Diagnosing Lymphoma:

Biopsy

The presence of swollen lymph nodes and other associated symptoms can suggest a diagnosis of lymphoma, but the only way to confirm the diagnosis is by carrying out a biopsy.

A biopsy involves removing some, or sometimes all, of an affected lymph node which is then studied in a laboratory. Biopsies can be carried out under a local anaesthetic, though there may be some cases where the affected lymph node is not easily accessible, and a general anesthetic may be required.

A pathologist (an expert in the study of diseased tissue) will then check the tissue sample for the presence of cancerous cells. If they do find cancerous cells, they can also identify exactly which type of lymphoma you have, which is an important factor in planning your treatment.

Further testing

If a biopsy does reveal the presence of lymphoma, further testing will be required in order to check how far the lymphoma has spread. These tests include:

• An X-ray.
• A computerized tomography (CT) scan.
• A magnetic resonance imaging (MRI) scan.

Another biopsy may be carried out to see if the lymphoma has spread to your bone marrow. This involves using a long needle to remove a sample of bone marrow from your pelvis. This can be done using a local anesthetic.

You may also undergo a series of blood tests in order to check how well certain organs, such as your liver or spleen, are working. Blood tests can also show how well, or not, your immune system is working.

Staging of lymphoma

When the testing is complete, it should be possible to determine the stage of your lymphoma. Lymphoma is staged using a measurement of  between 1-4, with stage four representing the most advanced stage of the condition. These stages are explained below.

• Stage 1 - the lymphoma is limited to one group of lymph nodes, such as your neck or groin that are either above or below your diaphragm (a muscle in the centre of your chest used in breathing).
• Stage 2 - two lymph node groups are affected, either above or below the diaphragm.
• Stage 3 - the lymphoma has now spread to lymph node groups that are both above and below the diaphragm.
• Stage 4 - the lymphoma has spread through the lymphatic system and is now present in organs and / or bone marrow outside of the lymphatic system.

Stage 1 or 2 lymphomas can usually be cured. Achieving a cure for a stage three or stage four lymphoma is more challenging, and a remission of symptoms may only be achievable.

Sometimes, health professionals also use an additional grading system, either 'A' or 'B'. A-type lymphoma means that you are experiencing no additional symptoms other than swollen lymph nodes.

B-type lymphoma means you are experiencing additional symptoms, such as weight loss, fever or night sweats.