The first symptoms of lymphoma

The first signs of the disease are characterized by the presence of a lump which is painless near the neck, abdomen, under the arm or in the groin region. They are usually discovered by a doctor during a physical examination.  Some of the other symptoms may include red irritable patches on the skin, nausea and vomiting, unusual pain in the abdomen, sudden fits of coughing and breathlessness.

Some people develop the B symptoms which are specific for this disease.

• Excessive sweating at nights

• Sudden weight loss up to 10% of total body weight.
• High infrequent fevers
• Red inflamed skin often without rashes.
• Unexplained fatigue  

These symptoms can occur as a result of other diseases, also but if they occur in combination for a period of more than two weeks, one should consult a physician.

How is Lymphoma diagnosed?

Once the doctor suspects lymphoma, the following tests are done to confirm its presence.

1. Through physical exam

A complete physical examination is performed by the doctor to check for lumps and signs of swelling and inflammation. Lymph nodes of the neck, underarm, and groin will be examined. The doctor will also check for an enlarged spleen. A record of the recent illness and medical history should be taken along for the examinations.

2. Blood Tests

A blood test will confirm the presence of any unusual substances in the blood. Abnormal amounts of enzymes, proteins and antibodies will be checked. It will also rule out the possibility of any other infections or disease. Anemia, blood leukocyte count will be checked. The extent to which the cancer has spread within the body can be evaluated by the blood test.

3. Imaging Tests

The doctor will re-confirm his diagnosis by ordering imaging tests  to get a better understanding of the abnormal activity inside the body.

X-rays, CT (computed tomography) scan, MRI (magnetic resonance imaging) scan are some of the tests which will confirm the presence of the cancer. A special test called the Lymphangiogram, which is a test done by using a special dye that makes the lymph nodes, cells and vessels show up in the presence of  x-rays. This will confirm the presence of the disease in a specific region in the body.

4. Biopsy

A biopsy is a small surgery performed on the lump or swollen region. To check if the cancer is truly lymphoma a small piece of the tissue is removed and further tests are performed on it. It will be seen under the microscope and the unusual shape of the cancer cell will enable the doctor to identify it and confirm the presence of lymphoma.

Staging

Once Lymphoma of any kind has been diagnosed, Doctors will make an attempt to discover the stage of the disease, how much it has spread and to identify the specific parts of the body which have been affected by the disease. Treatment of the disease will depend on the extent and type of spread of the disease. Stage I patients have a better chance of treatment and cure as detection has happened in the early stages of the disease while Stage IV patients would require aggressive treatment as the disease is more widespread.

In Hodgkin’s disease the Doctor will examine the amount of and the position of the affected lymph nodes and whether the affected nodes are to be found on both sides of the diaphragm or not. He will also do tests to see whether the bone marrow, spleen or outside the lymphatic system are involved.

He may use any or all the above tests to determine the extent of spread of the disease.  A bone marrow biopsy may be suggested or an operation called Laparotomy may be performed.

Non-Hodgkin disease staging is used to determine the groups of lymph nodes which have been impacted by the disease or the organs which have been affected by it.  Most often, Non-Hodgkin’s lymphomas are detected at Stage IV only. This is because they are often mistaken for common ailments and the swellings are dismissed as infections of the glands.  This gives the Lymphoma time to spread and impact large areas of the lymphatic system.   Doctors use all the above tests to determine the stage of the disease and chart the kind of treatment required.

It may be noted that if a physical examination points towards the possibility of Lymphoma, you should approach a hematologist-oncologist specializing in the diagnosis and care of the broad spectrum of malignant blood and related diseases to get the initial diagnosis confirmed. Treatment should begin only when there is no doubt that the disease manifested is Lymphoma.