What is Lymphoma?
Lymphoma is a cancer of the lymphocytes, which have a role to play in your immune system. When the lymphocytes become abnormal, they no longer function normally and become cancerous. Lymphoma can start in either the B lymphocytes or T lymphocytes of the immune system.
There are many types of lymphoma, which are separated into two general groups: Hodgkin lymphoma and non-Hodgkin lymphoma. To further subdivide non-Hodgkin lymphoma, there are over 50 subtypes.
Signs and Symptoms
There can be many signs and symptoms associated with lymphoma. These can include:
- Enlargement of lymph nodes in the neck, armpits, or groin
- Unexplained fevers or chills
- Drenching night sweats
- Unintentional weight loss
- Severe itching
- Extreme fatigue
- Pale skin
- Persistent cough
- Difficulty breathing
If someone is suspected of having lymphoma, or is experiencing symptoms that are suspicious and need further evaluation, a variety of tests may be ordered.
Tests can include x-rays, which can show abnormal masses in the lungs that may be causing cough or shortness of breath.
Another test that may be done is a CT scan, which can see abnormal lymph nodes as well as the other organs in the body to check for abnormalities.
If lymphoma is confirmed or strongly suspected after the above tests, a PET scan may also be done. This type of imaging test shows not only the location of any abnormality, but also if those areas are actively growing or not. A sugar is attached to a radioactive tracer and given through an IV before the PET scan is done. The tracer is given time to circulate through the body, and then the person is scanned. Any areas of the body that take up alot of sugar, and are seen to be active, will be seen as bright areas on the screen. These areas may be very suspicious for cancer involvement.
Ultimately a diagnosis of lymphoma is made through a biopsy. During a biopsy, a tissue sample from the suspicious lymph node is removed and tested for cancer cells. A biopsy can be done through a few different ways.
In an excisional biopsy, an entire lymph node is removed to be evaluated for cancer. This is preferred when lymphoma is suspected, as sometimes just taking a small sample of a lymph node can miss the cancer cells.
A needle biopsy may be done of a lymph node. During this procedure, a needle is placed into the suspicious area, and tissue is removed from it. Because less tissue is removed, it may not be as accurate of a way to diagnose lymphoma.
Sometimes a bone marrow biopsy is done as well. During this procedure, a sample of bone and the marrow inside of it is removed from the hip area. The bone marrow is where blood cells are made, and it can be important to know if lymphoma cells are present there. This procedure is often done with anesthesia for patient comfort.
Additional testing for specific chromosome changes and other markers may be done on the lymphoma tissue. This can help the oncologist with their treatment planning.