Having the correct diagnosis is important for getting the right treatment. Hodgkin lymphoma HL may be difficult to diagnosis. You may want to get a second medical opinion by an experienced hematopathologist before you begin treatment.
A hematopathologist is a specialist who studies blood and bone marrow cells and other tissues to help diagnose diseases of the blood, bone marrow and lymph system. Your doctor will take a comprehensive medical history and ask questions regarding your symptoms. A physical examination will include measurement of all accessible lymph node groups neck, underarms and groin as well as the size of palpable organs such as the spleen and liver.
A biopsy of an enlarged lymph node is needed to diagnose HL. If the lymph node is just under the skin, the biopsy procedure is usually simple and can sometimes be done with a numbing medication local anesthetic.
If the lymph node is inside the chest or abdomen stomach area , you may be sedated or receive general anesthesia. The biopsy samples will be sent to a hematopathologist, a doctor who has special training in diagnosing blood diseases by studying cells under a microscope. The hematopathologist examines the samples using a microscope to look for cancer cells.
It is important that a specialist with experience in diagnosing HL analyzes the biopsy tissue. Pathology slides may be sent to a specialty center for confirmation of diagnosis. This laboratory test can detect specific cancer cells based on the types of antigens or proteins on the surface of the cells.
Immunophenotyping is used to help diagnose specific types of leukemia and lymphoma. Alternatively, if your disease has been identified in the blood or lymph nodes, you may want to consider seeing a hematologist or oncologist, in addition to a dermatologist. Your treatment will likely consistent of both skin-directed as well as systemic therapy pills, shots, infusions.
As some hematologists specialize in non-malignant blood conditions, and conversely some oncologists do not routinely treat blood-based malignancy, it can be helpful for you to inquire about the conditions treated by your physician prior to your visit. Additionally, there are dermatologists who may not be comfortable treating cutaneous lymphoma. Again, it will be of benefit to reach out to the clinic to ensure he or she will be able to appropriately care for you.
When a patient has more advanced disease, with both skin and systemic involvement, this is my preferred approach. It is also important to note, based upon your specific diagnosis, you may also be referred to a radiation oncologist, who will work together with your physician to develop a treatment plan for parts of the disease to be treated with radiation.
I recommend discussing with them whether they are comfortable treating your specific diagnosis. You can also provide them with the Cutaneous Lymphoma Foundation website, as there are educational materials not only for patients but also for physicians.
Additionally, many physicians have reached out to me for consultations over email and the phone. If you are unable to travel to a specialist, your local physician may be able to speak with one to help better guide your care. Learn more recommendations for managing your cutaneous lymphoma when a specialist isn't nearby. When should I see a specialist? What specialist should I see? For illustrative purposes only. List your questions from most important to least important in case time runs out.
For lymphoma, some basic questions to ask your doctor include:. In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask additional questions. Your doctor is likely to ask you a number of questions. Being ready to answer them may allow more time to cover other points you want to address. Your doctor may ask:. Lymphoma care at Mayo Clinic. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.
This content does not have an English version. This content does not have an Arabic version. Diagnosis Bone marrow exam Open pop-up dialog box Close. Bone marrow exam In a bone marrow aspiration, a doctor or nurse uses a thin needle to remove a small amount of liquid bone marrow, usually from a spot in the back of your hipbone pelvis.
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Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Lymphoma — Hodgkin. Accessed Sept. Lymphoma — Non-Hodgkin. National Cancer Institute. Warner KJ.
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