Non-Hodgkins Lymphomas (cont.)

Medical Author:

Jerry R. Balentine, DO, FACEP

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Signs and symptoms of NHL include the following:

• Swollen, painless lymph nodes in the neck, armpits, or groin
• Unexplained weight loss
• Fever
• Night sweats
• Coughing, trouble breathing, or chest pain
• Weakness and tiredness that don't go away (fatigue)
• Abdominal pain or swelling, or a feeling of fullness in the abdomen
• Itching of the skin

Physical exam: Your doctor will complete a physical examination with a special emphasis on palpating your lymph nodes in your neck, underarms, and groin and establishing if they are swollen. He or she will also try to find out if your spleen or liver are swollen. In most cases, swollen lymph nodes are signs of infection (rather then lymphoma), and your doctor will try to establish if you have any other signs of infection and what the source of the infection could be.

Medical history: You will be asked questions in regards to your past medical history and about risk factors for NHL.

Blood tests: A complete blood count (CBC) will usually be performed to check the number of white blood cells. Additional tests might include a lactate dehydrogenase level (can be elevated in lymphoma). Additional tests might be performed to rule out an infection causing the swollen lymph nodes.

Imaging procedures: A chest X-ray or CT scan of the chest or neck might help detect the presence of tumors or more enlarged lymph nodes. Positron emission tomography (PET) scanning is a newer modality to help detect NHL.

Biopsy: Your doctor might recommend a biopsy of lymph nodes to diagnose the cause of the swelling. The samples will then be given to a pathologist who will review the sample under the microscope and establish a diagnosis.

There are three ways to diagnose a lymph node: removal of the entire lymph node (excisional biopsy); partial removal of a lymph node (incisional biopsy); fine-needle aspiration (using a thin needle to remove some lymph node tissue) is often not diagnostic as not enough tissue is removed for the pathologist to make a diagnosis.

Bone marrow biopsy: A bone marrow biopsy can establish the spread of the disease. This involves the insertion of a needle into bone to obtain bone marrow. In adults, the most common site for this biopsy is the pelvic bone.

Source: MedicineNet.com
http://www.medicinenet.com/non-hodgkins_lymphomas/article.htm