Lymphoma
often first appears as an inflammation to one or more lymph nodes, a
condition called lymphadenopathy.
Importantly, most cases of enlarged
lymph nodes are NOT cancers, as the following resource describes:
Lymphadenopathy: Differential Diagnosis
and Evaluation,
Robert Ferrer, M.D., M.P.H. American
Family Physician
"Although
the finding of lymphadenopathy sometimes raises fears about serious
illness, it is, in patients seen in primary care settings, usually
a result of benign infectious causes. Most patients can be
diagnosed on the basis of a careful history and physical examination.
Localized adenopathy should prompt a search for an adjacent
precipitating lesion and an examination of other nodal areas to rule
out generalized lymphadenopathy."
To make an accurate
diagnosis of lymphoma, a lymph node biopsy must be performed
by the surgical removal (resection) of a lymph node. A fine
needle aspiration may be performed if a lymph node is not accessible,
but this is not considered a definitive way to determine the
diagnosis.
A series of tests will then
be performed to determine the characteristics of the cells. If a
malignancy is determine, these characteristics will allow your doctors
to determine the appropriate treatments to use when
needed.
Waiting for the results of a
biopsy may be the most stressful time
for the patient and his or her loved ones. It can take many
weeks to accurately determine the pathology of the sample.
NOTE:
Snap-freezing part of
this tissue is advised at this time as custom vaccines and potentially
other advanced therapies can be developed from this tissue if it's
stored correctly. You may have to request this in order to make
it happen, as fast freezing is not yet a mainstream procedure in all
hospitals.
This simple request is likely to result in improved diagnosis and more rational
selection of treatments in the near future.
A bone marrow biopsy may
also be ordered to determine the extent of involvement
in the bone marrow. This sounds ominous, but the presence
of malignant cells in the bone marrow is not unusual because the bone
marrow is part of the immune system. It is where b-cells form.
Treatment can also clear the marrow of malignant
cells.
The science of making a
diagnosis is evolving rapidly. Uncovering genetic and molecular characteristics of
lymphomas will also lead to new treatment targets. You need to first identify the characteristics of the enemy before you can exploit its
weaknesses.
CT scans and other tests may
be ordered to determine where the disease is forming tumors.
This will serve as a baseline to allow your doctor to monitor how
fast or slow your lymphoma is progressing and/or evaluate response to
treatment.
When monitoring disease, you
may wish to consult with your doctor about alternatives to CT scans, such as
sonograms, especially when accurate measurements are not
required. See How Many CTs?
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