Laboratory Workup of Lymphoma in Adults

Patient Guideline Summary

Publication Date: November 10, 2020
Last Updated: March 3, 2023

Objective

Objective

This patient summary means to discuss key recommendations from the American Society for Clinical Pathology and the College of American Pathologists for laboratory workup of lymphoma in adults. It is limited to adults 18 years of age and older and should not be used as a reference for children.

Overview

Overview

  • Lymphoma is a cancer of lymphocytes (one kind of white blood cells).
  • Symptoms include:
    • A rubbery lump in the armpits, neck, throat, or groin that grows
    • Pain in other locations
    • Weight loss
    • Fatigue
    • Fever
    • Sweating
    • Itching
    • Infections
    • Symptoms in an affected organ: e.g., breathlessness (lungs), indigestion (stomach)
  • This patient summary focuses on specimen requirements for the diagnostic evaluation of lymphoma.

Diagnosis

Diagnosis

There are more than 60 distinct types of lymphoma. Recent profuse growth of treatment choices now requires matching growth in identifying the specific nature of each lymphoma.
  • A complete and accurate diagnosis requires an adequate surgical biopsy specimen, usually not possible through a needle.
  • Localizing the best biopsy site may require PET with FDG imaging (Positron emission tomography with 2-deoxy-2- [fluorine-18]fluoro-d-glucose (18F-FDG) is an imaging technique using a radioactive tracer that makes visible areas of high metabolic activity like cancers.)
  • A bone marrow biopsy, genetic testing, and/or a sample of spinal fluid may also be needed.
  • If symptoms persist and testing is negative, repeat testing should be done.

Abbreviations

  • FDG: Fluoro-d-glucose
  • PET: Positron Emission Tomography

Source Citation

Kroft SH, Sever CE, Bagg A, Billman B, Diefenbach C, Dorfman DM, Finn WG, Gratzinger DA, Gregg PA, Leonard JP, Smith S, Souter L, Weiss RL, Ventura CB, Cheung MC. Laboratory Workup of Lymphoma in Adults: Guideline From the American Society for Clinical Pathology and the College of American Pathologists. Arch Pathol Lab Med. 2021 Mar 1;145(3):269-290. doi: 10.5858/arpa.2020-0261-SA. PMID: 33175094.

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.