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Tonsillar cancer with Lymphoma - False PET positive Sarcoidosis
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Ricky_b posted:
Summary of my situation: Noticed something funny on my right tonsil 2 years ago but my physician said its all normal. Went again to check with him for a different issue this year and requested him to examine the tonsil again that was again declared to be normal. Went ahead and met with an ENT who gave Augmentin twice daily for 2 weeks. Tonsil on right side becomes inflamed and hard. CAT scan was performed which showed about 1.8 cm lymph node. FNA biopsy on the lymph node confirmed SCC/HPV-negative. PET scan was done and entire lymphatic system lighted up including the spleen. Docs doubted SCC lab results and were almost sure of Lymphoma or the other possibility of SCC in head and neck and lymphoma in the rest of the body. Section of inflammed tonsil excised off and biopsy revealed SCC/HPV -positive p16 but negative for Lymphoma FNA on inguinal node (PET signal of 10 units) came out negative for SCC/Lymphoma but showed Sarcoidosis. So, no cancer in rest of the body but right tonsil and right lymph node. Doc was not comfortable until he checks the left node of the neck too. FNA was done that came out negative for SCC/Lymphoma and Sarcoid. Treatment plan offered is to radiate right tonsil and lymph node (confirmed SCC) and also the left lymph node (inconclusive biopsy). 35 rads with 3 cisplatin chemos. No surgery because of a rare anatomy. There is some artery that runs close to the right tonsil and can be a risk.


Questions: How will docs check the spread and control of cancer if PET comes positive due to Sarcoid ? Can SCC diagnosis be confused with Sarcoid too ? How effective is chemo/radio treatment for tonsillar cancer ? Should the left side be left un-radiated ?

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Can SCC diagnosis be confused with Sarcoid too ? Should the left side be left un-radiated to prevent long term side-effects? How effective is chemo/radio treatment for tonsillar cancer ? How will docs check the spread and control of cancer if PET comes positive due to Sarcoid ?
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