Mantle cell lymphoma (MCL) belongs to a group of diseases known as non-Hodgkin's lymphomas (NHL). NHL's are cancers that affect the the lymphatic system (part of the immune system). MCL is aggressive (fast-growing) and usually occurs in middle-aged or older adults. Explore causes, symptoms, and treatment of MCL.
Mantle cell lymphoma
Image by Nephron
What Is
Nodular Mantle Cell Lymphoma - high power view - by Gabriel Caponetti
Image by Gabriel Caponetti/Wikimedia
Nodular Mantle Cell Lymphoma - high power view - by Gabriel Caponetti
Nodular Mantle Cell Lymphoma (high power view). Notice the irregular nuclear contours of the medium-sized lymphoma cells and the presence of a pink histiocyte. By immunohistochemistry the lymphoma cells expressed CD5, CD20 and cyclin D1. Author: Gabriel Caponetti, MD
Image by Gabriel Caponetti/Wikimedia
What Is Mantle Cell Lymphoma?
Mantle cell lymphoma (MCL) belongs to a group of diseases known as non-Hodgkin’s lymphomas (NHL). NHL's are cancers that affect the the lymphatic system (part of the immune system). In MCL, there are cancerous B-cells (a type of immune system cell). The cancerous B-cells are within a region of the lymph node known as the mantle zone. Although MCLs are slow-growing cancers, the cancer is usually widespread by the time it is diagnosed. In these situations, treatment must be intensive since MCL can become life threatening within a short period of time. MCL accounts for 6% of all NHL's and is mostly found in males during their early 60s.
Source: Genetic and Rare Diseases (GARD) Information Center
Additional Materials (5)
Mantle Cell Lymphoma with John P. Leonard, MD | Everything You Need to Know
Current and future therapies in mantle cell lymphoma
VJHemOnc – Video Journal of Hematological Oncology/YouTube
15:32
Panel discussion on mantle cell lymphoma
VJHemOnc – Video Journal of Hematological Oncology/YouTube
2:39
Biology of Mantle Cell Lymphoma
OncLiveTV/YouTube
Causes
Helicobacter pylori bacterium
Image by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Helicobacter pylori bacterium
H. pylori gastritis is one of the most common types of gastritis.
Image by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
What Causes Mantle Cell Lymphoma?
Most lymphomas are not inherited, but rather are acquired when the DNA within select body cells has been damaged (somatic DNA damage). Some risk factors for non-Hodgkin lymphomas (NHL) include age (older), gender (male), race (white), and having a condition which weakens the immune system, such as autoimmune conditions, certain genetic disorders, being on immune suppressing medications, HIV/AIDS, HTLV-1, Epstein-Barr virus, and helicobacter pylori infection.
Source: Genetic and Rare Diseases (GARD) Information Center
Additional Materials (1)
Panel discussion on mantle cell lymphoma
Video by VJHemOnc – Video Journal of Hematological Oncology/YouTube
15:32
Panel discussion on mantle cell lymphoma
VJHemOnc – Video Journal of Hematological Oncology/YouTube
Symptoms
Mantle cell lymphoma - low mag - cyclin D1
Image by Nephron/Wikimedia
Mantle cell lymphoma - low mag - cyclin D1
Low magnification micrograph of mantle cell lymphoma of the terminal ileum. Endoscopic biopsy. Cyclin D1 immunostain.
Histomorphologic features:
Monomorphic small lymphoid cells less than twice the size of a resting lymphocyte.
Abundant mitoses.
Sclerosed blood vessels.
Scattered epithelioid histiocytes.
Immunohistochemical staining:
Positive: Cyclin D1, CD5, CD43, CD20, CD45.
Negative: CD23.
Molecular features:
t(11;14)(q13;q32).
CCND1/IGHG1 fusion gene.[1]
Related images
Low mag.
Intermed. mag.
Low mag. - cyclin D1.
Intermed. mag. - cyclin D1.
References
↑ URL: https://www.ncbi.nlm.nih.gov/omim/168461. Accessed on: 18 August 2010.
Image by Nephron/Wikimedia
What Are the Signs and Symptoms of Mantle Cell Lymphoma?
Of note, people with MCL may be at an increased risk for gastrointestinal issues, such as obstruction, intussusception, and multiple intestinal polyps, as well as a very high white blood cell count.
