Pathology of Lymphoma
Pathology, in medical terminology, is the scientific study, analysis and diagnosis of disease. Pathology of lymphoma refers to the medical analysis of lymphoma--cancer of the immune system. It involves a combination of clinical, molecular genetic, immunophenotypic and morphological data in an attempt to study the causes of, and diagnose, lymphoma in an effort to streamline its treatment options.
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Symptoms
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The first sign of lymphoma is a swollen gland or painless lump in the groin area, underarm, abdomen or neck. Other symptoms include redness of the skin, abdominal pain, vomiting, nausea, breathlessness, coughing, night sweats, weight loss, itching skin and extreme lethargy.
Causes
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The exact factors causing lymphoma are unknown. There are, however, certain conditions that increase an individual's chance of developing the disease, including excessive exposure to certain chemicals, pesticides and solvents; taking immune suppressing drugs; suffering from an autoimmune disease, such as rheumatoid arthritis or lupus; a weak immune system; or developing gastritis or stomach ulcer caused by Helicobacter pylori, a specific kind of bacteria.
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Diagnosis
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Lymphoma is diagnosed by a physical exam, blood test(s), imaging tests (X-rays, magnetic resonance imaging, lymphangiogram and computed tomography scan, or CT) and a biopsy. A physical exam, blood tests and imaging tests are performed to rule out other causes or diseases causing the symptoms. A biopsy is performed to determine whether a swollen gland is a lymphoma.
Biopsy
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Lymphoma is diagnosed by a lymph node biopsy. The process involves examining a surgically extracted piece of enlarged lymph node under a microscope. It is not uncommon to use a procedure called fine needle aspiration, or FNA, to extract a tiny sample of lymph node cells. An FNA is performed with the help of a 25-gauge needle and is an easier procedure than a full surgical biopsy. A careful medical history, accompanying blood tests and complete physical examination is performed before the biopsy.
Lymph node architecture is the key feature of a lymphoma diagnosis. It involves viewing the structure of an entire lymph node, rather than its individual cells, under a microscope. The lymph node, after its initial microscopic examination, is finely cut, stained and sent to a pathologist for further analysis.
Pathology Lab
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A freshly cut lymph node must immediately be transported to a pathology lab. A pathologist studies its cells and ascertains whether or not they are normal. Next, if the cells are isolated as being abnormal, the pathologist determines whether the abnormality is malignant or benign.
A benign abnormality is not cancerous or harmful, while a malignant abnormality denotes a underlying cancer, or lymphoma. The pathologist determines whether the lymphoma is non-Hodgkin's or Hodgkin's.
Types
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A doctor will classify a lymphoma to decide which type of treatment is most suitable.
Lymphomas are classified as Hodgkins or non-Hodgkins. Hodgkins lymphomas include lymphocyte predominant, nodular sclerosis, lymphocyte depleted and mixed cellularity lymphomas.
Non-hodgkins lymphomas include mantle cell (indolent or aggressive), diffuse large B-cell, NK cell and T cell, MALT and follicular lymphomas.
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