Laboratory tests, biopsies, and imaging studies in the evaluation of lymphoma

The article was professionally consulted with Master, Doctor Nguyen Van Huong - Department of Diagnostic Imaging - Vinmec Danang International General Hospital.

Lymphoma is a disease that develops in the cells of the lymphatic system. A blood test or lymph node biopsy is the way to diagnose the disease. To determine if the cancer has spread, a patient may have a bone marrow biopsy, lumbar puncture, and other imaging tests. Treatment depends on the type of lymphoma, the stage of the disease, and the patient's age and overall health.

Lymphoma is cancer that develops in the white blood cells (lymphocytes) of the lymphatic system. White blood cells are part of the body's immune system. The lymphatic system consists of a network of small channels similar to blood vessels that circulate fluid (called lymph), the lymph nodes, bone marrow, and several organs in the body are all made up of cells. white blood cells. Lymph nodes have a flat oval shape, they are present all over the body, but they are concentrated in some areas such as the neck, armpits, and groin.
There are two main types of lymphoma: Hodgkin (HL) and non-Hodgkin (NHL). Within each category there are several sub-categories. Hodgkin's lymphoma is also known as less common Hodgkin's disease. Non-Hodgkin lymphomas are individual lymphomas that differ in how they work, how they spread, and how they respond to treatment.

Lymphoma is identified by examining certain cancer cells under a microscope. When the tumor has Reed-Sternberg cells, the lymphoma is classified as Hodgkin. When it is not present, the cancer is classified as non-Hodgkin.
Symptoms of lymphoma may include: swollen lymph nodes in the neck, armpits, groin, unexplained weight loss, fever, night sweats, body itching, fatigue, loss of appetite, cough or difficulty breathing pain in the abdomen, chest or bones, swollen abdomen.

To make a diagnosis, a doctor will begin by taking a patient's medical history and symptoms and performing a physical exam. Your doctor may recommend one or more of the following tests.
Blood tests: Usually the white blood cell, platelet, and red blood cell count will be low when the lymphoma has spread to the bone marrow. Blood test results also aid in assessing how well the liver and kidneys are functioning. Lymph node biopsy: A procedure in which part or all of a lymph node is surgically removed for examination under a microscope to look for the presence of lymphoma cells. Other laboratory tests may be performed on the biopsy sample, including molecular genetic testing. Biopsies are often used to determine disease status, disease progression, and determine further tests and treatments. Before the biopsy, the patient needs to do routine tests and imaging tests. The risk of the biopsy procedure is assessed as low risk, the most common risks that can only occur are local bleeding and infection but are very rare. Bone marrow aspiration and biopsy: This is a procedure in which a thin, hollow needle is inserted into the hip bone to remove a small amount of liquid bone marrow and analyze it under a microscope. This procedure is usually done after lymphoma has been diagnosed to determine if the disease has spread to the bone marrow.

Lumbar puncture (spinal canal): This is a minimally invasive test that takes a small amount of cerebrospinal fluid (CSF), the fluid that surrounds the brain and spinal cord, to analyze for the presence of cancer cells. lymphoma. This test is usually only done for certain types of lymphoma or if the patient has symptoms that suggest the lymphoma may have spread to the brain. Chest X-ray: A chest X-ray is used to look for lymph nodes in the mediastinum. CT scan: CT is used to detect lymph nodes or abnormalities in the abdomen, pelvis, chest, head, and neck. In some cases, a CT scan may be used to guide the biopsy needle precisely into the suspected area so that a tissue sample can be removed and examined under a microscope. This procedure is called a CT-guided needle biopsy. PET scan: A PET scan is a way of using a small amount of radioactive material to determine if an enlarged lymph node is cancerous and to find out the growth of cancer cells throughout the body that may be present. not seen on CT scan. Some lymphoma patients have PET scans after treatment to see if the cancer is responding to treatment. PET scans are often combined with CT or MRI scans to provide highly detailed views of the body. Scintigraphy: During a bone scan, a radioactive isotope called technetium-99m is injected into a vein and moved to areas of damaged bone. This test is usually done if the patient has bone pain or other tests show that the lymphoma has moved to the bone. MRI scan: An MRI scan is useful in detecting lymphoma that has spread to the spinal cord or brain. It may also be helpful in other areas of the body such as the head and neck area. Abdominal ultrasound: An abdominal ultrasound may be used to check for enlarged lymph nodes, especially within the abdomen. Ultrasound is also used to visualize the abdominal organs and kidneys, which may be affected by enlarged lymph nodes.

For female patients, the doctor or x-ray technician should be informed if there is a possibility that they may be pregnant. For pregnant women with lymphoma, MRI and ultrasound can be used to stage the disease while also protecting the fetus from harmful radiation.
Lymphoma is a disease with a good prognosis, if detected early, if not detected and treated promptly, it will lead to severe disease progression and inability to cure
Periodic health check-up is Vinmec's strength Due to good organization, accurate results, continuous monitoring and evaluation of patients, it is possible to detect early systemic abnormalities especially of the lymphatic system. Highly trained and skilled personnel, modern machinery, especially the CT 640 and MRI 3 systems, Tesle scans the whole body for abnormal lymph nodes very well.
Currently, Vinmec International General Hospital has been and continues to be fully equipped with modern diagnostic facilities such as: PET/CT, SPECT/CT, MRI... biology, immunohistochemistry, genetic testing, molecular biology testing, as well as a full range of targeted drugs, the most advanced immunotherapy drugs in cancer treatment. Multimodal cancer treatment from surgery, radiation therapy, chemotherapy, hematopoietic stem cell transplantation, targeted therapy, immunotherapy in cancer treatment, new treatments such as autoimmunotherapy body, heat therapy...
After having an accurate diagnosis of the disease and stage, the patient will be consulted to choose the most appropriate and effective treatment methods. The treatment process is always closely coordinated with many specialties: Diagnostic Imaging, Biochemistry, Immunology, Cardiology, Stem Cell and Gene Technology; Department of Obstetrics and Gynecology, Department of Endocrinology, Department of Rehabilitation, Department of Psychology, Department of Nutrition... to bring the highest efficiency and comfort to the patient. After undergoing the treatment phase, the patient will also be monitored and re-examined to determine whether the cancer treatment is effective or not.
Especially, now to improve service quality, Vinmec also deploys many cancer screening packages that can help customers detect cancer early before there are no symptoms, bringing a better prognosis. treatment and a high chance of recovery.

Reference source: radiologyinfo.org