Diagnosis and Staging of Lymphoma
-If patient has the symptoms that suggests lymphoma, doctor must find out whether those symptoms are due to lymphoma or some other cause.
-Doctor may ask about the personal and family medical history of patient.
-Doctor checks for swollen lymph nodes in the neck, underarms and groin.
-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.
-X-ray pictures may show swollen lymph nodes or other signs of disease in the chest.
Biopsy
-A biopsy is the only sure way to diagnose lymphoma.
-Doctor may remove an entire lymph node (excisional biopsy) or only a 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 Hodgkin’s lymphoma cells.
-A person with Hodgkin lymphoma usually has large, abnormal cells known as Reed-Sternberg cells. They are not found in people with non-Hodgkin lymphoma.
-Doctor needs to know the extent (stage) of lymphoma to plan the best treatment.
-Staging is a careful attempt to find out what parts of the body are affected by the disease.
-Lymphoma usually starts in a lymph node. It can spread to nearly any other part of the body. For example, it can spread to the liver, lungs, bone and bone marrow.
Staging
Bone marrow biopsy
-The doctor uses a thick needle to remove a small sample of bone and bone marrow from the hipbone or another large bone.
-Local anesthesia can help control pain.
-A pathologist looks for lymphoma cells in the sample.
CT scan
-An x-ray machine linked to a computer takes a series of detailed pictures of the head, neck, chest, abdomen, or pelvis.
-Doctor may order MRI pictures of the spinal cord, bone marrow, or brain.
-MRI uses a powerful magnet linked to a computer.
-It makes detailed pictures of tissue on a computer screen or film.
MRI
Ultrasound
-An ultrasound device sends out sound waves that we cannot hear.
-A small hand-held device is held against the body.
-The waves bounce off nearby tissues, and a computer uses the echoes to create a picture.
-Tumors may produce echoes that are different from the echoes made by healthy tissues. The picture can show possible tumors.
-The doctor uses a long, thin needle to remove fluid from the spinal column.
-Patient receives an injection of a small amount of radioactive sugar.
-A machine makes computerized pictures of the sugar being used by cells in your body.
-Lymphoma cells use sugar faster than normal cells, and areas with lymphoma look brighter on the pictures.
PET scan
-The stage is based on where lymphoma cells are found (in the lymph nodes or in other organs or tissues).
-The stage also depends on how many areas are affected.
-The lymphoma cells are in one lymph node group (such as in the neck or underarm).
-Or, if the abnormal cells are not in the lymph nodes, they are in only one part of a tissue or organ (such as the lung, but not the liver or bone marrow).
Stage I
-The lymphoma cells are in at least two lymph node groups on the same side of (either above or below) the diaphragm.
-Or, the lymphoma cells are in one part of a tissue or an organ and the lymph nodes near that organ (on the same side of the diaphragm).
-There may be lymphoma cells in other lymph node groups on the same side of the diaphragm.
Stage II
-The lymphoma cells are in lymph nodes above and below the diaphragm.
-Lymphoma also may be found in one part of a tissue or an organ (such as the liver, lung, or bone) near these lymph node groups. It may also be found in the spleen.
Stage III
-Lymphoma cells are found in several parts of one or more organs or tissues.
-Or, the lymphoma is in an organ (such as the liver, lung, or bone) and in distant lymph nodes.
Stage IV
-In addition to these stage numbers, doctor may also describe the stage as A or B:
-A: You have not had weight loss, drenching night sweats, or fevers.
-B: You have had weight loss, drenching night sweats, or fevers.
Diagnosis of salivary gland cancer
The following tests and procedures may be used to diagnose salivary gland cancer
Physical exam and history
-MRI
-CT scan
-PET scan
-Ultrasound exam
-Endoscopy
-Biopsy
Head and neck cancer staging
-Head and neck cancer staging involves both the size of the tumor and whether or not it has spread to other parts of the body such as the lymph nodes.
-Staging helps doctor to determine whether or not to try a particular treatment.
-Stages of head and neck cancer start at 0 and go up to 4 (I–IV)
-Generally, a lower number means the cancer has spread less. A higher number means the cancer has spread more.
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