• Slider-Image-lymphoma
    Read the stories of ASCP Patient Champions Tyler, Pat, Brian and Nuan and learn about
    the role of laboratory testing in the diagnosis and treatment of lymphomas.


Hodgkin lymphoma is a rare type of cancer that begins in the white blood cells of the lymphatic system. Unlike non-Hodgkin lymphoma, large, abnormal cells called Reed- Sternberg cells are present in the lymph fluid. The two main types of Hodgkin lymphoma are classic Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma.


Reed-Sternberg cells (at arrow) are the hallmark of Hodgkin Lymphoma. They are binucleate (have two distinct nuclei) and very large compared with surrounding cells because of the nuclei and the abundant cytoplasm (cell body). The cells are derived from B-cells in the activity centers of lymph nodes and transform, typically, after infection with Epstein-Barr Virus and a series of mutations.

What is Non-Hodgkin Lymphoma?

Non-Hodgkin lymphoma (NHL) is the most common type of lymphoma, and starts in the white blood cells that are part of the body’s immune system. It can be further diagnosed in to different subtypes, of which large B-cell and follicular lymphoma are the most common. It is distinguished from Hodgkin Lymphomas for treatment purposes.


Large cell non-Hodgkin lymphoma is shown with atypical cells.

What is Large B-Cell Lymphoma?

Large B-cell lymphoma is a type of non-Hodgkin lymphoma. It is an aggressive cancer that can develop in lymph nodes, areas outside of the lymph nodes (such as testes, thyroid, breast, bone) or any organ of the body. It is possible to cure large B-cell lymphoma.



Educational Materials: Lymphoma



Image features a typical image of large b-cell lymphoma, which is more aggressive, is shown with variation in size, shape, and coloration of the cells including very large cells.


Tyler was on the couch watching football with his wife when he suddenly felt a small lump in his neck. He pulled up Google and searched his symptoms, and result after result pointed to cancer. He tried to not to assume the worst, and he went to a local urgent care clinic the next morning. The clinic doctor performed an exam, ordered blood work and an x-ray. Once she reviewed the x-ray results, she cancelled the rest of the tests and told Tyler and his wife to go to the hospital immediately. The x-ray showed a mass in Tyler’s chest. The doctor hoped she was wrong, but she had seen something similar before and it was lymphoma.

As they got in the car to go to the hospital, Tyler looked at his wife: “We just stared at each other for a while, I can’t quite tell you how long. I can’t tell you who said what, but one of us said, ‘is this really happening?’ and the other said, ‘yes’ and we cried.”

At the hospital, Tyler underwent a series of tests and scans, and then spoke to the oncologist on call. The oncologist told Tyler he was worried that the lump was a growth in one of his lymph nodes. To learn more, he needed to perform a biopsy and remove a piece of the lymph node. Once removed, the surgeon sent the tissue to the lab for diagnosis. There, a pathologist reviewed the tissue under a microscope, and diagnosed Tyler with Hodgkin Lymphoma.

Hodgkin Lymphoma is a type of cancer that affects part of the immune system called the lymphoid system. The lymphoid system fights against infection by using white blood cells to destroy foreign substances like bacteria, viruses, and cancer cells. Lymphoma develops when these white blood cells, called lymphocytes, start to change, and grow out of control.

Tyler was young and otherwise healthy and responded well to his treatment. However, three months into remission, tests showed that his cancer had come back. He completed another round of treatment, but this time remission was even shorter. When the cancer came back a third time, Tyler qualified for a different type of treatment – high-dose chemotherapy followed by a stem cell transplant.

Bone marrow transplants help patients replace the stem cells that are destroyed by cancer or high doses of chemotherapy and are essential to helping a patient’s body rebuild their blood supply. Tyler is quick to share that the transplant was a painful and grueling experience. “I wouldn’t wish it upon my worst enemy,” he said, “but I’m lucky.” In most cases, it takes months for patients to rebuild their blood supply after a stem cell transplant. Within a week of his transplant, Tyler’s lab results showed that his blood counts were close to normal.

Throughout his diagnoses and treatments, Tyler and his doctors relied on lab tests to monitor how his body responded to treatment and to catch his cancer recurrence quickly. Closely monitoring his test results allowed Tyler to understand what was happening inside of his body and make the best decisions for his health.

Almost five years into remission, Tyler has dedicated his life to giving back by supporting and educating others navigating cancer, and he looks forward to spending the rest of his life advocating for and educating cancer patients.



