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Non-Hodgkin Lymphoma

  • Posted: 02/12/2008

Diagnosis

Types of Non-Hodgkin Lymphoma

If you have swollen lymph nodes or another symptom that suggests non-Hodgkin lymphoma, your doctor will try to find out what's causing the problem. Your doctor may ask about your personal and family medical history.

You may have some of the following exams and tests:

  • Physical exam: Your doctor checks for swollen lymph nodes in your neck, underarms, and groin. Your doctor also checks for a swollen spleen or liver.
  • Blood tests: The lab does a complete blood count to check the number of white blood cells. The lab also checks for other cells and substances, such as lactate dehydrogenase (LDH). Lymphoma may cause a high level of LDH.
  • Chest x-rays: You may have x-rays to check for swollen lymph nodes or other signs of disease in your chest.
  • Biopsy: A biopsy is the only sure way to diagnose lymphoma. Your doctor may remove an entire lymph node (excisional biopsy) or only part of a lymph node (incisional biopsy). A thin needle (fine needle aspiration) usually cannot remove a large enough sample for the pathologist to diagnose lymphoma. Removing an entire lymph node is best. The pathologist uses a microscope to check the tissue for lymphoma cells.
You may want to ask your doctor these questions before having a biopsy:
  • How will the biopsy be done?
  • Where will I have my biopsy?
  • Will I have to do anything to prepare for it?
  • How long will it take? Will I be awake? Will it hurt?
  • Are there any risks? What are the chances of swelling, infection, or bleeding after the biopsy?
  • How long will it take me to recover?
  • How soon will I know the results? Who will explain them to me?
  • If I do have cancer, who will talk to me about next steps? When?

Types of Non-Hodgkin Lymphoma

When lymphoma is found, the pathologist reports the type. There are many types of lymphoma. The most common types are diffuse large B-cell lymphoma and follicular lymphoma.

Lymphomas may be grouped by how quickly they are likely to grow:

It's a good idea to get a second opinion about the type of lymphoma that you have. The treatment plan varies by the type of lymphoma. A pathologist at a major referral center can review your biopsy. See the Second Opinion section 1 for more information.


Glossary Terms

aggressive lymphoma (uh-GREH-siv lim-FOH-muh)
A type of lymphoma that grows and spreads quickly and has severe symptoms. Also called high-grade lymphoma and intermediate-grade lymphoma.
biopsy (BY-op-see)
The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures. The most common types include: (1) incisional biopsy, in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.
complete blood count (kum-PLEET blud kownt)
A test to check the number of red blood cells, white blood cells, and platelets in a sample of blood. Also called blood cell count and CBC.
diffuse large B-cell lymphoma (dih-FYOOS larj ... sel lim-FOH-muh)
A type of B-cell non-Hodgkin lymphoma (cancer of the immune system) that is usually aggressive (fast-growing). It is the most common type of non-Hodgkin lymphoma, and is marked by rapidly growing tumors in the lymph nodes, spleen, liver, bone marrow, or other organs. Other symptoms include fever, night sweats, and weight loss. There are several subtypes of diffuse large B-cell lymphoma.
excisional biopsy (ek-SIH-zhuh-nul BY-op-see)
A surgical procedure in which an entire lump or suspicious area is removed for diagnosis. The tissue is then examined under a microscope.
fine-needle aspiration biopsy (... NEE-dul AS-pih-RAY-shun BY-op-see)
The removal of tissue or fluid with a thin needle for examination under a microscope. Also called FNA biopsy.
follicular lymphoma (fuh-LIH-kyoo-ler lim-FOH-muh)
A type of B-cell non-Hodgkin lymphoma (cancer of the immune system) that is usually indolent (slow-growing). The tumor cells grow as groups to form nodules. There are several subtypes of follicular lymphoma.
high-grade lymphoma (... lim-FOH-muh)
A type of lymphoma that grows and spreads quickly and has severe symptoms. Also called aggressive lymphoma and intermediate-grade lymphoma.
incisional biopsy (in-SIH-zhuh-nul BY-op-see)
A surgical procedure in which a portion of a lump or suspicious area is removed for diagnosis. The tissue is then examined under a microscope to check for signs of disease.
indolent lymphoma (IN-doh-lent lim-FOH-muh)
A type of lymphoma that tends to grow and spread slowly, and has few symptoms. Also called low-grade lymphoma.
intermediate-grade lymphoma (IN-ter-MEE-dee-ut-grayd lim-FOH-muh)
A type of lymphoma that grows and spreads quickly and has severe symptoms. Also called aggressive lymphoma and high-grade lymphoma.
lactate dehydrogenase (LAK-tayt dee-hy-DRAH-jeh-nays)
One of a group of enzymes found in the blood and other body tissues and involved in energy production in cells. An increased amount of lactate dehydrogenase in the blood may be a sign of tissue damage and some types of cancer or other diseases. Also called lactic acid dehydrogenase and LDH.
low-grade lymphoma (... lim-FOH-muh)
A type of lymphoma that tends to grow and spread slowly, and has few symptoms. Also called indolent lymphoma.
pathologist (puh-THAH-loh-jist)
A doctor who identifies diseases by studying cells and tissues under a microscope.
x-ray (EX-ray)
A type of radiation used in the diagnosis and treatment of cancer and other diseases. In low doses, x-rays are used to diagnose diseases by making pictures of the inside of the body. In high doses, x-rays are used to treat cancer.

Table of Links

1http://www.cancer.gov/cancertopics/wyntk/non-hodgkin-lymphoma/page8