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Doctor speaking with patient about her lymphoma diagnosis

Lymphoma is a group of cancers that affect the lymphatic system, a vast network of tissues and organs that helps eliminate waste and toxins from the body. A key part of the body’s immune system, the lymphatic system also produces and circulates lymph, a fluid that contains infection-fighting white blood cells. The cancer develops when certain white blood cells (lymphocytes) undergo abnormal changes that cause them to grow and divide uncontrollably, sometimes spreading beyond the lymphatic system.

How do they test for lymphoma?

Testing for lymphoma usually begins with a physical examination and medical history review. The physician will also evaluate any symptoms, such as swollen lymph nodes. A definitive diagnosis usually requires a biopsy, which involves removing a small sample of suspicious tissue for microscopic analysis by a pathologist.

Biopsy procedures that may be used to diagnose lymphoma include:

  • Excisional lymph node biopsy – A physician will make a small incision and remove an enlarged lymph node located near the surface of the skin.
  • Pleural fluid biopsy – A physician will insert a fine needle into the space between the chest wall and lungs (pleural space) and withdraw a small amount of fluid.
  • Bone marrow aspiration – A physician will insert a thin needle into a bone cavity and withdraw a small sample of liquid bone marrow.
  • Bone marrow biopsy – A physician will insert a large needle into a bone cavity and remove a small piece of bone and bone marrow.

In some cases, a lymphoma biopsy is performed with imaging guidance, such as ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI), which can be particularly helpful if the targeted lymph nodes or tissues are deep-seated or difficult to access.

Are other tests used to diagnose lymphoma?

In addition to biopsy, other tests may be used to diagnose lymphoma, such as:

Complete blood cell (CBC) count

Blood testing can help a physician assess the overall health of the patient and detect abnormalities, such as an elevated white blood cell count or the presence of certain proteins that may indicate lymphoma.

Flow cytometry

When performing this laboratory technique, a pathologist will analyze the characteristics of cells, such as their size, shape and protein content. Flow cytometry can help a physician identify abnormal lymphocytes and, if lymphoma is present, classify its type.

Cytogenetic analysis

A detailed study of the chromosomes in cancer cells, cytogenetic analysis can help a physician identify genetic abnormalities that may guide treatment decisions.

Molecular testing

When performing this laboratory technique, a pathologist will thoroughly analyze a sample of tissue, blood or another bodily fluid to check for certain genes, proteins or other molecules that may indicate lymphoma.

Hematopathology consultation

A subspecialty of anatomic pathology, a hematopathology consultation is a diagnostic evaluation of blood and/or bone marrow samples performed by a pathologist with specialized expertise in the diagnosis of blood disorders (hematopathologist).

Fluorescence in situ hybridization (FISH) panel

A sensitive genetic testing technique, a FISH panel can help a physician detect the presence or absence of specific DNA sequences on chromosomes that are associated with lymphoma.

Clonality study

An analysis of the genetic or molecular markers present in cells, a clonality study can help a physician determine if a population of cells, such as those found in a tumor or the bone marrow of a patient with lymphoma, originated from a single cell (clonal) or multiple cells (polyclonal). Because virtually all forms of lymphoid malignancies contain rearrangements of one or more antigen receptor genes, this test is central to the diagnosis of lymphomas and lymphocytic leukemias.

Benefit from world-class care at Moffitt Cancer Center

Moffitt’s Malignant Hematology Program is home to a multispecialty team that focuses exclusively on diagnosing and treating lymphoma and other hematological cancers. In a single location, our patients have convenient access to a wide array of advanced treatment options, including cutting-edge therapies that are available only through our robust clinical trials program.

If you would like to learn more about the diagnostic process for lymphoma, you can request an appointment with a specialist in our Malignant Hematology Program by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.