Thyroid Biopsy

[arkie13]

According to this do you think the  cancer was contained to the thyroid gland or has spread?

Biopsy Report

CD3: neoplastic cellular infiltrates negative ( background reactive T-cells positive)
CD5: neoplastic cellular infiltrates negative ( background reactive T-cells positive)
MUM-1: subset (about 80%) of neoplastic cellular infiltrates positive
BCL-2: subset of neoplastic cellular infiltrates positive
BCL-6: neoplastic cellular infiltrates negative
BCL-10: neoplastic cellular infiltrates negative
CD20: neoplastic cellular infiltrates strongly positive
Ki67: 90% neoplastic cellular infiltrates positive
Pan-cytokeration: neoplastic cellular infiltrates negative (background follicular cells

positive)
CAM 5.2: neoplastic cellular infiltrates negative (background follicular cells positive)

Final Diagnosis:
Thyroid Gland
1. Diffuse Large B-Cell Lymphoma
2. Hurthle Cell Change

[Ken_PA]

that's great news, arkie. That just goes to show, you can never know when things can turn out well. Good luck at the onc today.

[arkie13]

Got the results of the PET. Nothing has spread. Only shows some residual in the neck area. Praise the Lord! Off to see the oncologist on Friday....
Thanks to everyone!

[arkie13]

Thanks for the response. Will be going for the PET Friday.

[Ken_PA]

Hi, arkie. (Sometimes people do post homework on sites like this.)

In general, DLBCL is aggressive - and therefore more prone to spread.

What you want to know is how aggressive is this particular DLBCL. Offhand, I can say it's very complicated and particular to the type of lymphoma, and then to any subtype. People with the "germinal-center" subtype of DLBCL do better.

Here's an example of the complexity:
http://pleiad.umdnj.edu/~dweiss/diffuse_large/diffuse_large.html

Note very well that "there is some controversy" to using these markers.

Note even more so that I am just guessing as a complete amateur. But that page (it's undated so is this current knowledge?) says: "DLBCLs that express germinal center markers CD10 and/or Bcl-6 tend to have a better prognosis than those that express activated B-cell markers MUM1/IRF4 and/or CD138."

But the report you post says CD10 negative and BCL-6 negative, and MUM1 positive. So unfortunately it looks like the non-germinal center subtype.

Then "In the non-germinal center group, expression of Bcl-2 and cyclin D2 are adverse predictors" and the report does say BCL-2 positive.

I recall from the past that high Ki-67 is also not good.

Then again this seems to be DLBCL that started in the thyroid which is rare, so maybe all of this doesn't apply. Everything I say is just guesswork.

I'd get a copy of the PET report rather than wait for a doc appt to have it explained. If nothing lights up then that can set your mind at ease.

It's also true in general that more aggressive lymphomas respond better to treatment, precisely because they are more active. Imagine a room being filled with poison gas: anyone who is running in place would get poisoned quicker and more thoroughly than someone resting. So it's often similar with cancer cells.

Good luck.

[arkie13]

My friend had thyroid surgery on the 6th and this was the results from the biopsy. She will be getting a pet scan Friday. I was doing some research on the report and wondering if you could tell if it had spread from the biopsy.

[arkie13]

No.

[Mochadelicious]

Hi arkie13,

Is this something you are doing for school?