Day Four

The department was down two members of staff today so I was able to be more hands on.

A patient came in today who had only just been diagnosed with Non Hodgkin Lymphoma (NHL). Her patient pathway so far has been a visit to her GP 6 weeks ago with a lump in her groin which rapidly increased in size. She was then referred for a lymph node and a bone marrow biopsy, with diagnosis definitively by histopathology. That was Tuesday, today she attended for a PET/CT scan. There was certainly an area of increased FGD uptake in the left groin and also on the right illiac crest, but this is where the bone marrow biopsy was performed. The report should be ready in a couple of days, her case may also be discussed at next week’s lymphoma forum. The patient was asymptomatic but appeared to be in shock from the diagnosis. I interviewed this patient and got her ready for the scan, so definitely will follow the case through as far as my visit allows.

Lymphoma is a general term for a group of cancers that originate in the lymphatic system. They can be divided into two groups Hodgkin Disease (HD) and all other lymphatic cancers called Non Hodgkin Lymphoma (NHL). Lymphomas result when a lymphocyte undergoes a malignant change and begins to multiply creating tumours which enlarge the lymph nodes and other parts of the immune system. NHL is much less predictable than HD and has a greater chance of spreading to extra nodal sites. HD is the more curable of the two and is characterised by an orderly spread from one lymph node to another.