Source: Genetic and Rare Diseases (GARD) Information Center
Image by National Human Genome Research Institute (NHGRI)
Fluorescence In Situ Hybridization (FISH)
Fluorescence in situ hybridization (FISH) is a laboratory technique for detecting and locating a specific DNA sequence on a chromosome.
Image by National Human Genome Research Institute (NHGRI)
How Is Mantle Cell Lymphoma Diagnosed?
The following tests and procedures may be used to diagnose mantle cell lymphoma:
Physical exam and medical history
Flow cytometry
Bone marrow aspiration or biopsy
Lymph node biopsy (surgical removal of all or part of a lymph node)
If cancer is found, the following tests may be done to study the cancer cells:
Immunohistochemistry
Cytogenetic analysis
FISH
Immunophenotyping
Source: Genetic and Rare Diseases (GARD) Information Center
Additional Materials (5)
Biology of Mantle Cell Lymphoma
Video by OncLiveTV/YouTube
Bone Marrow Biopsy & Aspiration (BMBx)
Video by Leukemia & Lymphoma Society/YouTube
What is a bone marrow aspiration?
Video by MD Anderson Cancer Center/YouTube
Having a lymph node biopsy
Video by London Cancer/YouTube
Lymph Node Biopsy
Video by Leukemia & Lymphoma Society/YouTube
2:39
Biology of Mantle Cell Lymphoma
OncLiveTV/YouTube
2:37
Bone Marrow Biopsy & Aspiration (BMBx)
Leukemia & Lymphoma Society/YouTube
6:10
What is a bone marrow aspiration?
MD Anderson Cancer Center/YouTube
4:59
Having a lymph node biopsy
London Cancer/YouTube
2:44
Lymph Node Biopsy
Leukemia & Lymphoma Society/YouTube
Immunophenotyping Test
Immunophenotyping Test
Also called: Lymphocyte Subtyping, Lymphocyte Immunophenotyping, Immunophenotype Profile
Immunophenotyping is a test that detects the presence or absence of white blood cell (WBC) antigens in a sample of blood, bone marrow or lymph node cells. The test is used in basic research and to help diagnose and classify diseases, such as specific types of leukemia and lymphoma.
Immunophenotyping Test
Also called: Lymphocyte Subtyping, Lymphocyte Immunophenotyping, Immunophenotype Profile
Immunophenotyping is a test that detects the presence or absence of white blood cell (WBC) antigens in a sample of blood, bone marrow or lymph node cells. The test is used in basic research and to help diagnose and classify diseases, such as specific types of leukemia and lymphoma.
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Use the slider below to see how your results affect your
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Your result is Normal.
No significant immunophenotypic abnormality detected.
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Immunophenotyping | NCI's Dictionary of Cancer Terms [accessed on Feb 19, 2022]
Blood Work | How This Provides Clues On Your Health | Leukemia & Lymphoma Society® (LLS) [accessed on Feb 18, 2022]
Immunophenotyping | Labcorp [accessed on Feb 19, 2022]
480260: Leukemia/Lymphoma Immunophenotyping Profile | Labcorp [accessed on Feb 19, 2022]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (3)
Burkitts lymphoma
Burkitt's lymphoma histology image
Image by Ed Uthman, MD.
Immunophenotyping | Flow Cytometry & Immunophenotyping Test |
Video by BMH learning/YouTube
Immunophenotyping made easy: streamline your bench
Video by Miltenyi Biotec/YouTube
Burkitts lymphoma
Ed Uthman, MD.
2:21
Immunophenotyping | Flow Cytometry & Immunophenotyping Test |
BMH learning/YouTube
1:51
Immunophenotyping made easy: streamline your bench
Miltenyi Biotec/YouTube
FISH Test
FISH Test
Also called: Fluorescence In Situ Hybridization, FISH, FISH Test for Cancer, FISH Study
Fluorescence in situ hybridization (FISH) is a laboratory technique used to detect and locate a specific DNA sequence on a chromosome. It is utilized to diagnose genetic diseases, gene mapping, and identification of chromosomal abnormalities, and may also be used to study comparisons among the chromosomes' arrangements of genes.
