Diagnosis
If you have any symptoms of AIDS-related lymphoma, make an appointment wth the doctor. Your doctor will conduct a physical exam and ask you questions about your general health, lifestyle, and medical history. If you have AIDS or any of the symptoms associated with AIDS-related lymphoma you need to have a thorough physical exam and possibly imaging studies (described below). Enlarged lymph nodes should have a biopsy or be removed for study.
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Physical Exam and History
During a physical exam it is important to carefully examine the lymph nodes as well as check for enlarged abdominal organs. A history of the patient's lifestyle and habits (diet, smoking status, past illnesses (especially HIV), etc.) will also be taken.
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Complete Blood Count (CBC)
A complete blood count (CBC) measures levels of different cell types and determines the volume of red blood cell and hemoglobin in a person's blood. The CBC typically includes white blood cells (protect against infections), platelets (help repair vessel injury and stop bleeding) and hemoglobin (carries oxygen).
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HIV Test
This test may be done in order to measure the number of HIV antibodies in a sample of blood. A high level of HIV antibodies may indicate that the patient has been infected by HIV. Usually, this is measured as a "CD4 count". A high number for this count would indicate weakened immune system that is much more susceptible to infection and disease. Typically, the closer to normal CD4 cell count, the healthier the individual.
X-Ray/CT Scan
A physician may choose to perform specialized radiographic studies of suspicious body areas including the head, neck, chest and abdomen. Getting an X-ray is important because, although it is not a diagnostic method for lymphoma, it is useful in planning the next steps as it typically correlates with results from the pathology. HIV-related complications including infection and lymphoma frequently involve the chest, lungs, and often the abdomen.
Blood Chemistry Studies
There are multiple blood tests available to determine the extent of cancers, effects of HIV infection on organ function and for specific identifying characteristics of HIV viruses.
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Bone Marrow Aspiration and Biopsy
A physician may also choose to carry out a bone marrow aspiration and biopsy. Bone marrow as well as a small piece of bone is removed using a hollow needle that is inserted into a patient's pelvic bone and rarely the breastbone. The bone marrow and bone removed are then studied using tests as mentioned. The initial bone marrow biopsy may detect lymphoma in up to 20% of cases, however it may be necessary to repeat studies at a later date.
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Lymph Node Biopsy
A lymph node biopsy consists of the removal of all or part of the lymph node. The tissues removed will then be examined using multiple special techniques to identify various types of tumors. Listed below are the types of biopsies that a physician may choose to perform:
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Lumbar Puncture
If your symptoms and diagnostic studies suggest lymphoma is possibly present in your nervous system, it may be necessary to obtain spinal fluid by performing a lumbar puncture.
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Computed Tomography (CT) Scan
As mentioned, specialized radiology studies including CT scans, MRI scan and studies using nuclear radiography are available and maybe indicated by your physician during the period of diagnosis and later resins to medications.
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Magnetic Resonance Imaging (MRI) Scan
Magnetic resonance imaging (MRI) uses radio waves and a powerful magnet to produce detailed images of body parts. Radio waves are absorbed by the body and then released in a certain pattern, which is translated by a computer in order to show "slices" of the body. Typically MRI is useful in imaging soft tissues such as the brain, bone marrow, etc. Doctors uses MRIs to assess cancer spread and look at the brain and spinal cord, as these structures include such tissues. In other words, MRIs can be especially effective when the cancer of HIV associated lymphoma has spread to the central nervous system tissues (brain and spinal cord).
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Positron emission tomography (PET)/Computed Tomography (CT) scan
For a PET/CT scan, the physician injects a radioactive substance into the your bloodstream. This substance collects in malignant (cancerous) cells in the body, particularly because cancerous cells consume glucose at much higher rates than other normal cells. The physician then uses a PET scanner to determine locations of the cancer cells. In HIV associated lymphomas, FDG/PET may effectively detect the uptake of fluorodeoxyglucose by lymph nodes before other tests detect enlargement of lymph nodes.
