Your doctor can usually determine that you have non-Hodgkin's lymphoma by using a microscope to look at the lymphomatous tissue taken from your biopsy. Some people need more than one test to tell which type of lymphocyte, B cell or T cell, is affected.
Your doctor can diagnose lymphoma with a biopsy. But you may need other lab tests to confirm the diagnosis, identify the specific type and stage of lymphoma, and show how rapidly the lymphoma is growing. This information helps determine your treatment plan and gives a sense of your prognosis.
Here are some of the tests you may need.
Cytogenetic analysis. For this test, you need to give either a blood sample or a bone marrow sample obtained from a bone marrow aspiration. (For a bone marrow aspiration, your doctor takes marrow from your hip bone. You are numbed for this procedure.) The cells are then grown in a laboratory. After about three weeks, a pathologist looks under a microscope at a cell's chromosomes. These are the pieces of DNA that control cell growth. The DNA changes related to lymphoma are not inherited. They usually occur after birth. With some types of lymphoma, chromosomes may exchange DNA. For instance, part of chromosome 1 is on part of chromosome 2 and vice versa. This is called translocation. Or there may be the wrong number of total chromosomes. A chromosome can be deleted. Or one can be added.
Immunohistochemistry. This test can help identify the different types of non-Hodgkin's lymphoma. For it, your doctor treats part of the biopsy sample with special antibodies that attach to the cell surface. These antibodies cause color changes seen under a microscope.
Flow cytometry. This is another test that can help tell the type of non-Hodgkin's lymphoma. It looks at more cells than immunohistochemistry. Your doctor uses fluorescent antibodies on your biopsy sample and then passes them in front of a laser beam. The laser causes the cells to give off light of different colors, which can be detected with a special machine.
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