2012年9月15日 星期六

Common Methods of Diagnosing Lymphoma


Lymphoma is a highly problematic disease that raises serious impediments in the process of diagnosis. Considering the fact that it can occur in a variety of forms and produce a wide spectrum of unspecific symptoms, lymphoma is usually diagnosed with the aid of many different techniques. In order to establish the accurate diagnosis, pathologists need to analyze the disease from multiple angles. Morphological traits, as well as the genotype and phenotype of the lymphoid lesions should sometimes be carefully analyzed in the process of diagnosis. The administration of lymphoma treatments and therapies can only begin after patients with suspected lymphoma are given the correct diagnosis.

In order to reveal evidence of the disease in patients with suspected malignant lymphoma, doctors often perform a series of preliminary tests. These tests include blood analyses, elaborate physical examinations (enlargement of the lymph nodes often suggests the presence of lymphoma) and sometimes local biopsies of the bone marrow.

Tissue biopsies can provide cancer specialists with valuable data regarding the type of lymphoma, the type of cells involved in causing the disease, the progression rate of the lymphoma, as well as the prognosis of the affected patient. In order to reveal whether the lymphoid lesions are of benign or malign nature, pathologists analyze the tissue samples from multiple perspectives: overall cell appearance under the microscope (morphological examination), exact cell subtype (phenotype analysis) and genetic provenience (genotype analysis). If the analyzed lymphoid lesions prove to be malignant, doctors will begin the administration of chemotherapeutic drugs soon after the type of lymphoma is properly classified.

A major stage in diagnosing lymphoma consists in carefully analyzing the morphological features of the lymphoid lesions. The morphological characteristics of the lymph nodes and tissues provide doctors with valuable data on the disease, helping them distinguish benign forms of lymphoma from the malignant ones. Although morphological investigations are crucial in the process of diagnosing lymphoma, doctors often choose to further analyze the tissue samples by performing phenotypic and genotypic tests.

In order to determine the phenotype of the lymphoid cells, doctors conduct a series of tests that are commonly referred to as cell marker analysis. The procedure characteristic to these tests involves the use of different antibodies for revealing clear cell markers carried by malignant lymphatic cells. These tests offer doctors clear information about the causative cells and help in determining the exact type of lymphoma. Although they can also reveal the presence of Hodgkin's Disease, cell marker tests are commonly used to identify Non-Hodgkin's Lymphoma subtypes. Such tests are used to detect whether the lymphoma is caused by abnormal activity of B-cells or T-cells and how mature the causative cells are.

In rare cases, only genotypic studies can help doctors determine if the lymphoid lesions are benign or malignant. Genotypic tests involve elaborate analyses of the cells' genetic composition and comprise a series of different methods: cytogenetic analyses, the polymerized chain reaction method and the Southern blot hybridization analysis. Despite the fact that such tests provide doctors with detailed information on lymphoma, they are also time consuming and costly. Due to these disadvantages, they are only performed under special circumstances, when all other tests fail to reveal conclusive data on lymphoma.




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