DIAGNOSIS

Lymphoma is a type of cancer that begins in a lymphocyte, usually in a lymph node or occasionally in another organ.

Mantle cell lymphoma (MCL) is the result of a malignant transformation of a B lymphocyte in the outer edge of a lymph node follicle, called the mantle zone.

The transformed B lymphocyte (lymphoma cell) grows in an uncontrolled way and the accumulated lymphoma cells form tumours in lymph nodes leading to their enlargement.

The lymphoma cells can enter the lymphatic channels and the blood and spread to other lymph nodes or tissues such as the marrow, liver and gastrointestinal tract.

Signs and Symptoms

Patients with MCL may experience loss of appetite and weight loss, nausea and/or vomiting, indigestion, abdominal pain or bloating, a feeling of “fullness” or discomfort due to an enlarged liver or spleen, pressure or pain in the lower back often extending down one or both legs, or fatigue due to anaemia, which may develop.

At the time of diagnosis most patients have multiple lymph nodes and other sites of the body affected.

These sites may include the spleen, marrow and blood, the lymph nodes in the throat (tonsils and adenoids), the liver, or the gastrointestinal tract. In the gastrointestinal tract a condition known as “multiple small intestine polyps” may result from the lymphoma cell growth. MCL cells may invade the brain and spinal cord.

Diagnosis of Mantle Cell Lymphoma

In the case of mantle cell lymphoma it involves the microscopic examination of tissue obtained by a lymph node biopsy.

Diagnosing the extent of the disease

The extent of the disease or “staging” is determined to plan the best treatment. Tests used for staging NHL may include the following tests:

• Complete blood counts to assess the concentration of red and white cells and platelets
• Bone marrow biopsy to identify if the disease has extended beyond the lymph nodes and into the marrow.
• Imaging studies, including computed tomography scans of the chest, abdomen and pelvis, to see whether the disease is present in the deep lymph nodes, liver, spleen or in other parts of the body
• Blood studies to check levels of specific proteins in the blood, which are indirect markers of disease extent and rate of progression.