The world-renowned medical research experts at the OSUCCC – James are currently studying a number of different ways to detect cutaneous lymphoma early so that treatment can begin as soon as possible, when options for treatment and cure are best.

Diagnosing Cutaneous Lymphoma

Cutaneous lymphoma usually is diagnosed with a skin biopsy. If you have cutaneous lymphoma symptoms, the OSUCCC – James experts will conduct a variety of tests, which may include:

Physical Exam

During a physical exam, your OSUCCC – James specialist will check for signs of cutaneous lymphoma by examining general signs of health; discussing your health habits, past illnesses and previous treatments; and looking for anything unusual on your skin such as rashes and bumps.

Skin Biopsy

During a skin biopsy, your lymphoma specialist will numb your skin with a local anesthetic and use a small, round tool to remove a sample of skin.

An OSUCCC – James pathologist then analyzes the skin cells under a microscope to look for abnormal cells.

Lymph Node Biopsy

Your lymphoma specialist will use a fine needle to remove a small sample of lymph node to examine under a microscope. Most lymph node biopsies can be performed with local anesthesia and with little discomfort. Sometimes the experts will remove all or part of a lymph node during surgery for diagnosis.

An OSUCCC – James pathologist then analyzes the tissue under the microscope to look for abnormal cells.

Bone Marrow Aspiration & Biopsy

After cutaneous lymphoma is confirmed, a patient may have a bone marrow aspiration and biopsy to determine if the lymphoma has spread to the bone marrow.

During a bone marrow aspiration, an OSUCCC – James specialist will insert a hollow needle into the hipbone or breastbone to remove a small sample of liquid bone marrow. For a bone marrow biopsy, a hollow needle will be inserted into the hipbone to collect a small sample of bone and marrow.

By studying blood and bone marrow samples, blood disorder specialists (called hematopathologists) can look for certain changes in the white blood cells, called lymphocytes.

Immunophenotyping

This process analyzes cells from a lymph node, blood or bone marrow sample and then identifies those cells based on the kind of specific markers (genetic and molecular identifiers) on the surface of the cells. Immunophenotyping may include special staining of the blood cells.

T-Cell Receptor Gene Rearrangement Test

This laboratory test analyzes cells from a tissue sample to determine if there is a certain change in the genes, which can lead to the body making too many of one kind of T-cells.

Flow Cytometry

This laboratory test measures the number of cells in a blood sample and the percentage of live cells in that sample. It also analyzes certain cell characteristics such as size and shape, and the presence of tumor markers on the cell’s surface. A light-sensitive dye is used to stain the cells to identify subtypes of lymphoma.

Cytogenetic Analysis

Cytogenetic analysis identifies abnormal chromosomes (where genes are) that contribute to developing cutaneous lymphoma. Identifying these abnormalities can help the OSUCCC – James sub-specialists decide the very best kind of personalized treatment for a cutaneous lymphoma patient.

Molecular Genetic Tests

Molecular genetic tests analyze a cutaneous lymphoma cell’s DNA to help diagnose the cause of a rash or lesion or to classify the subtype of a cutaneous lymphoma.

One example is fluorescent in situ hybridization, or FISH, which is similar to cytogenetic analysis. Another is polymerase chain reaction, or PCR, a test that identifies chromosome changes, even when only a few cutaneous lymphoma cells are present in a sample.

Imaging Tests

The OSUCCC – James lymphoma specialists may use imaging tests to help determine which lymph nodes are affected by cutaneous lymphoma, what stage it is in, and if the disease has spread to other parts of the patient’s body.

Diagnostic medical imaging exams might include the following:

Ultrasound

Uses high-frequency sound waves and echoes to produce images on a monitor. Ultrasound is particularly useful for imaging children because it involves no X-rays.

Computed Tomography (CT) Scanning

Use X-rays to capture cross-sectional images of the lymph nodes. Patients may need to have a dye injected into a vein to help highlight certain organs or tissues.

Magnetic Resonance Imaging (MRI) Scans

Use powerful magnets to capture high-resolution images. MRIs can show excellent detail of certain areas inside the body, especially soft tissues.

Positron Emission Tomography (PET) Scans

A nuclear medicine technology that finds spots of cancer activity in the body. By injecting a small amount of radioactive glucose (sugar) into a vein, the scanner can capture images where the sugar collects and identify cancer cell activity.

Some of these imaging tests, such as CT and PET, might also be used to see how well a patient’s cancer treatment is working.

Staging Cutaneous Lymphoma

There is no such thing as routine cancer, and cutaneous lymphoma behaves differently in each person.

Staging is just one of many ways the OSUCCC – James lymphoma experts plan the most targeted, accurate way to treat your specific cancer. By identifying cutaneous lymphoma stages, your lymphoma sub-specialists can determine how much of the disease is in your body, whether or not it has spread, and if so, where it has spread.

Stage IA

Less than 10 percent of the skin’s surface is covered with patches, papules and/or plaques.

Stage IB

Ten percent or more of the skin’s surface is covered with patches, papules, and/or plaques.

There may also be abnormal white blood cells (called lymphocytes) in the blood, but they are not cancerous.

Stage IIA

Any amount of the skin’s surface is covered with patches, papules and/or plaques. Lymph nodes are enlarged, but cancer has not spread to them.

Stage IIB

One or more tumors that are 1 centimeter or larger are found on the skin. Lymph nodes may be enlarged, but cancer has not spread to them.

There may also be abnormal lymphocytes in the blood, but they are not cancerous.

Stage III

Nearly all of the skin is reddened and may have patches, papules, plaques or tumors. Lymph nodes may be enlarged, but cancer has not spread to them.

There may also be abnormal lymphocytes in the blood, but they are not cancerous.

Stage IVA

Most of the skin is reddened and any amount of the skin’s surface is covered with patches, papules, plaques or tumors, and either:

• Cancer has spread to lymph nodes and there may be cancerous lymphocytes in the blood, or

• There are cancerous lymphocytes in the blood and lymph nodes may be enlarged, but cancer has not spread to them

Stage IVB

Most of the skin is reddened and any amount of the skin’s surface is covered with patches, papules, plaques or tumors. Cancer has spread to other organs in the body. Lymph nodes may be enlarged and cancer may have spread to them. There may also be cancerous lymphocytes in the blood.

(Source: National Cancer Institute)

 

If you’ve been diagnosed with cutaneous lymphoma, would like a second opinion or would like to speak with a lymphoma specialist, please call The James Line at 800-293-5066 or 614-293-5066 to make an appointment.

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