But infections or autoimmune processes result in groups of cells due the actual infection or immune response "residue" left on the battlefield. Chronic infections in particular often leave the immune system "residue" of the battle in the Lymph nodes. The type and character of the immune white cells ( T, B, NK, Eosinophils, Neutrophils, Basophils, Macrophages etc..) that have collected in the Lymph nodes gives some indication as to the type of infection that may have caused them. Normally the Lymph node is cleaned out and they do not collect. But for a chronic infection, they can accumulate into a granuloma and their location in the body gives some idea of where the infection has been.
My PET/CT showed many Lymph node granulaomas, seemingly clustered in my torso. So my results came back and sure enough the results were positive for Lymph node granulomas. That's Lymph node "growths". Could be an immune process or Lymphoma. I had a biopsy and the results were not cancer but as suspected, they were granulomas associated with an infection or autoimmune process. Confirmation. The pathology report called it Reactive Florid Follicular Hyperplasia. That term is very general but is indicative of a chronic infection or autoimmune process of some kind. The actual language used by the pathologist gives a little more insight. That is as far as I've gotten but I thought the pathology report was interesting enough to share.
It says they found a group of normal B and T cells in my Lymph node follicles that were accumulating and not being flushed out. This suggests my immune system was so active with an infection process that B and T cells were accumulating in these Lymph nodes and beginning to calcify. You might note the fairly casual list of possibilities that includes some kind of viral, spirochetal or autoimmune driven immune reaction. Its both sad and humorous that they felt they must list spirochetal but added the "less likely" qualifier seems to indicate even pathologist are biased. The IDSA reaches deep. Nobody wants to admit Lyme can be chronic. I've been tested for syphilis 3 times negative. I'm also negative for CMV, EBV, HSV-1 etc... So no obvious viral source.Histologic sections show lymphoid tissue with anthracotic pigment and florid follicular hyperplasia, including large and irregularly shaped follicles; but no abnormal or atypical lymphocytes are seen. A comprehensive immunohistochemical panel shows reactive B and T cell features, as well as follicular hyperplasia, and is without aberrant staining patterns. The features are suggestive, but not limited to several etiologies including infectious processes such as viral and spirochetal (less likely) and possible autoimmune disorders. In the context of the clinical presentation and symptoms, correlation with appropriate serologic and ancillary microbiologic studies is recommended.
An EBER stain is pending and any additional results will be issued
in an addendum report.
There are other possibilities like bartonella which I could have caught from my 1/2 feral kitten I had when I noticed I was first ill. So its not specific. But so far, I've not been able to convince ANY mainstream doctor I had a chronic infection let alone Lyme. Now they all believe I have a chronic infection. Praise the Lord! This is evidence they CANNOT ignore. That one of the reasons I'm sharing it. It sucks when your mainstream PCP and other non-ID specialists think its all in your mind. But they are important because any chronic infection can cause a myriad of complications and if your PCP doesn't believe you have a chronic infection, the context for complications is a mess which just carries forward to other non-ID specialists. That is one reason this was good. Now they all believe. Maybe not in Lyme, but my PCP actually wondered now if I was right all along. Many of you might have had a similar experiences but never had this kind of evidence that was irrefutable to even the mainstream. A biopsy is very real.
One of my many symptoms is night arthritic pain that slowly goes away in the morning and repeats and migrates from sets of joints in my legs to hips to back to shoulders to arms. This is suggestive a reactive arthritis which is consistent with the PET/CT/Biopsy report. I've discovered that both prednisone and the antibiotic Bactrim seem to be the only things that push that into remission. But it returns in another location some time later. The Bactrim caued remission is interesting. I've included a list of infection types that are believed to cause this kind of reactive arthritis. Its an interesting list and both Lyme and Bartonella are on the list. So is Mycoplasma Pn for which I'm also IgG positive.
So Lyme is at the top of the overall differential list but there are other possibilities. Thought I would share that for people who are frustrated with "testing" and disbelieving mainstream doctors and wanted another way to determine if there is some sort of infection ( or autoimmune) problem they would believe. The PET/CT is expensive at $2100 and there is no way insurance will approve it in most cases. But maybe. Thought others might find my lates line of investigation interesting. I've never heard of using a PET/CT for Lyme detection but maybe its because I've never thought to look.
Example discussion of using PET/CT in ICU for infection detection.
PET/CT is typically too expensive for diagnostic workup except in this ICU life or death setting but can be quite effective. At $2100, it doesn't take too many IGenex, ALS or other Lyme workups to add up to $2100. But the mainstream rejects IGenex and ALS results while a biopsy based on a PET/CT scan detection provides near 100% evidence of an infection process. That in turn can led to a more thorough diagnostic effort since the infection process is a known fact and if a microbiology/serology workup comes up with nothing, its probably incomplete.
More to come!
The List of Infections associated with Joint arthritis-like pain - i.e. Reactive Arthritis