Day Seven

An interesting patient pathway:-

Patient B presented to GP with 3 week history of L loin/testicular pain in July ‘07. Patient was referred for an IVU which showed L uretheric obstruction and hydronephrosis for which he underwent a nephrostomy and was stented. A follow-up CT revealed two abdominal masses. A biopsy followed which diagnosed Diffuse Large B Cell Lymphoma (DLBCL) and a PET/CT was requested to see the extent of the disease. The scan revealed multiple areas of FDG uptake with a large primary in the abdomen, surrounding the psoas muscle. It was decided at the lymphoma meeting today that this patient will have two cycles of what is known as CHOP-R. The acronym accounts for the initial letter of the 5 drugs involved, and is the chemotherapy regime for DLBCL . He will then be re PET scanned after the two cycles of chemo to assess response to treatment. PET/CT has clearly played a pivotal role in this patient’s diagnostic and treatment programme. Treatment response scans are a relatively new thing for PET/CT, but they seem to be performed regularly in this trust.