Diagnosis of AIDS-Related Lymphoma

Diagnosis of AIDS-Related Lymphoma

The following tests and procedures may be used for diagnosis of AIDS-related lymphoma:
  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:
    • The number of red blood cells, white blood cells, and platelets.
    • The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
    • The portion of the sample made up of red blood cells.
  • Lymph node biopsy: The removal of all or part of a lymph node. A pathologist views the tissue under a microscope to look for cancer cells. One of the following types of biopsies may be done:
    • Excisional biopsy: The removal of an entire lymph node.
    • Incisional biopsy: The removal of part of a lymph node.
    • Core biopsy: The removal of tissue from a lymph node using a wide needle.
    • Fine-needle aspiration (FNA) biopsy: The removal of tissue from a lymph node using a thin needle.
  • Bone marrow aspiration and biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologist views the bone marrow, blood, and bone under a microscope to look for abnormal cells.
  • HIV test: A test to measure the level of HIV antibodies in a sample of blood. Antibodies are made by the body when it is invaded by a foreign substance. A high level of HIV antibodies may mean the body has been infected with HIV.
  • Epstein-Barr virus (EBV) test: A test to measure the level of EBV antibodies in a sample of blood, tissue, or cerebrospinal fluid (CSF). Antibodies are made by the body when it is invaded by a foreign substance. A high level of EBV antibodies may mean the body has been infected with EBV.
  • Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.

Factors Affecting Prognosis

The prognosis (chance of recovery) and treatment options depend on the following:
  • The stage of the cancer.
  • The number of CD4 lymphocytes (a type of white blood cell) in the blood.
  • Whether the patient has ever had AIDS-related infections.
  • The patient’s ability to carry out regular daily activities.

Stages of AIDS-Related Lymphoma

After AIDS-related lymphoma has been diagnosed, tests are done to find out if cancer cells have spread within the lymph system or to other parts of the body. The following tests and procedures may be used in the staging process:
  • CT scan
  • PET scan
  • MRI
  • Bone marrow aspiration and Biopsy
  • Lumbar puncture
  • Blood Chemistry studies
Stages of AIDS-related Lymphoma may include E and S.
  • E: “E” stands for extranodal and means the cancer is found in an area or organ other than the lymph nodes or has spread to tissues beyond, but near, the major lymphatic areas.
  • S: “S” stands for spleen and means the cancer is found in the spleen.
The following stages are used for AIDS-related lymphoma: Stage I-– Stage I AIDS-related lymphoma is divided into stage I and stage IE.
  • Stage I: Cancer is found in one lymph node group.
  • Stage IE: Cancer is found in an area or organ other than the lymph nodes.
Stage II— Stage II AIDS-related lymphoma is divided into stage II and stage IIE.
  • Stage II: Cancer is found in two or more lymph node groups on the same side of the diaphragm (the thin muscle below the lungs that helps breathing and separates the chest from the abdomen).
  • Stage IIE: Cancer is found in an area or organ other than the lymph nodes and in lymph nodes near that area or organ, and may have spread to other lymph node groups on the same side of the diaphragm.
Stage III— Stage III AIDS-related lymphoma is divided into stage III, stage IIIE, stage IIIS, and stage IIIS+E.
  • Stage III: Cancer is found in lymph node groups on both sides of the diaphragm (the thin muscle below the lungs that helps breathing and separates the chest from the abdomen).
  • Stage IIIE: Cancer is found in lymph node groups on both sides of the diaphragm and in an area or organ other than the lymph nodes.
  • Stage IIIS: Cancer is found in lymph node groups on both sides of the diaphragm and in the spleen.
  • Stage IIIS+E: Cancer is found in lymph node groups on both sides of the diaphragm, in an area or organ other than the lymph nodes, and in the spleen.
Stage IV — In stage IV AIDS-related lymphoma, the cancer either:
  • is found throughout one or more organs other than the lymph nodes and may be in lymph nodes near those organs; or
  • is found in one organ other than the lymph nodes and has spread to lymph nodes far away from that organ.
For treatment, AIDS-related lymphomas are grouped based on where they started in the body, as follows:

Peripheral/Systemic Lymphoma

Lymphoma that starts in lymph nodes or other organs of the lymph system is called peripheral/systemic lymphoma. The lymphoma may spread throughout the body, including to the brain or bone marrow.

Primary CNS Lymphoma

Primary CNS lymphoma starts in the central nervous system (brain and spinal cord). Lymphoma that starts somewhere else in the body and spreads to the central nervous system is not primary CNS lymphoma. If you are experiencing the signs or symptoms of AIDS-related lymphoma, contact us to request an appointment with our cancer specialists to begin diagnostic testing.