Pleural or peritoneal fluid sampling: Lymphoma that has spread to the chest or abdomen can cause fluid to build up. Pleural fluid inside the chest or peritoneal fluid inside the abdomen can be removed by placing a hollow needle through the skin into the chest or abdomen. The doctor uses a local anesthetic to numb the skin before inserting the needle. The fluid is then taken out and checked in the lab for lymphoma cells.
All biopsy samples and fluids are looked at in the lab by a pathologist a doctor specially trained to recognize cancer cells.
The size and shape of the cells and how they are arranged may show not only if the person has a lymphoma, but also what type of lymphoma it is. But usually other types of lab tests are needed as well. Flow cytometry and immunohistochemistry: For both flow cytometry and immunohistochemistry, the biopsy samples are treated with antibodies that stick to certain proteins on cells. The cells are then looked at in the lab immunohistochemistry or with a special machine for flow cytometry , to see if the antibodies attached to them.
These tests can help determine whether a lymph node is swollen because of lymphoma, some other cancer, or a non-cancerous disease. The tests can also be used for immunophenotyping — determining which type of lymphoma a person has, based on certain proteins in or on the cells. Different types of lymphocytes have different proteins on their surface, which correspond to the type of lymphocyte and how mature it is.
Chromosome tests: Normal human cells have 23 pairs of chromosomes strands of DNA , each of which is a certain size and looks a certain way in the lab. But in some types of lymphoma, the cells have changes in their chromosomes, such as having too many, too few, or abnormal chromosomes. These changes can often help identify the type of lymphoma. Imaging tests use x-rays, sound waves, magnetic fields, or radioactive particles to produce pictures of the inside of the body.
These tests might be done for a number of reasons, including:. The chest might be x-rayed to look for enlarged lymph nodes in this area. A CT scan combines many x-rays to make detailed, cross-sectional images of your body. This scan can help tell if any lymph nodes or organs in your body are enlarged. CT scans are useful for looking for lymphoma in the abdomen, pelvis, chest, head, and neck.
CT-guided needle biopsy: A CT can also be used to guide a biopsy needle into a suspicious area. For this procedure, you lie on the CT scanning table while the doctor moves a biopsy needle through the skin and toward the area.
CT scans are repeated until the needle is in the right place. A biopsy sample is then removed to be looked at in the lab. But MRI scans use radio waves and strong magnets instead of x-rays. This test is not used as often as CT scans for lymphoma, but if your doctor is concerned about spread to the spinal cord or brain, MRI is very useful for looking at these areas. Ultrasound uses sound waves and their echoes to create pictures of internal organs or masses.
To accurately stage NHL, the healthcare provider will need to determine the extent of the malignancy, if it occurs above or below the diaphragm , and whether the cancer has become extranodal spread beyond the lymph nodes.
To determine this, additional tests may be performed, including the following. Based on these and other findings, the cancer specialist known as an oncologist can stage the disease. The most common system used in clinical practice today is called the Lugano Classification System.
In some cases, the treatment is based on whether there is "bulky disease," meaning the presence of large tumors in the chest. Even with early-stage NHL, the presence of bulky disease almost invariably indicates the need for more aggressive therapy. As part of a diagnostic work-up, healthcare providers will consider other conditions with symptoms and characteristics similar to that of NHL. This not only includes Hodgkin lymphoma but other benign or malignant conditions affecting the lymphatic system.
Among the possible conditions explored in the differential diagnosis are:. Like all other forms of cancer, NHL is most readily treated in the early stages.
However, because the symptoms can be so non-specific, it may be difficult to recognize the signs until the disease is already advanced. In the end, the one sign you should never ignore is swollen lymph nodes. Lymphadenopathy should never be considered "normal," particularly when it persists or recurs for no apparent reason. Even if there are no other symptoms, have them checked out. In most cases, cancer will not be the cause.
But, even if it is, there are treatments today that can cure NHL in many people or offer disease-free survival even in the advanced stages. Limiting processed foods and red meats can help ward off cancer risk. These recipes focus on antioxidant-rich foods to better protect you and your loved ones. Sign up and get your guide!
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This content does not have an English version. This content does not have an Arabic version. Diagnosis Bone marrow exam Open pop-up dialog box Close. Bone marrow exam In a bone marrow aspiration, a doctor or nurse uses a thin needle to remove a small amount of liquid bone marrow, usually from a spot in the back of your hipbone pelvis.
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