Diagnosing

Non-Hodgkin Lymphoma (NHL)


Diagnosing Non-Hodgkin Lymphoma

At Sheba Medical Center, our team of specialists has extensive and comprehensive knowledge and experience with non-Hodgkin lymphoma. Sheba’s extensive facilities offer all the testing and equipment necessary to help our oncologists and hematologists diagnose and determine the stage of your disease.

At Sheba, you’ll stay informed every step of the way as our experienced doctors guide you through the critical diagnostic part of your cancer care. As soon as a diagnosis is made, we’ll come up with an individualized treatment plan tailored to your specific needs.

During your diagnostic evaluation, we may perform the following procedures:

 

Complete Blood Count (CBC)

A CBC is a blood test that provides a count of the red blood cells, platelets, hemoglobin, and lymphocytes in your blood.

 

Biopsy.

An NHL diagnosis cannot be made without a biopsy. A portion or all of a lymph node is removed and sent for testing in a lab, where pathologists assess the sample to determine whether a person has lymphoma, and what type it is. Depending on the case, the patient may require other types of biopsies, including bone marrow aspiration or lumbar puncture (spinal tap).

 

Flow cytometry and immunohistochemistry.

This laboratory test uses a biopsy sample to determine whether lymph nodes are swollen and lymphocyte count is raised because of infection, another type of cancer, or lymphoma.

 

Fluorescent in situ hybridization (FISH).

This laboratory test uses special dyes to assess lymphoma cell DNA. It can pick up small chromosome changes that cannot be seen with other kinds of testing. This information can help doctors build customized treatment plans.

 

Imaging tests.

Imaging tests used in diagnostic evaluation include x-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, ultrasound, positron emission tomography (PET) scans, and bone scans. These tests help to determine the stage of lymphoma. They are also used during treatment to show if treatment is working and after treatment to look for signs of the lymphoma coming back.

 

Staging

After a non-Hodgkin lymphoma diagnosis is made, doctors try to figure out how advanced the cancer is by determining whether it has spread. Our specialists will gather all the information from the diagnostic tests, and perform further testing if necessary.

If the lymphoma is in the lymph nodes, the following stages are used:

Stage I: The lymphoma is in one lymph node or in a lymphoid organ (I); or, the cancer is found in one area of one organ outside the lymph system (IE).
Stage II: The lymphoma is in two or more groups of lymph nodes on the same side of (above or below) the diaphragm (II); or, the lymphoma is found in a group of lymph nodes in one area of the body (IIE).
Stage III: The lymphoma is found in two or more groups of lymph nodes, both above and below the diaphragm; or cancer is found both in lymph nodes above the diaphragm and in the spleen.
Stage IV: In the most advanced stage of non-Hodgkin lymphoma, the cancer has spread to several parts of one or more organs and tissues. It may also have spread to the liver, lungs, or bones.

If the cancer is found in the blood or bone marrow, such as in chronic lymphocytic leukemia (CLL), a different staging system is used.

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