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A few lymphoma related questions
Mar 6, 2002

I have a few questions related to lymphomas and lymph nodes appeareances. 1) What is the appeareance of lymph nodes in an indolent (slow-growing) or intermediate NHL? Are the lymph nodes bulky in appeareance, or could they be very little out of proportion? 2) In a slowly growing lymphoma, do lymph nodes start to swell right away, or is there a period of clinical symptoms with no lymph nodes? 3) Would you consider a 6 - 7 months period enough for a lymphoma, even a slowly going one, to attain a characteristic physical appeareance (enlarged nodes)? 4) Considering your impressive clinical activity, could you trigger some questioning marks regarding diagnosing a lymphoma from a full-battery of blood tests (CBC, biochemistry, electrolytes, hormones, immunology...), with no biopsy available ? I'm looking forward for your answers, thank you so much.

Response from Dr. Dezube

These are all reasonable questions

1) There is absolutely no way of looking at an enlarged lymph node and being able to tell whether it is aggressive (high-grade) or non-aggressive (low grade or indolent). The only way to be sure is by a biopsy. Clearly aggressive lymphomas tend to grow quicker so you might get an idea what you're dealing with by looking at growth over a period of time.

2) Lymphomas can present either as swollen, enlarged lymph nodes or alternatively with clinical symptoms (fever, chills, night sweats, weight loss). A diagnosis can only be made by a biopsy.

3) Some aggressive lymphomas take months to present as a mass or with clinical symptoms; some non-aggressive (indolent) lymphomas take years!

4) There is just no simple way of diagnosing a lymphoma from blood tests. However, blood tests can give you a clue as to where the lymphoma may be hiding. For example, low blood counts might suggest that lymphoma is hiding in the bone marrow. Only a biopsy can tell for sure what's going on.

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