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Lymphoma: Patient Information

Our cancer healthcare teams at the Winship Cancer Institute of Emory University are available to help find  the best treatment plan for you. Our healthcare teams come together from different treatment specialties areas of medical oncology, radiation oncology, and surgical oncology with specialist in diagnosis from radiology and pathology. For some cancers we include experts in related areas such as dermatology, neurology, and urology. Teams focus on a single type or related types of cancer; so they are researching, studying, and diagnosing specific cancers every day. This means our teams see more cases of a specific cancer and gain vast amounts of experience with specific cancers.

If you would like to visit our cancer center to discuss your healthcare please visit our
Becoming a Patient section for appointment information and other useful links.
 

The Lymphoma Program
The Lymphoma Clinic is located on the Plaza Level of Winship Cancer Institute, Building C. Self-parking is located on Lowergate Street. Valet parking is available on both the front (Uppergate) and back (Lowergate) entrances.

 We understand that this is a challenging time for you and your family, and we are committed to providing the highest quality of care in a supportive and comfortable environment.  A detailed plan and calendar regarding your treatment will be discussed with you and your family. This plan and calendar will also be sent to your referring physician to ensure close communication.

Before Your First Visit
What to Expect on Your First Visit
Special Tests
 

Before Your First Visit
To ensure that you receive the highest quality care and that you and your family are well-informed about the treatment process, we maintain close communication with you and your referring physician.  A copy of your medical records, CT/PET scans and pathology slides will be requested, so that your accurate medical information can be carefully reviewed in detail. To start the process, please call the call center at 404-778-1900 or 1-888-WINSHIP (946-7447) and give them information about you.  Once your information is entered, a new patient coordinator will call you to set up an appointment.

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What to Expect on Your First Visit
Your first visit to the Lymphoma Clinic will take place on the Plaza Level of the Emory Winship Cancer Institute, which is located in Building C, 1365-C Clifton Road, Atlanta, GA 30322.  Parking is located on Lowergate Street.  Valet parking is also available.

Upon your arrival, you will go to the First Floor (make a right out of the elevator, to the receptionist's desk) to speak with the Oncology Resource Counselor (ORC) where you will be asked to present a copy of your insurance card and sign authorization forms. Then you will proceed to the Plaza Level, Ambulatory Treatment Center (ATC) where you will have your blood drawn (additional labs may be may be necessary after you see your healthcare provider).  Afterward, you will go across the hall to the Hematology Department and check in at the front desk.  Additional forms will be given to you as you are in the waiting area. Medical personnel will escort you into the exam room.  A Social Worker will visit while you are waiting in the exam room before you see your doctor.  Because of these steps, please allow plenty of time (several hours) for your first visit. 

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Special Tests
The following tests may need to be performed: 

  • CT Scan
  • PET Scan
  • Biopsy
  • Bone Marrow Biopsy
  • Lumbar Puncture
  • Blood Tests

CT scan - provides a detailed picture of the internal anatomy that reveals the location, size and shape of abnormal cancerous growths. People with lymphoma often have computed tomography (CT) scans of the neck, chest, abdomen and pelvis. These tests are useful in determining how many nodes are involved, how large they are and whether internal organs are affected by lymphoma. 

This study is performed by the Radiology department of Emory Hospital. You may be required to refrain from eating or drinking prior to the test. You may also receive contrast dye by mouth and/or intravenously. The contrast material makes it easier for the doctor to see swollen lymph nodes and other abnormal areas on the CT scan.

*Please notify your medical provider if you have allergies to contrast dye, iodine, shellfish, or if you have known kidney disease.

 PET scan  (Positron Emission Tomography)- after receiving an injection of a small amount of radioactive sugar, a machine makes computerized pictures of the sugar being used by cells in your body. Lymphoma cells use sugar faster than normal cells, and areas with lymphoma look brighter on the pictures. 

This study is performed by the Nuclear medicine department of Emory Hospital. You will need to refrain from eating or drinking at least 6 hours prior to the procedure.  An intravenous catheter (IV) will be inserted into your arm and a glucose-like substance will be infused. You will be required to sit quietly for about one hour and then have head to toe imaging obtained. 

Biopsy - A biopsy is the only sure way to diagnose lymphoma. Your doctor may remove an entire lymph node (excisional biopsy) or only part of a lymph node (incisional biopsy). A thin needle (fine needle aspiration) usually cannot remove a large enough sample for the pathologist to diagnose lymphoma. Removing an entire lymph node is best. The pathologist uses a microscope to check the tissue for lymphoma cells.

Bone Marrow Biopsy - Bone marrow is the spongy material found inside our bones. Bone marrow contains immature cells called stem cells, which develop into three main types of cells found in the body: red blood cells that deliver oxygen to all parts of the body and take away the waste product carbon dioxide; white blood cells that protect the body from infection; and platelets that help blood clot. Lymphoma can spread to the bone marrow or start in the bone marrow; therefore doctors may examine part of the marrow to see whether cancer is present. Bone marrow is obtained by numbing the skin, tissue, and surface of the bone with a local anesthetic, inserting a thin needle into the pelvis or another large bone and withdrawing a small sample.

This is an outpatient procedure performed by highly trained physician assistants/ nurse practitioners. Plan on arriving approximately one hour prior to the procedure, and be sure to bring an updated medication list.  Please notify your medical provider if you are currently taking any types of blood thinners including heparin, coumadin (warfarin), lovenox, plavix, or aspirin. There are options available for pain relief during the procedure.  Please discuss these options with your provider to determine what is best, as you may need to refrain from eating or drinking 3 hours prior to your procedure.

Lumbar Puncture - In a small number of patients, NHL can spread to the nervous system. When this occurs, the fluid present around the spinal cord and the brain (cerebrospinal fluid) may be abnormal and contain cancer cells. To determine whether this has occurred, the physician may recommend a test called a spinal tap or a lumbar puncture in which a thin needle is inserted into the lower back under local anesthetic. A small sample of fluid is then removed. Cerebrospinal fluid is examined for chemical content and abnormal cells.

Blood Tests - performed to determine whether different types of blood cells are normal in number and appearance when viewed under the microscope. These include red blood cells, white blood cells, and platelets. Abnormalities in these blood cells may sometimes be the first sign of lymphoma. Certain blood tests can be used to determine whether a tumor is affecting the liver, kidneys, or other parts of the body. Blood abnormalities can also help doctors determine potential treatment choices and predict outcomes. For example, in patients with NHL, levels of lactate dehydrogenase  (LDH) and/or beta (2) microglobulin (B2M) are commonly measured because higher levels of either or both of these proteins suggests that the lymphoma may be more aggressive and that more intensive treatment may be needed.

*Biopsies, CT scans, and PET scans performed at outside facilities should be mailed to Winship Cancer Institute's new patient coordinator.  From there our expert Hematopathologist and Radiologists will review your studies and confirm a diagnosis.

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