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Lymphomation.org > Tests & Imaging

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Last update: 04/13/2015

Diagnostic
 

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Overview of how lymphoma is diagnosed
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Biopsy  

FNA | IGCNB

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Bone Marrow Biopsy

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Flow Cytometry  

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FISH Panel

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Histology

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Immuno-cytochemistry

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Kappa / Lambda Ratio

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Lumbar Puncture

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LymphoChip

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Mediastinoscopy

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PCR testing for
Minimal Residual Disease (MRD)
- updated 

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Splenectomy

Imaging

Surveillance controversy

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About & Comparing

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Bone Scan

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CT Imaging

Risks of CT


Medical Imaging: Safety Resources
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Gallium scan

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Lymphangiogram

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MRI 

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PET scan

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SPECT

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Ultrasound 

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Ultrasound Endoscopy

Labs

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About Blood Tests

CBC | CRP | WBC

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Disease direction Indicators

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Immunoglobulins

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LDH

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Human beta-2 M

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H-pylori

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T-cells

Other

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DiSC Assay

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Doppler

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Endoscopy

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Epstein-Barr virus

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MUGA scan
(Cardiac function)

Also see Molecular Diagnostic Tests - surgery.wustl.edu

 

American Association of Bioanalysts - Rule for Patient Access to Lab Test Results 

A “final” rule that gives patients (or their representatives) direct access to the patient’s laboratory test reports was published in the Federal Register on February 6, 2014.
 

Every Test for Lymphoma has limitations!

For example, PET:

How sensitive PET is at picking up a cluster of malignant cells depends on the type of cancer (aggressive versus indolent) but also how many cells exist in the area imaged. A single cell is far too small to be detected, even dozens of cells. But a large lesion that is negative suggests a non-malignant cause. So yes, there are false-negative PET test results, but it’s certainly a favorable sign when negative.

So imaging tests are not diagnostic, and blood tests rarely diagnostic … Only a biopsy can determine if the cells in the sample taken are a cancer and what type– and even with a biopsy the finding is limited to the cells that are sampled.

What's New:

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Your Test Results and HIPAA - rules and tips
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Labtests Online: understanding lab tests (an excellent resource)
bullet American Association of Bioanalysts - Rule for Patient Access to Lab Test Results 
 

PCR Testing  moved here

 
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SV40 virus tests?  Our understanding is that there is no reliable standard blood test for the virus. PCR testing of tissue stored at biopsy may be used, however. See SV40 for updates.

 

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SPECT Scan

"Similar to PET, single photon emission computed tomography (SPECT) uses radioactive tracers 
and a scanner to record data that a computer constructs into two- or three-dimensional images." 

See http://imaging.cancer.gov

 

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Free Kappa and Lambda Light Chains Plus Ratio
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Serum free light chains)

B-cell carries either kappa- or lambda-light chains on its surface (a distinctive marker). 

Normal, polyclonal B-cells are a mixture of kappa-B-cells and lambda-B-cells (one marker or the other)
 
When malignant B-cell clone proliferates it will lead to b-cell population consisting 
of either only kappa- or only lambda-B-cells.  (one marker, and not the other, suggests malignancy)

Adapted from med4you. 

Serum free light chains as marker for CLL?

Dr Furman writes: 
It is important to remember that there are over 75 different prognostic markers for CLL. Serum free light chains is just another one. Any time there is an increase in the number of B cells, there can be an increase in the serum immunoglobulins and serum free light chains. The serum immunoglobulins are the antibodies produced by CLL cells. Every antibody contains two heavy chains linked to two light chains. The serum immunoglobulins are the complete molecule. You can also have heavy chains alone (uncommon) or light chains alone (common) secreted. The serum free light chains that are measured just represent the light chains from the antibody.

Most CLL patients are hypogammaglobulinemic (low antibodies). Some of these patients will still have elevated light chains, but many will have low values for these as well. The light chains are usually filtered in the kidney and do not accumulate very much in the serum and it has only been the last 15 years that we have been able to measure the serum free light chains. The times the light chains accumulate are usually due to increased secretion or decreased clearance by the kidneys. Thus, light chains can be a surrogate for kidney function. Not necessary the cause of kidney dysfunction, but just not cleared because the kidneys are not working properly.

It is extremely rare for CLL patients to develop kidney problems due to light chains, but not so uncommon for myeloma and Waldenstrom's patients to develop these problems There are two types of light chains, kappa and lambda, and it is almost only lambda that can cause the problem, sometime as resulting in amyloid.

I encourage patients to not worry about light chains as prognostic markers and only use them in patients with kidney disease that might be attributable to them.




 

 
Disclaimer:  The information on Lymphomation.org is not intended to be a substitute for 
professional medical advice or to replace your relationship with a physician.
For all medical concerns,  you should always consult your doctor. 
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