Lymphoma Diagnosis: Right from the Start

  • Myron S. Czuczman, MD, Head of Lymphoma/Myeloma Service and Lymphoma Translational Research Laboratory, Department of Immunology

First Things First: Is your Diagnosis Correct?

Because there are several subtypes of lymphoma, an accurate diagnosis is essential to effective treatment.

Roswell Park is equipped with a Clinical Cytogenetics Laboratory, a Molecular Diagnostics Laboratory, and a Flow Cytometry Laboratory, all operating with state-of-the-art technology to provide a complete diagnostic workup. These resources enable us to determine the unique features of a patient’s lymphoma so we can pinpoint the best treatment options.

At Roswell Park, standard diagnostic tests for lymphoma include:

  • Physical exam: Your doctor checks for swollen lymph nodes, spleen, or liver.
  • Blood tests: The lab does a complete blood count to check the number of lymphocytes and other cells in the blood. A comprehensive metabolic profile and other blood tests will evaluate kidney and liver functions, and additional tests may be important for prognosis in lymphoma patients.
  • Chest x-ray: An x-ray can show swollen lymph nodes or other signs of disease in your chest.
  • Lymph node biopsy: The best way to diagnose lymphoma is to perform a biopsy of a lymph node. The pathologist uses a microscope to look for abnormal cells. If an abnormal cell called a Reed-Sternberg cell is present, the disease is Hodgkin lymphoma.

Additional key pathology studies for a lymphoma diagnosis include:

  • Immunohistochemistry study: After adding an antibody, dye, or radioisotope (radioactive atoms) to the sample of cancer cells, the pathologist looks for certain antigens or proteins, which help distinguish one type of lymphoma from another.
  • Light and electron microscopy: A high-powered microscope helps identify changes in the cancer cells.
  • Cytogenetic analysis: This process makes it possible for the pathologist to look at the actual chromosomes of the cancer cell.
  • FISH (fluorescence in situ hybridization): This process makes it possible for the pathologist to use special probes to look at the actual genes and chromosomes of the cell to identify any abnormalities.
  • Flow cytometry: This test measures the number of cells in a sample and can determine the percentage of cells that are live, or that have a certain characteristic, size, shape or tumor marker.
  • Molecular diagnostics: These tests can examine DNA, proteins, and other components of blood or tissue.

To see how far the lymphoma has spread through the lymphatic system, other tests may be done. Typically, these include a CT scan and/or a PET-CT scan. Both of these procedures provide detailed images of the areas studied.

Our specialized laboratories will also provide information about unusual genetic and molecular markers of your disease, which may not only be important for your prognosis but also used to determine your eligibility for clinical trials that are not widely available.