u/QuantumBenG

My EOT scan showed 1 lymph node lighting up with 4.1 SUV uptake above liver blood pool.

Asked oncologist for lymph node removal and biopsy. Doc only performed aspiration.

Copying, pasting results below. Oncologist recommended waiting until July PET scan.

I struggle with CPTSD and I'm having a tough time recieving these results. If you'd be willing to share similar experience, I'd be most grateful.

Final Diagnosis

Lymph node, 2R, endobronchial ultrasound-guided fine needle aspiration:

- heterogenous lymphoid population, see microscopic description with comment

- negative for carcinoma

Lymph node, 2R, flow cytometric analysis:

- no abnormal B-cell population identified

- no abnormal T-cell population identified

(see flow cytometry summary)

Microscopic Description

Microscopic examination shows a heterogenous lymphoid population. Very rare binucleated cells are present which may be reactive or neoplastic in nature. There is no notable increase in eosinophils. Fine-needle aspiration sampling can not exclude focal involvement by Hodgkin lymphoma in this case. There is insufficient material in the cell block for further studies. If there is significant clinical concern for involvement by classic Hodgkin lymphoma, excisional biopsy is suggested.

Flow Cytometry Summary

COMMENT

Flow cytometric analysis of the tissue specimen shows no abnormal lymphocyte population by immunophenotyping. Clinical correlation is suggested. Flow cytometry may not entirely exclude the presence of a lymphoproliferative disorder.

FLOW CYTOMETRIC ANALYSIS

The flow cytometric analysis shows 98% lymphocytes with a viability of 98%. Of the lymphocytes, 9% are B-cells, 86% are T-cells and there are 1% NK cells. The B-cells appear polytypic. T-cells show a CD4:CD8 ratio of 4.3: 1 with no aberrant antigen expression. No significant increase in CD34 positive blasts is seen.

Antibodies Tested:

CD2, CD3, CD4, CD5, CD7, CD8, CD10, CD19, CD20, CD22, CD34, CD38, CD45, CD56, sKappa, sLambda

MICROSCOPIC

A cytospin preparation shows a heterogeneous population red blood cells, occasional lymphocytes, and monocytes.

CLINICAL HISTORY

The patient has a tissue submitted for flow cytometric analysis.

CBC

Order Date: 04/29/26. Actual result date may vary.

CBC W AUTOMATED DIFFERENTIAL

Result

Value

Ref Range

WBC

5.24

4.00 - 10.50 x10(9)/L

RBC

4.74

4.00 - 5.50 x10(12)/L

Hemoglobin

13.3

13.0 - 17.0 gm/dL

Hematocrit

42.6

37.0 - 50.0 %

MCV

89.9

82.0 - 100.0 fL

MCH

28.1

28.0 - 35.0 pg

MCHC

31.2

31.0 - 36.5 gm/dL

RDW, CV

13.4

11.0 - 14.5 %

RDW, SD

44.7

36.0 - 50.0 fL

Platelet Count

286

140 - 375 x10(9)/L

MPV

9.9

Differential result

See Diff Report

Order Date: 04/29/26. Actual result date may vary.

WBC DIFF AUTO, 6 PART

Result

Value

Ref Range

% Neutrophils

50.7

% Myeloid Precursors Auto

0.4

% Lymphocytes

35.7

% Monocytes

9.0

% Eosinophils

3.2

% Basophils

1.0

# Neutrophils

2.66

1.80 - 8.30 x10(9)/L

# Myeloid Precursors Abs Auto

0.02

0.00 - 0.07 x10(9)/L

# Lymphocytes

1.87

1.00 - 4.80 x10(9)/L

# Monocytes

0.47

0.00 - 0.90 x10(9)/L

# Eosinophils

0.17

0.00 - 0.40 x10(9)/L

# Basophils

0.05

0.00 - 0.20 x10(9)/L

ANC Auto

2.66

1.80 - 8.30 x10(9)/L

Gross Description

A. LYMPH NODE (SPECIFY SITE).

Received in the laboratory are 6 diff-quik stained slides and 6 fixed slides. Also received with the slides is ~5 mL of clear, colorless, watery, fluid. All slides and containers are labeled with the patient’s name and HRN. Fixed slides are pap stained. Fluid is processed into cell block.

B. FLOW CYTOMETRY.

Received in a RPMI Tube is a TISSUE sample for flow cytometry. A flow cytometric evaluation is performed.

Including radiology report below.

Oncologist thinks 1 lymph node is inflammation.

I'm honestly experiencing extreme anxiety deeply worried there was only partial response to Nivo-AVD: that I'll be facing need for ASCT upon next PET scan in July.

Please let me know your thoughts.

PET RESULTS:

FINDINGS: There is physiologic FDG uptake in the brain. There is no obvious mass effect or midline shift. Previously seen small mildly hypermetabolic right supraclavicular lymph node has resolved. There is no suspicious FDG uptake in the neck.

A right paratracheal lymph node in the superior mediastinum measures 7 mm and has maximal SUV of 4.1, previously measured 4.8. Anterior mediastinal mass is decreased in size with resolution of FDG uptake.

Additional previously seen hypermetabolic mediastinal lymph nodes are decreased in size with resolution of FDG uptake compared to background blood pool activity.

Circumferential thickening of the distal esophagus with associated FDG uptake, nonspecific and may be physiologic. Underlying inflammatory or neoplastic process cannot be excluded. Gastrohepatic node has low level FDG uptake, maximal SUV measures 2.9, previously measured approximately 3.5. The evaluation is limited due to adjacent physiologic myocardial activity. Physiologic FDG uptake is present in the bowel and urinary tracts. There is no new suspicious FDG avid lesion in the abdomen and pelvis. The spleen is grossly unremarkable.

There is interval resolution of FDG uptake at T11 vertebral body. There is no new focal FDG avid bony lesion. There are degenerative changes. Reference physiologic mediastinal blood pool uptake maximal SUV: 3.0, previously 2.5. Reference physiologic hepatic uptake maximal SUV 3.3, previously 3.1.

Impression

Decreased anterior mediastinal mass with resolution of FDG uptake.
Unchanged small residual right paratracheal lymph node in the superior mediastinum. Deauville 4. Additional hypermetabolic mediastinal lymph nodes have resolution of FDG uptake.
Gastrohepatic lymph node has low level FDG uptake, unchanged to decreased since the prior exam.
Resolution of metabolic lesion at T11.
Circumferential thickening of the distal esophagus with associated FDG uptake, nonspecific and may be physiologic. Underlying inflammatory or neoplastic process cannot be excluded.

Anyone with Similar Experience, Post Chemo Abnormal Lymph Node Biopsy