In 2009, a physician’s assistant noticed a small lump in Pat’s right axilla (right armpit) during a routine checkup. A biopsy was conducted and lab tests confirmed that she had Stage 1 lymphocyte rich classical Hodgkin Lymphoma. Pat was shocked by this diagnosis because at age 60, she was older than the typical person who has this cancer type and she had no symptoms other than the small lump, which she had not noticed herself. Pat’s career in medical laboratory science helped her understand her diagnosis, which helped her navigate the treatment and decision-making surrounding her cancer. Specifically, lab tests identified the markers that needed to be targeted to treat her cancer. There were times when her blood counts got dangerously low during treatment which put her at risk of infection.

“Without the lab, I probably wouldn’t be alive either from the progression of the Hodgkin lymphoma or the treatment.”

After completing her chemotherapy and radiation treatment, Pat noticed a lump in her left axilla in 2020. After another biopsy, she was diagnosed with mixed lymphoma, a recurrence of the classical Hodgkin Lymphoma and a new diagnosis of Stage IV non- Hodgkin lymphoma. A diagnosis of mixed lymphomas at the same site is very rare. Again, the role of the lab was integral to guiding Pat’s treatment as she underwent chemotherapy a second time. She advises patients and caregivers to “Ask a lot of questions so we can understand what’s going on and know what to watch for if and when changes occur in our signs and symptoms.”

Today, Pat’s PET scans are clear and she’s living life with her husband and her dogs by her side, with the mindset that she is cancer free. Throughout her entire cancer journey, Pat remained dedicated to her career in pathology and laboratory medicine and she was able to continue working.

“Don’t neglect checkups even if you feel fine and take notes of discussions with providers to understand your diagnosis and treatment plan.”


“Honestly, I didn’t even want to go to the appointment the week before Christmas but I’m glad I did.”

Brian's Story

Brian was building up a website design and computer repair company while also acting as the primary caregiver for his young daughter, and his stress levels were on the rise. At the same time, he could tell something wasn’t right with his health, but he couldn’t seem to get any answers from his doctors. But when doctors found a large mass in his chest via CT scan, he finally got the answers—though not the one he was looking for.

Brian was diagnosed with large B-cell lymphoma, a rare subtype of cancer. It is composed of abnormal b cells, which are a type of white blood cells that produce antibodies. The cancer is aggressive, and Brian was diagnosed at stage 3, and the cancer had spread to some lymph nodes but thankfully hadn’t spread to any other organs.

Having worked for a couple of years as a processor in a laboratory environment, Brian was roughly acquainted with some of the testing he underwent, and had a good understanding of workflows and time frames for the various cultures and biopsies he had to have. Having undergone chemotherapy, and 40 total rounds of radiation, Brian has added to his knowledge of the laboratory. “I have learned that my doctors tend to disregard abnormal test results, especially if there are no symptoms and the test doesn’t directly diagnose something,” he says. “If the numbers are slightly off, I usually have to request further testing.”


Brian has been in remission since 2016, and gets a CT scan every six months as part of his follow-up care. His wife and daughter, he says, have been essential to his recovery, along with his doctors, friends and family. “Ultimately, trust your doctors and their treatments,” he says, “but do not be afraid to question them or ask for further testing if something health-related is not right.”

Nuan’s Story

In 2015, Nuan was diagnosed with Type B, stage 2 Non-Hodgkin lymphoma. She started treatment immediately and completed it in May of 2016. But by the end of that same year, the lymphoma had returned, in the same spot, and the same type. Thankfully, it hadn’t spread, and Nuan once again started chemotherapy and radiation treatment, which she completed in August 2017.

Prior to his diagnosis, Nuan had the same understanding of the laboratory that most people do—cholesterol, HDL, LDL, and triglyceride numbers that are checked from time to time. But after being diagnosed with Non-Hodgkin lymphoma, she better understands that she can use the lab to monitor her diet and health. Nuan encourages people to learn about the lab and ask questions about their lab results, and what the doctors and nurses are looking for so patients can monitor it themselves as well, and compare it to past lab results.

Before being diagnosed, Nuan says she didn’t think much about her health. “I always heard about other people having cancer,” she says. “I never thought it could have happened to me.” But since his diagnosis, she’s become more health conscious, changed her diet, and exercises and meditates regularly to “keep my body and mind together.” Being a regular mediator helped Nuan during her diagnosis and treatment, she says. She had no fears or worries, just focused on what she needed to do to get cured. And she believes her health is much better now than it was before her cancer diagnosis.


“I feel that I am blessed,” she says. “I count my blessings every day. I still continue doing good karma so I will be happy and feel content in what I have with gratitude.”