FISH Test
Also called: Fluorescence In Situ Hybridization, FISH, FISH Test for Cancer, FISH Study
Fluorescence in situ hybridization (FISH) is a laboratory technique used to detect and locate a specific DNA sequence on a chromosome. It is utilized to diagnose genetic diseases, gene mapping, and identification of chromosomal abnormalities, and may also be used to study comparisons among the chromosomes' arrangements of genes.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal FISH study indicates the amount of cells counted and analyzed and that no gene rearrangements were observed.
Related conditions
Fluorescence in situ hybridization (abbreviated FISH) is a laboratory technique used to detect and locate a specific DNA sequence on a chromosome. In this technique, the full set of chromosomes from an individual is affixed to a glass slide and then exposed to a “probe”—a small piece of purified DNA tagged with a fluorescent dye. The fluorescently labeled probe finds and then binds to its matching sequence within the set of chromosomes. With the use of a special microscope, the chromosome and sub-chromosomal location where the fluorescent probe bound can be seen.
Fluorescence in situ hybridization (FISH) provides researchers with a way to visualize and map the genetic material in an individual's cells, including specific genes or portions of genes. This may be used for understanding a variety of chromosomal abnormalities and other genetic mutations.
FISH is useful, for example, to help a researcher or clinician identify where a particular gene falls within an individual's chromosomes. The first step is to prepare short sequences of single-stranded DNA that match a portion of the gene the researcher is looking for. These are called probes. The next step is to label these probes by attaching one of a number of colors of fluorescent dye.DNA is composed of two strands of complementary molecules that bind to each other like chemical magnets. Since the researchers' probes are single-stranded, they are able to bind to the complementary strand of DNA, wherever it may reside on a person's chromosomes. When a probe binds to a chromosome, its fluorescent tag provides a way for researchers to see its location.
Scientists use three different types of FISH probes, each of which has a different application:
Locus specific probes bind to a particular region of a chromosome. This type of probe is useful when scientists have isolated a small portion of a gene and want to determine on which chromosome the gene is located, or how many copies of a gene exist within a particular genome.
Alphoid or centromeric repeat probes are generated from repetitive sequences found in the middle of each chromosome. Researchers use these probes to determine whether an individual has the correct number of chromosomes. These probes can also be used in combination with "locus specific probes" to determine whether an individual is missing genetic material from a particular chromosome.
Whole chromosome probes are actually collections of smaller probes, each of which binds to a different sequence along the length of a given chromosome. Using multiple probes labeled with a mixture of different fluorescent dyes, scientists are able to label each chromosome in its own unique color. The resulting full-color map of the chromosome is known as a spectral karyotype. Whole chromosome probes are particularly useful for examining chromosomal abnormalities, for example, when a piece of one chromosome is attached to the end of another chromosome.
For many applications, FISH has largely been replaced by the use of microarrays. However, FISH remains useful for some tests. FISH may also be used to study comparisons among the chromosomal arrangements of genes across related species.
Fluorescence In Situ Hybridization Fact Sheet | National Human Genome Research Institute (NHGRI) [accessed on Feb 19, 2022]
Fluorescence In Situ Hybridization (FISH). Genome.gov [accessed on Feb 19, 2022]
PDQ® Adult Treatment Editorial Board. PDQ Chronic Myelogenous Leukemia Treatment. Bethesda, MD: National Cancer Institute. [accessed on Feb 19, 2022]
510669: Fluorescence in situ Hybridization (FISH), Oncology | Labcorp [accessed on Feb 19, 2022]
Blood Work | How This Provides Clues On Your Health | Leukemia & Lymphoma Society® (LLS) [accessed on Feb 18, 2022]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (41)
FLUORESCENCE IN SITU HYBRIDIZATION (FISH)
Fluorescence in situ hybridization (abbreviated FISH) is a laboratory technique used to detect and locate a specific DNA sequence on a chromosome. In this technique, the full set of chromosomes from an individual is affixed to a glass slide and then exposed to a “probe”—a small piece of purified DNA tagged with a fluorescent dye. The fluorescently labeled probe finds and then binds to its matching sequence within the set of chromosomes. With the use of a special microscope, the chromosome and sub-chromosomal location where the fluorescent probe bound can be seen.
