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Diagnosis of Non-Hodgkin’s Lymphoma

Your healthcare provider will ask about your symptoms and medical history and perform a physical exam. In particular, he or she will carefully examine your lymph nodes. Most enlarged or swollen lymph nodes result from infection, not lymphomas. If infection is suspected, you may be given medication and told to return for re-examination.

Lymph Node Biopsy

If swelling persists, your doctor may order a lymph node biopsy. For this test, your doctor will remove all or part of a lymph node. A pathologist will examine the tissue sample under a microscope. The biopsy results will show whether there is cancer, and if so, the type of the cancer that is present.

Lymphoma may be:

  • Aggressive (high grade) – grows quickly and causes serious symptoms
  • Indolent (low grade) – grows more slowly and produces few symptoms

In addition to microscopic examination of the lymphoma, other studies may be done to determine its type and grade, including flow cytometry and cell marker studies.

Staging

If cancer is found, treatment will depend on the stage of your cancer. The doctor will order additional tests to determine the stage of the cancer. Staging is a careful attempt to determine whether the cancer has spread and, if it has, what body parts are affected.

Additional tests to determine staging may include:

  • Urine and blood tests
  • Additional physical exam
  • X-rays of various parts of the body, including lungs, bladder, kidney, lymph nodes
  • CT scan – a series of x-rays put together by a computer to make detailed pictures of areas inside the body
  • Ultrasonography – a procedure in which sound waves are bounced off tissues and the echoes produce a picture
  • MRI – a test that uses magnetic waves and a computer to make pictures of structures inside the body
  • Bone marrow biopsy – a tissue sample from the bone marrow is removed through a needle and examined under a microscope to check for cancer cells
  • Laparoscopy – a visual examination of the abdomen using a fiberoptic tube with a lighted tip (a laparoscope). The doctor can remove tissue samples using additional instruments. The tissue samples will be checked for cancer cells.

The following stages are used to classify non-Hodgkin’s lymphoma:

Stage I – Cancer involves a single lymph node region. Or if the cancer started in an organ, it is limited to that organ.

Stage II – Cancer has spread to two or more lymph node regions on the same side of the diaphragm. Or if the cancer started in an organ, it has spread to one or more lymph node groups on the same side of the diaphragm.

Stage III – Cancer has spread to two or more lymph node regions on both sides of the diaphragm.

Stage IV – Cancer has spread to other parts of the body in addition to lymph nodes.

References:

American Cancer Society website. Available at: http://www.cancer.org/docroot/home/index.asp .

The Leukemia & Lymphoma Society website. Available at: http://www.leukemia-lymphoma.org/hm_lls .

National Cancer Institute website. Available at: http://www.cancer.gov/ .



Last reviewed February 2007 by Barbara Harty-Golder, MD, JD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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