Diagnosing Lymphoma

With over 90 different subtypes, lymphoma is a tricky cancer to diagnose. The diagnosis must be correct for the treatment plan to succeed. Given the complexity of lymphoma diagnosis and care, it’s very important to get your diagnosis from oncologists who specialize in this type of cancer.

The lymphoma team at Siteman Cancer Center works on lymphoma every day. They’ll draw on years of advanced training, research, and experience to get you an accurate diagnosis.

How is lymphoma diagnosed?

If you are unwell with symptoms that could indicate lymphoma, you will probably start by seeing your primary care provider. Your doctor will talk with you about your medical history and perform a physical exam to check for abnormalities, such as swollen lymph nodes or a swollen spleen. If your main symptom is a swollen lymph node, your doctor may suggest waiting for a period of time to see if it goes away on its own.

After conducting an exam, your doctor might ask you to undergo blood tests to look for evidence of lymphoma.

If these tests suggest you may have lymphoma, you will undergo more advanced tests. Patients are often referred for a bone marrow biopsy, a procedure in which bone marrow is collected from the hipbone so it can be examined for lymphoma cells. You’ll be given local anesthesia to keep you comfortable. Your physicians may recommend a biopsy of one or more lymph nodes as well.

Patients may also undergo one or more imaging procedures before their physicians reach a diagnosis. These usually include PET (or positron emission tomography) scans and CT scans. The scans are used to identify lymphoma cells, tumors, and potential problem areas throughout the body.

Your oncologist or a pathologist may run additional tests on your blood or bone marrow samples in order to get a better picture of what type of lymphoma you have.

Staging of Lymphoma

Once an oncologist has diagnosed lymphoma, he or she will also determine the stage of the disease. Staging defines how far lymphoma has spread in the body.

The staging system for Hodgkin and non-Hodgkin lymphoma uses the numerals I, II, III, and IV to indicate how much the disease has spread. Stage I lymphomas have not traveled beyond a single area of lymph nodes or site in the body. Stage II lymphomas have advanced to additional lymph nodes but have not crossed to areas on the opposite side of the patient’s diaphragm. Stage III lymphomas may be found on both sides of the diaphragm, and Stage IV lymphomas have spread to another organ outside of the lymph nodes.