Diagnosis of Lymphoma

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It is essential to carry out a biopsy on one of the enlarged lymph nodes whenever lymphoma is suspected. Considering each node gives the same result, doctors tend to select whichever is most accessible. Hence, if a patient’s neck and abdominal lymph nodes are inflamed, then the neck will be selected because the procedure is more straightforward and recovery is quicker.

However, if only abdominal nodes, or those in the chest, are effected, then there is no choice but to employ more complicated surgical techniques, such as mediastinoscopy (a surgical procedure used to examine the mediastinum, the space which separates the lungs located behind the sternum and in the centre of the thorax) or laparoscopy (exploration or examination of the abdominal cavity by introducing a laparoscope through a small incision).

In some cases, the disease does not appear in a lymph node and so this may complicate the diagnosis. It sometimes originates in the spleen (which is also a lymphatic organ), in the digestive system (stomach, intestine, which also feature lymphatic tissues), the tonsils, or even inside bones (bone marrow).

Study to determine the degree of spread

Once the diagnosis of lymphoma has been confirmed, doctors then need to know how much it has spread. This mainly involves two tests:

Magnetic Resonance Imaging or MRI machine

Positron Emission Tomography (PET-CT) or Computed Tomography (CT). These are radiological tests used to determine the size and location of all the body’s lymph nodes, as well as the rest of the organs (heart, lungs, liver, kidneys, etc.).

Bone marrow harvesting from the lumbar region

Bone marrow biopsy. This test is conducted because lymphomas often spread to the inside of bones.

Degree of spread

The results of these tests (PET-CT or CT, and bone marrow biopsy) can be used to determine the cancer’s degree of spread. This is classified according to the Ann Arbor staging system.

Stage I. Only one lymph node is affected, the cancer is confined to a single region.

Stage II. Two lymph nodes located close to each other are affected (they are either all above or all below the diaphragm, the muscle separating the thorax from the abdomen).

Stage III. More than one lymph node is affected in different areas of the body (on both sides of the diaphragm).

Stage IV. There is diffuse involvement in areas other than the lymph nodes or spleen (bone marrow, liver, lungs, pleurae, kidneys).

These stages are further subdivided into A or B in function of whether or not the patient presents symptoms associated with lymphoma (fever, sweats, weight loss, etc.).

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Substantiated information by:

Jaume Güell Picazo
Julio Delgado González

Published: 20 February 2018
Updated: 20 February 2018

The donations that can be done through this webpage are exclusively for the benefit of Hospital Clínic of Barcelona through Fundació Clínic per a la Recerca Biomèdica and not for BBVA Foundation, entity that collaborates with the project of PortalClínic.


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