Diagnosing Non-Hodgkin Lymphoma

Overview

Non-Hodgkin lymphoma (NHL) is a type of cancer that develops when lymphocytes, which are a type of white blood cell, start to grow abnormally, weakening the immune system and potentially forming tumors throughout the body.

To diagnose non-Hodgkin lymphoma, doctors use a variety of examinations, tests, and procedures. Diagnosing non-Hodgkin lymphoma involves multiple specialists working together as a team. These specialists may include:

Primary care doctors
Oncologists (cancer specialists)
Hematologists (blood disorder specialists)
Pathologists (who examine tissue samples under microscopes)
Radiologists (who interpret imaging tests)
Other healthcare professionals with expertise in diagnosing and treating lymphomas.

Diagnosis may include:

Medical history: The healthcare professional will ask about symptoms, medical history, medications, and family medical history.
Physical exam: During a physical exam, the doctor looks for swollen lymph nodes in the neck, groin, and underarms, and checks for swelling in the spleen and liver. This helps provide a baseline for your diagnosis.
Blood tests: A complete blood count (CBC) is performed to check the number of red blood cells, white blood cells, and platelets in your blood. It also measures the amount of hemoglobin (the protein that carries oxygen) in the red blood cells. Other blood tests may check for general health of the kidneys and liver or for signs of inflammation or infection.
Lymph node biopsy: A lymph node biopsy is a key procedure for diagnosing lymphoma. During this procedure, a specialist takes a sample of a lymph node and examines it under a microscope for signs of lymphoma. The biopsy can also help determine the type of lymphoma and how fast it's growing.
Imaging tests: X-rays, ultrasound, magnetic resonance imaging (MRI), computed tomography (CT), or PET scans may be used to examine areas inside the body, such as the liver, spleen, brain and spinal cord. These tests help doctors understand the extent of the cancer.

Additional tests or procedures may be performed based on initial findings or to determine the stage or severity of non-Hodgkin lymphoma. These may include:

Lumbar puncture: This procedure, also called a Spinal Tap, involves collecting cerebrospinal fluid (CSF) from the spinal column by placing a needle between two bones in the spine. The CSF sample is then checked under a microscope for cancer cells or other signs that the cancer has spread to the brain and spinal cord.
Bone marrow biopsy: A small sample of bone marrow is taken from your hipbone or another large bone to check for cancer cells. The sample is then examined under a microscope to see if cancer is present in the bone marrow. This test helps determine if the cancer has spread to the bone marrow.
Heart and lung function tests: These tests assess how well your heart and lungs are functioning. They provide important information about your overall health and help determine if you can tolerate certain treatments.

After diagnosis of NHL, the doctor will determine the stage of NHL. The stage is based on where the lymphoma is located, if it has spread, and where it has spread. The stage helps the healthcare provider to determine a recommended treatment plan. The stages of NHL are:

Stage I

Lymphoma is in one lymph node area or one lymphoid organ (spleen, bone marrow, or thymus)
Lymphoma in just one area of a single organ outside of your lymph system. (this is Stage 1E)

Stage II

Lymphoma is in two or more lymph node groups s on the same side of the diaphragm (either above or below the diaphragm).
Lymphoma is in a group of lymph nodes and is in one area of a nearby organ.

Stage III:

Lymphoma is in lymph node areas on both sides of the diaphragm (both above and below the diaphragm).
Lymphoma is in lymph nodes above the diaphragm and in the spleen.

Stage IV:

Lymphoma in at least one organ outside the lymph system, such as the liver or lung

Remember that each person's diagnosis may be unique based on their specific symptoms and health history. It's always important to consult with your doctor who can guide you through appropriate diagnostic procedures based on your individual circumstances.