that this is at the area of the brain stem, the opening of the spinal cord into the brain complicates things - treatment MUST concentrate on minimizing swelling as well as eradicating any possible spread of cancer. Treatment that focuses on the foramen magnum should have desirable effects on the lung as well.
Sincerely,
Tre