NCCN Guidelines for Patients® | Diffuse Large B-cell Lymphoma

19 NCCN Guidelines for Patients ® : Diffuse Large B-cell Lymphoma, 2017 Diagnostic CT In addition to PET/CT, you may receive a diagnostic CT scan. Images of your chest, abdomen (belly area), and pelvis (between your hip bones) are advised. A contrast dye is used for diagnostic CT. It makes the pictures clearer. The dye will be injected into a vein in your hand or arm. You will also be given a liquid contrast to drink. The contrast may cause you to feel flushed or get hives. Rarely, serious allergic reactions occur. Tell your doctor and the technicians if you have had bad reactions to contrast. Bone marrow exam The PET scan may suggest there’s cancer inside your bones. If so, a bone marrow exam is needed to confirm the PET results. If the PET scan doesn’t show cancer, a bone marrow exam is only needed if your doctor thinks you may have another type of lymphoma. The bone marrow exam may consist of two procedures. A bone marrow biopsy removes a sample of bone and soft bone marrow. A bone marrow aspiration also may be done. A bone marrow aspiration removes a small amount of liquid bone marrow. If needed, these procedures are often done at the same time. They are performed on the back of hip bone. You may receive a light sedative beforehand. You will likely lie on your side as shown in Figure 6 . Some people lie on their belly. Your doctor will first clean and numb your skin. For aspiration, a hollow needle will be inserted into your skin and pushed into the bone. Liquid bone marrow will then be drawn into a syringe. For the biopsy, a wider needle will be inserted into your bone and rotated to remove a core sample. The samples will be sent to a lab for testing. You may feel bone pain during and after the procedures for a few days. Your skin may bruise. Figure 6 Bone marrow exam A bone marrow exam removes a sample of bone and marrow for testing. The procedure is often done on the back of the hip. Illustration Copyright © 2017 Nucleus Medical Media, All rights reserved. 2 Treatment planning Bone marrow exam