Skip to main content

Things may not always be as they appear

I've always considered the t(11;14) translocation as the defining marker for Mantle Cell Lymphoma (MCL). If that translocation presents itself, there is a very high probability you have MCL, but the more I read, the less I am convinced of that argument being so set in stone.

Why can't my diagnosis of atypical MCL just as easily be an atypical variant of Splenic Marginal Zone Lyphoma (SMZL)? Sure, I have the t(11;14) translocation, but when all the other factors are considered, I believe I'm a more likely fit for atypical SMZL.

From Lymphomation.org
Splenic Marginal Zone Lymphoma is an indolent (slow growing) b-cell lymphoma. It typically presents with an enlarged spleen (splenomegaly). "Splenic lymphomas present with a massive splenomegaly (enlarged spleen) sometimes with mesenteric lymph nodes or hepatic involvement, but without peripheral lymph nodes; bone marrow and blood are often involved."

With the exception of mesenteric lymph nodes, and hepatic involvement (both of which only occur sometimes), and excluding evidence of the t(11;14) translocation, I fit that description perfectly.

Not that any of this will change how I approach my lymphoma, nor will it influence my treatment decisions. It is interesting none the less, and what I consider a teachable moment.

There are few no absolutes in life! Different conclusions can be drawn from the same facts. We see it in politics, I've experienced it all my life working as a metallurgist, and it is certainly true in medicine.

Like metallurgy and politics, medicine is not an exact science, and we must never lose sight of that.
Labels:

Comments

Alan said…
There are absolutes. Don't forget death & taxes
11:41 PM
Marc said…
A technicality. Or semantics might be a better term.

Death is inevitable, as are taxes, but are better described as approximations or "givens".

There is no way to determine in advance when someone is going to die, nor exactly how much in taxes you may have to pay. There are too many variables which can effect the final outcomes.
12:10 AM
Alan said…
The "taxes" aspect of that quotation of course is facetious, but while no one can predict when somebody is going to die (except may by execution) it is an absolute that everyone will die. (unless I'm missing something).
12:42 AM
Marc said…
That's why I said it's really semantics.

Absolutes are like the earth is round, the surface is flat, the line is straight, etc. They're not really, but they're close approximations.

Some things are givens, like death or givens in a mathematical equation. They can be changed and altered, so by definition, not absolute.

Just my opinion!
12:53 AM
Post a Comment

Popular posts from this blog

The green tea phenomenon

Despite being a heavy drinker of green tea since my diagnosis, mainly for its cancer prevention, and hopefully cancer curing qualities, I recently have developed a new found enthusiasm for green tea. Now whether it has been the green tea I have been drinking for the past 6+ years, my heavy exercise routine, or just pure chance that has kept my MCL stable, or at least [very] slow progressing, for the past 7+ years is certainly open to debate, but based on past research, I have chosen to believe green tea has at least helped to some degree. So what has given me this new found enthusiasm? Well, a friend of mine, and cycling buddy, was recently diagnosed with bladder cancer, and knowing my daily regimen called to ask my advice on green tea. He had already done a lot of research on the subject, so when I told him my obsession with green tea consisted principally of drinking the least expensive, decaffeinated green tea available (Trader Joe's brand of 18 tea bags for $3, and more recentl...
10 comments
Read more

When is enough, enough?

Today I learned, Lance Armstrong, the most drug tested athlete in the history of sport, is being accused of doping, again . This time by the US Anti Doping Agency (USADA), who claim they have collected blood samples from him in 2009 and 2010 that were “fully consistent with blood manipulation including EPO use and/or blood transfusions.” Really! What took them so long? The French have been trying to make allegations of drug doping stick for years, ever since he won his first Tour d'France, but to no avail. And now the USADA claims to have evidence to support that claim, and they've waited almost 3 years before releasing this evidence. Needless to say, I am skeptical. Then there's this from the Congressional Budget Office (CBO): Increasing the federal excise tax on cigarettes by 50 cents per pack eventually would increase Medicare and Social Security spending, slightly. Eventually? What is the CBO suggesting here? That we should encourage smoking, because if we don't, in...
11 comments
Read more

Oxycodon Withdrawal

If there's one thing I've gained from this entire ordeal, it's a much greater appreciation for the trials and tribulations of drug addicts. For me it's been just over 4 days since my last Oxycodon, after only being on it for around 2 months, but the desire to take another pill still exists. While the severity of the symptoms of Oxycodon withdrawal I've been experiencing, i.e. abdominal cramps, chills, body aches, runny nose, etc. have subsided some, they have not gone away yet. And while some of that may be psychosomatic, it's still not hard for me to imagine how difficult it must be for someone addicted for a much longer period of time, or on a greater quantity to kick the habit. I even have a new found sympathy for Rush Limbaugh. It's not that the Oxycodon was so instrumental in relieving the tightness and discomfort in my chest, because it wasn't. [Although I'm starting to have some doubts.] It was because the Oxycodon provided a feeling of well ...
8 comments
Read more