NCCN Guidelines for Patients® | Mantle Cell Lymphoma

10 NCCN Guidelines for Patients ® : Mantle Cell Lymphoma, 2019 1  MCL basics Tests for MCL Tests for MCL One of the first signs of MCL may be a swelling of lymph nodes. These nodes may be in your neck, armpit, or groin area. The cancer may also affect your GI tract and bone marrow. GI symptoms include pain in your gut, diarrhea, and bloody stools. MCL can also cause abnormal blood counts. Tests needed to confirm (diagnose) MCL are described next. Biopsy The only way to know if you have cancer is to test tissue or fluid. A biopsy is a procedure that removes samples of fluid or tissue for testing. There are many types of biopsies. For B-cell lymphomas, NCCN experts advise getting an incisional or excisional biopsy. These biopsies remove tissue through a cut into your skin. An incisional biopsy removes only a part of the tumor. An excisional biopsy removes the whole tumor and not much else. Other biopsy methods remove very small samples with a needle. FNA (fine-needle aspiration) removes a small group of cells. A core needle biopsy removes a solid tissue sample. Needle biopsies are not the best method for diagnosing lymphoma. Only in certain cases, a core needle biopsy may be used to obtain samples. For hard-to-reach lymph nodes, FNA and core needle biopsies may be used to obtain samples. Blood and tissue samples will be sent to a doctor called a hematopathologist. These doctors are experts at diagnosing cancers of blood and immune cells. They spend much of their time working with samples of blood, bone marrow, and lymph nodes. Protein tests The hematopathologist will study the proteins on the surface and inside of cancer cells. See Figure 3 . This is called immunophenotyping. It is done to assess the type of cancer. Derivative work of NIAID - Rituxima Binding to CD20 on a B Cell Surface, CC BY 2.0, Figure 3 Protein tests Mantle cell lymphoma has common patterns of proteins in its cells. Immunophenotyping is the process of identifying the proteins in cells.