b cell lymphoma stage 4. Here is my story. My father was admitted to the hospital with severe stomach and back pain and a blocked bile duct. He is now on morphine and has lost 30 pounds since diagnosis a month ago. Is this typical with lymphoma? Advise?

Anyone?

What else do you know about his diagnosis? "B cell lymphoma" could conceivably refer to 20 different non-Hodgkin's lymphomas. Perhaps it's diffuse large b-cell lymphoma, the most common subtype, or follicular lymphoma (although this doesn't seem likely).

Losing 30 pounds in a month is pretty severe. Many things could be contributing, including bulky sites / tumors; solid tumors aren't overly common in NHL but they do occur.

Okay well the location of that tumor very likely explains the bile duct blockage.

There's a very VERY rare NHL subtype known as isolated Primary Pancreatic lymphoma (PPL); patients are typically older, more often male than female, it often presents with abdominal pain (which often radiates to the back), jaundice from bile duct blockage, and a tumor. It can sometimes be misdiagnosed as a pancreatic adenocarcinoma. Making certain that the dx is correct is a BIG deal because treatment regimens differ, and those with PPL have a much better prognosis.

It appears as though weight loss, as well as anorexia (meaning an absence of appetite), are common symptoms of PPL.

PPL is one option, another is secondary involvement of the pancreas by the NHL, meaning that the cancer spread to the pancreas from another site (this seems more likely only because PPL is so rare). Since PPL is extra-lymphatic, this would automatically stage your father at IV.

At any rate, from the scant amount of literature out there on pancreatic involvement in NHL, your father's symptoms don't seem out of the ordinary (although the weight loss is pretty significant).

Ross

It can sometimes be misdiagnosed as a pancreatic adenocarcinoma. Making certain that the dx is correct is a BIG deal because treatment regimens differ, and those with PPL have a much better prognosis.