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I am enquiring for a 76 year old man. In 2011 he was

Hi I am enquiring for...
Hi I am enquiring for a 76 year old man . In 2011 he was diagnosed with non hodgkinsons lymphoma that he had chemo for ( rchop or a similar I believe ). He was also found to have a slow growing NET . This regime of chemo finished 6 months later and he has apparently been clear of cancertain since then. In July of this year he had redness in one eye. Then in September he felt his eye to be uncomfortable and he got double vision in early October and now has a protruding eye as a result of a hard mass. Although he has double vision - his actual eye sight has not deteriorated
The eye specialist has ordered a CT scan ( he is unable to have a MRI scan ) - and will do a biopsy . My question is does this sound to you based on this info that it is a high likelihood that it is CNS lymphoma ? And woukd it be advisable for delays in diagnosis be avoided so as to get testament quickly ?
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Answered in 10 hours by:
11/14/2017
Dr. Scott
Dr. Scott, Doctor (MD)
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It sounds like his doctors are working him up appropriately. There are no specific symptoms of CNS lymphoma. About 70% of people will have a focal neurological deficit such as weakness, numbness, or ocular findings. For these reasons, the list of causes for this 76-year-old man's symptoms is very long which makes it imperative to get a biopsy sample. The other reason to get a biopsy is that tumors are evaluated based upon their morphology and immunophenotype. The vast majority of CNS tumors (80 to 85 percent) are of the aggressive or highly aggressive, diffuse large cell subtypes, and almost all are of B-cell phenotypic origin. So you need biospy prior to treatment to guide what type of treatment you should start. It is all based on the tissue, type, morphology, and immunophenotype.

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Customer reply replied 8 months ago
Thank you very much for the quick response and for tolerating my typos ( apologies for those). I appreciate the response so far. Thank you . I wonder if you would able to comment on what would be considered an okay length of time to wait for biopsy results given the sympton of double vision and the history. Given these symptons of double vision have been present for nearly six weeks ( and othets for longer )and a biopsy won't be done for at least another 10 days . I am trying to gather information so as to be able to be more assertive with the doctor on the man's behalf . The limited info I have picked up seems to indicate that treatment needs to happen fairly urgently. I understand your point that a biopsy needs to be done to determine what treatment is needed . But are we really at the limits of what would be considered a wise wait with treatment starting at least 2 months after double vision and tumour mass visibly pushing eyeball .
Also are you able to comment on whether there is any chance that this could be conjuctival lymphoma ? My guess is that the hard tumour lump that is possible to feel below the top of the eye socket rules this out ? Thank you.
I don’t know anyone who with disagree with you. The biopsy and treatment should be started as soon as possible. This should be an urgent process.When will he have the Ct scan? The scan will help determine the location whether it is conjunctiva or cns or brain or eye or surrounding tissues like mengines.
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