Diagnosing Follicular Lymphoma
Follicular lymphoma is a type of non-Hodgkin lymphoma that develops in the lymph nodes, a part of the body’s immune system. It mainly affects white blood cells, called B-cells. It is usually slow growing but can vary in how it progresses.
To diagnose follicular lymphoma, doctors may perform several exams, screening tests, and procedures. These tests help confirm the diagnosis and determine the type (specific kind), severity (how serious it is), or stage (how far is has spread) of the condition. The specialists involved in diagnosing follicular lymphoma may include doctors, pathologists (who study cells and tissues), nurses, physician assistants, and lab technicians.
Here are some of the exams, screening tests, and procedures used to diagnose follicular lymphoma:
- Physical exam: During a physical exam, the doctor will check for signs like swollen lymph nodes, unusual lumps, or tenderness in areas where lymph nodes are located (like the neck, armpits, and groin). They will also look for symptoms like fever, fatigue (feeling very tired), or weight loss, which can be related to lymphoma and check the overall health of the person.
- Medical history: The doctor will ask about your medical history to understand your symptoms and any details that could help with the diagnosis.
- Blood tests: A complete blood count (CBC) checks the numbers and appearance of blood cells, like red and white blood cells. Unusual levels might show signs of lymphoma or other health issues. Blood chemistry tests check for certain substances in the blood to see how well your liver and kidneys are working, which can be affected by lymphoma.
- Lymph node biopsy: In this procedure, the doctor takes a small piece of the lymph node or sometimes an entire lymph node. This tissue is examined under a microscope to check if cancer cells are present.
- Imaging tests: Doctors may recommend imaging tests to see the lymphoma in the body and plan treatment. Common imaging scans include computed tomography (CT) scan, positron emission tomography (PET) scan, or PET/CT scans that combine both methods.
- Bone marrow aspiration and biopsy: Using a long needle, doctors remove small amounts of blood, bone marrow, and bone. These samples are then checked under a microscope to look for any signs of cancer in these areas.
- Additional lab tests: A pathologist may run more tests on samples from body fluids, like spinal fluid, fluid around the lungs, or fluid in the abdomen. These tests help diagnose lymphoma and find out its specific type.
To determine the type, severity, or stage of follicular lymphoma, additional exams, tests, or procedures may be performed:
- Immunophenotyping: This test looks at specific markers, called antigens, on the surface of cancer cells to identify the type of lymphoma.
- Chromosome tests: These test help doctors find important genetic details, which guide them in diagnosing and planning the best treatment for lymphoma.
- Molecular cytogenetics:
- This test looks at chromosomes, the structures in our cells that carry DNA instructions for cell growth and function.
- Doctors check for any unusual patterns or changes in chromosomes to help identify the type of lymphoma and guide treatment.
- Fluorescent in situ hybridization (FISH):
- Uses special dyes to highlight specific parts of DNA within chromosomes.
- Helps doctors find unusual changes that might be linked to lymphoma
- Polymerase chain reaction (PCR):
- This test helps identify certain genetic changes by making more copies of specific DNA sections.
- By creating more copies, it becomes easier to see if there are any changes in the DNA that are linked to the type of lymphoma.
- Molecular cytogenetics:
These various exams and tests play an important role in confirming a diagnosis of follicular lymphoma and determining its type, severity, or stage. It is important to talk with a doctor who can help you through this based on your specific symptoms and medical history.