Image by National Human Genome Research Institute
HER2 FISH on Breast Cancer
HER2 FISH on Breast Cancer
Image by Anistalista
Indian Muntjac fibroblast cells
Indian Muntjac cultured cells; DAPI nuclei, Alexa Fluor 488 Phalloidin actin, Mitotracker Red CMXRos; 63x/1.4. Imaged with ZEISS ApoTome.2, Axiocam 702 mono and Axio Imager www.zeiss.com/axiocam Sample courtesy of Michael W. Davidson, Florida State University
Image by ZEISS Microscopy/Flickr
Aspergillosis
Under a magnification of 562X, this photomicrograph, stained using a fluorescent antibody (FA) staining technique, and NOT stained using a Candida conjugate, revealed the presence of Aspergillus sp. organisms, in a case of aspergillosis.
Image by CDC/ Dr. William Kaplan
FISH Confirmation of a Human-Specific Duplication of a Gene Cluster on Chromosome 5q13.3 Detected by Interspecies cDNA aCGH - journal.pbio.0020207.g003
FISH Confirmation of a Human-Specific Duplication of a Gene Cluster on Chromosome 5q13.3 Detected by Interspecies cDNA array CGH
(A) Human duplication of a cluster of genes at Chromosome 5q13.3. is shown by two separate, and sometimes multiple, red BAC probe (CTD-2288G5) signals in interphase cells, with only one green BAC probe signal (RP11-1077O1) for a flanking region. Metaphase FISH shows both probes at band 5q13. The third nucleus in (A) shows four signals of the control probe (green) and eight copies of the BAC probe duplicated in the aCGH assay, consistent with the pattern expected in an S/G2 nucleus.
(B–E) Bonobo (B), chimpanzee (C), gorilla (D), and orangutan (E) interphase FISH studies all show no increased signal for the human duplicated gene cluster, with signals of comparable size for the CTD-2288G5 (red) and the flanking RP11-107701 (green) probes. Metaphase FISH analyses show the gene cluster to be in the p arm of Chromosomes 4 (corresponding to the human Chromosome 5) in both the bonobo and chimpanzee, in the q arm of Chromosome 4 (corresponding to the human Chromosome 5) in the orangutan, and in the p arm of the gorilla Chromosome 19 (syntenic regions to human Chromosomes 5 and 17).
doi:10.1371/journal.pbio.0020207.g003
Image by Fortna, A.; Kim, Y.; MacLaren, E.; Marshall, K.; Hahn, G.; Meltesen, L.; Brenton, M.; Hink, R.; Burgers, S.; Hernandez-Boussard, T.; Karimpour-Fard, A.; Glueck, D.; McGavran, L.; Berry, R.; Pollack, J.; Sikela, J. M./Wikimedia
FISH (Fluorescent In Situ Hybridization)
Scheme of the principle of the FISH (Fluorescent in situ hybridization) Experiment to localize a gene in the nucleus.
Image by MrMatze/Wikimedia
FISH for Bacterial Pathogen Identification
This figure outlines the process of fluorescence in situ hybridization (FISH) used for bacterial pathogen identification. First, a sample of the infected tissue is taken from the patient. Then an oligonucleotide that is complementary to the suspected pathogen’s genetic code is synthesized and chemically tagged with a fluorescent probe. The collected tissue sample must then be chemically treated in order to make the cell membranes permeable to the fluorescently tagged oligonucleotide. After the tissue sample is treated, the tagged complementary oligonucleotide is added. The fluorescently tagged oligonucleotide will only bind to the complementary DNA of the suspected pathogen. If the pathogen is present in the tissue sample, then the pathogen’s cells will glow/fluoresce after treatment with the tagged oligonucleotide. All other cells will not glow after treatment.
Image by Pepetps
Togopic
Ivan Akira
Magnus Manske
Timothy W. Ford/Wikimedia
Results of in situ hybridization of chromosome X and Y BAC probes
Results of in situ hybridization of chromosome X and Y BAC probes. (A) Dual color hybridization showing highly specific signals on the X (red) and Y (green) chromosomes in metaphase cells. The two diploid interphase cell nuclei from a normal male donor show the expected pair of single signals. (B) The approximate locations of the hybridization targets shown along ideograms of the human X and Y chromosomes.
