A lymphoma diagnosis involves a series of steps and tests that help identify the type and stage of the cancer and guide treatment decisions. The diagnostic process includes:
- Medical History and Physical Exam: A doctor will take a detailed medical history, including any symptoms, family history of cancer, and exposure to risk factors. A physical examination will be conducted to check for signs such as pale skin and swelling of the lymph nodes, liver, or spleen.
- Blood Tests:
- Complete Blood Count (CBC): Measures the number of red blood cells, white blood cells, and platelets. Abnormal levels can indicate leukemia.
- Peripheral Blood Smear: A sample of blood is examined under a microscope to look for leukemia cells.
- Biopsy
- Lymph Node Biopsy: A sample of lymph node tissue is taken for examination under a microscope. This is the most definitive way to diagnose lymphoma.
- Bone Marrow Test (Bone Marrow Aspiration and Biopsy): A sample of bone marrow is taken from the hipbone or another large bone using a needle to determine if the lymphoma has metastasized (spread) to the bone marrow.
- Liver and kidney function tests
- Echocardiogram: To evaluate the size and function of the heart
- Immunophenotyping: Cells from a lymph node, blood, or bone marrow are examined with a microscope to determine what type of non-Hodgkin lymphoma cells are present
- Pulmonary function test: Finds out how well the lungs function
- Imaging Tests:
- X-ray: X-rays don’t diagnose leukemia but may give the first signs that something is wrong. An X-ray may indicate osteopenia (thinning of the bone) or enlarged lymph nodes.
- Computed Tomography (CT) Scan: This provides a more detailed cross-sectional image of the body and is more detailed than an X-ray. CT scans are better at showing the size, shape, and position of nodes in the chest or other parts of the body and identifying an enlarged spleen and/or liver.
- Magnetic Resonance Imaging (MRI) Scan: Used to look at the brain and spinal cord when metastasis is suspected. The combination of these tests helps doctors determine the type, subtype, and extent of leukemia, which is crucial for developing an effective treatment plan.
- A PET scan (Positron Emission Tomography): A specialized imaging test often used in cancer diagnosis and monitoring. It provides detailed information about the metabolic activity of cells in the body.
Each of these steps provides essential information that helps tailor the treatment to the individual's specific condition. Depending on the suspected stage and type of the cancer, the process can be quick, involving only a few tests, or extensive. Individuals experiencing lymphoma symptoms can obtain a prompt and accurate diagnosis from the GW Cancer Center Malignant Hematology Program’s multidisciplinary team of medical and radiation oncologists, pathologists, and advanced practice providers.
