How do doctors diagnose lymphoma?

Dear Ms,

Thank you for your question. Lymph nodes should first be palpated to ensure
that they are lymph nodes. Palpation of the lymph nodes provides
information about the possible presence of a malignant or inflammatory
process and the localization or generalization of that process. The
consistency felt may be soft (normal), rubbery (suggestive of lymphoma),
hard/firm (suggestive of malignancy or granulomatous infection).

Common areas where you might notice swollen lymph nodes include your neck,
under your chin, in your armpits and in your groin. Swollen lymph nodes
which remain swollen and palpable after several weeks, will warrant
attention as concern as this indicates either a prolonged infection or a
biologically proliferative process.

Relevant investigations include radiology scans, blood tests and tissue
biopsy sampling, which will help to determine the cause of the swelling.
Pathologists are able to diagnose the conditions, benign or malignant, via
examining biopsy specimens under the microscope.

Best regards
Dr Quah

Thank you for your question. Lymphoma is a malignancy of the immune system,
and is characterized by the abnormal proliferation of lymphocytes. Lymphoma
usually arises from the lymphatic system and forms large swollen lymph
nodes which eventually becomes tumour masses. Lymphomas often form silently
and without significant clinical symptoms. Some symptoms include persistent
fatigue, weight-loss, lymph node swelling, night sweats and shortness of
breath.

As with any unusual masses, a biopsy is usually indicated to determine the
histopathology of the tumour. On microscopic examination, a lymphoma will
show features of uncontrolled multiplication of lymphocytes and the
characteristics of the lymphoma have to be determined with further
immunohistochemistry or molecular testings. As there are hundreds of types
of lymphomas, with varied behaviours, the acute diagnosis of the specific
lymphoma entity is extremely crucial and important to the management. I am
proud to say that Singapore has some of the best lymphoma pathology
specialists in the world, who constantly make difficult and rare diagnosis
as well as discover new lymphoma entities.

Best regards
Dr Quah