Christiane Querfeld, M.D., director, Cutaneous Lymphoma Program
Cutaneous lymphomas include a large group of cancers with overlapping features — and since every patient’s disease looks different, getting an accurate diagnosis can be the most challenging part of treatment. The difference between skin lymphomas is subtle and may be difficult to distinguish some from other skin problems. For these reasons treatment at City of Hope begins with leading-edge diagnostics, performed by dermatopathologists who are versed about the entire spectrum of this disease.
How cutaneous lymphoma is diagnosed
Skin lymphoma diagnosis begins with a complete physical examination, which includes a comprehensive skin exam. To arrive at the most accurate diagnosis and staging — and ultimately the best treatment — we perform tests that include:
- Blood testing to measure levels of substances in the blood, such as white blood cells and cells specific to certain skin lymphomas, such as Sezary cells.
- Skin biopsy, which involves removing a small sliver of tissue and examining it under a microscope.
- PET-CT scans
We perform several tests on the tissue to arrive at the most accurate diagnosis. Other diagnostic tests that may be performed include:
- Molecular testing: Determining whether a growth is benign or cancerous is a subtle process, requiring a trained eye and deep experience. As part of the diagnostic process, our specially trained dermatopathologist performs wide-ranging, leading-edge molecular testing for the most accurate diagnosis, including FISH analysis (fluorescent in situ hybridization)
- Bone marrow aspiration and biopsy, taking a small sample of marrow cells from inside the bone and looking at them under a microscope
- Lymph node biopsy, involving removing a small sample of the lymph node using a thin, hollow needle or removing the entire node