What stage is this CT scan? Large mesenteric mass measuring 15 cm x 7 cm. Extensive large retroperitoneal adenopathy. This is both to the right and left of the aorta, the masses measure up to 3cm.

Here is the full finding.

FINDINGS: Following oral and intravenous administration of
contrast material, thin section computed tomographic examination was done from
the diaphragm of the pubic symphysis. Upon acquisition of these helical data
sets, axial, coronal and sagittal images were synthesized.

Review of the lower lungfields show them to be within normal limits. The liver
is homogeneous. The spleen is likewise unremarkable. The pancreas is within
normal limits. There is a large mesenteric mass measuring 15 cm x 7 cm. In addition, there is extensive large retroperitoneal adenopathy. This is both to the right and left of the aorta, the masses measure up to 3 cm each. There is adenopathy between the aorta and vena cava, also quite large. In addition, there is extensive soft tissue density involving and extending outward from both right and left kidneys. This constellation of findings would be consistent with lymphoma. The lymphoma obviously involves both kidneys.
In addition to the large mesenteric mass, there are other (3 cm) masses in the mesentery. There are no pelvic mass lesions.

IMPRESSION: Mesenteric mass, retroperitoneal masses, bilateral renal invasion. These findings are most likely due to lymphoma.
ADDENDUM: On the coronal imaging, the mesenteric mass measures 15 x 12 cm.

Albert-
Very hard to say based strictly on this, and I'm not a doctor or health professional, but:

At first, Stage II seems possible because the two lymphatic sites involved - mesenteric and retroperitoneal - are on the same (lower) side of the diaphragm, and could be considered in the region of the extra-lymphatic organ involvement (the kidneys).

But I would imagine that Stage IV is much more likely, since that is defined by diffuse (meaning spread out, not localized) involvement of one or more extra-lymphatic organs, again the kidneys. And that seems to be the case here.

But again, it's really hard to say. Plus if this CT scan is the extent of the work-up done, then by no means should it be considered a diagnosis of lymphoma. Radiologists reading CT scans aren't qualified to make such a diagnosis, period. This should be considered preliminary at best until a qualified pathologist can study a sample from a biopsy.

Ross

Albert-
I'm sorry to read you're in that phase of not knowing. I know that stage IV sounds a whole lot worse than stage II, and IV certainly isn't better than II, but you shouldn't read too much into that, especially if you're not entirely familiar with staging in lymphomas. I say this because the staging is much different than other cancers, and normally when we hear 'stage IV' of a cancer, it means that it's malignant and metastatic and spread throughout the body, and it just sounds dire. But in lymphomas, you can have a minor tumor in a lymph node but have involvement of the nearby liver or bone marrow for instance and get stage IV.

Good luck, and remember that no matter what, you're in control of what happens. it's easy to feel out of control in this situation, ordered around by authoritative doctors, but ultimately you make the decisions.

Ross

Thank you Ross. Your words are soothing. I know you are a good human being. Your presence is a gift.

Albert Nahmani