Diagnosing Mantle Cell Lymphoma
Mantle cell lymphoma (MCL) is a rare form of B-cell non-Hodgkin's lymphoma. To diagnose MCL, doctors may perform several examinations, screening tests, and procedures. These tests help confirm the presence of MCL and determine its type, severity, and stage.
Specialists involved in diagnosing MCL may include hematologists, oncologists, radiologists and pathologists. Here are the examinations, tests, and procedures used in diagnosing MCL:
- Medical History: Doctors gather information about the person's symptoms, risk factors, and other medical conditions. This includes asking about lifestyle habits, chronic conditions in the family, and exposures to possible infectious agents.
- Physical Examination: During a physical examination, doctors carefully examine the person's body, paying special attention to lymph nodes to locate any swellings. They may also check for organ enlargement by putting pressure on the abdomen.
- Blood Tests: Blood tests can provide valuable information general health and about organ function and indicate if MCL has reached the bone marrow. Doctors may measure levels of LDH (lactate dehydrogenase) and check white blood cell counts.
- Biopsy: A biopsy is a crucial procedure for confirming an MCL diagnosis. During a biopsy, a small sample of tissue suspected to be cancerous is removed for microscopic review. Multiple biopsies from different areas of the body may be needed to assess the extent of MCL.
- Antigen Testing: Antigen testing is part of an immunohistochemistry workup and involves using cell samples from biopsies to screen for specific antigens associated with MCL. These antigens, such as CD5, CD19, CD20, and CD22, are markers on the surface of cells that uniquely identify MCL cells.
- Genetic Screening: Genetic testing plays an important role in diagnosing MCL. Using biopsy tissue, doctors can look for a specific genetic translocation featured in this condition. In MCL, a genetic translocation occurs when a section of genetic material breaks off from one chromosome and attaches to another chromosome. The genetic translocation associated with MCL involves the CCND1 gene.
Additionally, to determine the type, severity, or stage of MCL, further examinations and tests may be conducted:
- Bone marrow aspiration and biopsy: A sample of bone marrow is taken and examined under a microscope for MCL.
- Body scans: Imaging tests like computed axial tomography (CAT) and positron emission tomography (PET) scans may be performed to determine the location and extent of the cancer in the body.
- Depending on symptoms and spread of MCL, additional procedures may include endoscopy of the upper gastrointestinal tract or colon to check for signs of MCL.
After diagnosing MCL, the healthcare team will assess the stage of MCL. Staging may be important for treatment recommendations. Staging is based upon whether MCL has spread from the lymph node where the MCL first developed. Staging will consider if spread of MCL is:
- Within the lymphatic system (lymph nodes, bone marrow, spleen, tonsils, and thymus)
- Outside of the lymphatic system (such as to the gastrointestinal tract or liver)
Other examinations, test or procedures may be performed based on initial findings and individual factors. It's important to consult your healthcare provider for specific recommendations and guidance regarding these examinations, tests, and procedures.