I have four lymph nodes in my neck that we have been following by PET scan for quite some time. The last PET in July showed increase in FDG activity and size.

We attempted a FNA about a month ago. The specimens from three of the nodes were "inadequate for diagnosis", although the fourt showed "numerous small and large lymphocytes admixed with blood. There was an epithelial component that is not dosgnostic and lymphoma could not entirely be excluded by this material". They have recommended a repeat FNA for next week.

I would just like to know if it is common to have small and large lymphocytes in lymphoma and/or what is the significance of an epithelial component?

doesn't one single person have any input about this???

Please?

FNA isn't usually very successful. An excissional biopsy would be most accurate.

Lifewithtwins,
I'm sorry I wasn't here soon enough to try and answer your question.

I too have felt the way you do when I"ve asked questions and no one responds. it's humilating to me. so now i make sure I try to at least reply to each person so they know they are being heard.
nothing's worst than being worried and needing to reach out to others and have others answer back in such a frightening time.
I can do more extensive studies for you if you want me to, but this was the best expalanation of large and small lymphocytes.

At first it may not make much sense to you but the further research you do you will begin to recognize what each sentance and word means. It's just studying. take your time and re-read it over if you have to.


Lymphocytes are small cells, 7-9 µm in diameter in blood smears, and are the second most common white blood cell type, comprising about 30 % of the leukocyte population in peripheral blood. Lymphocytes have a round heterochromatic (deeply staining) nucleus surrounded by a relatively thin rim of cytoplasm.
Lymphocytes travel in the blood, but they routinely leave capillaries and wander through connective tissue. Therefore, lymphocytes may be normally encountered at any time in any location. They even enter epithelial tissue, crawling between the epithelial cells. They reenter circulation via lymphatic system channels (hence their name).

Lymphocytes also emigrate from blood in response to inflammation, but they accumulate somewhat later during the inflammatory process than neutrophils. Their presence in large numbers indicates the continuing presence of antigen. Lymphocytes produce the multitude of diverse antibody molecules (one specific type of antibody per lymphocyte) which provide the mechanism for chemical recognition of foreign materials (distinguishing between self and non-self) and so for mediating and regulating immune responses.

Lymphocytes are most easily recognized in histological sections as small "naked" nuclei (the cytoplasm is usually inconspicuous) which occur here and there in most connective tissues, especially commonly near mucous membranes. Lymphocytes are found densely packed in lymphoid tissue--spleen, lymph nodes, and lymph nodules in mucous membranes (e.g., tonsils, appendix), where they proliferate.

Plasma cells are lymphocytes which are specialized for mass production and secretion of circulating antibodies. Plasma cells have more extensive cytoplasm filled with rough endoplasmic reticulum (for synthesizing protein, specifically antibody molecules). This cytoplasm is distinctly basophilic, a consequence of the large numbers of ribosomes associated with the rER, and typically forms a lopsided bulge on one side of the nucleus. The heterochromatin of plasma cells is typically clumped in a characteristic "spoke-wheel" arrangement which also aids plasma cell recognition.

hope this helps,

Linda

There are many different patterns and many different types of lymphoma-there are also many other nonlymphomatous conditions that can give you enlarged lymph nodes- toxoplasmosis, cat scratch fever, etc for instance and other reactive conditions. Be happy they are getting second opinions and biopsies. It sounds like you are in good hands. Ask for copies of your reports, etc and get more consultative opinions if necessary. Good luck.