Image by Joanne H. Hsu, Hui Zeng, Kalistyn H. Lemke, Aris A. Polyzos, Jingly F. Weier, Mei Wang, Anna R. Lawin-O’Brien, Heinz-Ulrich G. Weier and Benjamin O’Brien/Wikimedia
Hordeum vulgare stained by fluorescent in situ hybridization
Staining of chromosome Hordeum vulgare by Fluorescent in situ hybridization (FISH)
Image by Karol007 and Marcello002/Wikimedia
FISH versus CISH Detection
Fluorescence in situ hybridization versus chromogenic in situ hybridization
Image by Escott16/Wikimedia
FISH (technique)
Fluorescent in-situ hybridization is a process which vividly paints chromosomes or portions of chromosomes with fluorescent molecules. This technique is useful for identifying chromosomal abnormalities and for gene mapping.
Image by Thomas Ried/Wikimedia
Results of in situ hybridization of a chromosome 16 BAC probe
Results of in situ hybridization of a chromosome 16 BAC probe on metaphase spreads of ‘normal’ cells. (A) The dual color FISH results showing a normal diploid metaphase spread. The DAPI DNA counterstain is shown in gray; (B) Schematic diagram illustrating the relative positions of the chromosome 16 whole chromosome painting probe (Coatasome-16, Oncor) and the biotinylated DNA repeat probe prepared from BAC RP11-486E19 (detected with avidin-FITC, green).
Image by Joanne H. Hsu, Hui Zeng, Kalistyn H. Lemke, Aris A. Polyzos, Jingly F. Weier, Mei Wang, Anna R. Lawin-O’Brien, Heinz-Ulrich G. Weier and Benjamin O’Brien/Wikimedia
FISH human lymphocyte nucleus stained with DAPI with chromosome 13 (green) and 21 (red) centromere probes hybrydized (fluorescent in situ hybridization, FISH)
human lymphocyte nucleus stained with DAPI with chromosome 13 (green) and 21 (red) centromere probes hybrydized (fluorescent in situ hybridization, FISH)
Obraz fluorescencyjny jądra ludzkiego limfocytu barwionego diaminofenyloindolem (DAPI) z sygnałami sond swoistych dla chromosomów 13 (zielony, sonda znakowana fluoresceiną) i 21 (czerwony, sonda znakowana rodaminą), uzyskany w wyniku zastosowania techniki FISH
Image by Gregor1976/Wikimedia
MicroRNA and mRNA visualization in differentiating C1C12 cells
ViewRNA assay for detection of miR-133 microRNA (green) and myogenin mRNA (red) in differentiating C2C12 cells.
Image by Ryan Jeffs/Wikimedia
FISH Her2
Her2 gene amplification by FISH (fluorescent in situ hybridization) in breast cancer cells
Image by IrinaPav/Wikimedia
PLoSBiol3.5.Fig7ChromosomesAluFish
Human metaphase chromosomes were subjected to fluorescence in situ hybridization with a probe to the Alu Sequence (green signals)and counterstained for DNA (red).
Image by Andreas Bolzer, Gregor Kreth, Irina Solovei, Daniela Koehler, Kaan Saracoglu, Christine Fauth, Stefan Müller, Roland Eils, Christoph Cremer, Michael R. Speicher, Thomas Cremer/Wikimedia
Q-FISH workflow
General workflow for Q-FISH with cultured cells.
Image by Jclam at English Wikipedia/Wikimedia
Fluorescence in Situ Hybridization (FISH)
Video by Leukemia & Lymphoma Society/YouTube
Hybridization (microarray) | Biomolecules | MCAT | Khan Academy
Video by khanacademymedicine/YouTube
Fluorescence In Situ Hybridization (FISH)
Video by Abnova/YouTube
FISH Technique Fluorescent In Situ Hybridization HD Animation 1
Video by ПИМУ - Приволжский исследовательский мед.универ./YouTube
Microbiology: Immunofluorescence Detection of Bacteria
Video by biologycourses/YouTube
Fluorescence In Situ Hybridization (FISH)
Fluorescence in situ hybridization (FISH) is a laboratory technique for detecting and locating a specific DNA sequence on a chromosome.
Image by National Human Genome Research Institute (NHGRI)
Hybridization
Hybridization is the process of combining two complementary single-stranded DNA or RNA molecules and allowing them to form a single double-stranded molecule through base pairing.
Image by National Human Genome Research Institute (NHGRI)
FISH Confirmation of a Human-Specific Duplication of a Gene Cluster on Chromosome 5q13.3
FISH Confirmation of a Human-Specific Duplication of a Gene Cluster on Chromosome 5q13.3 Detected by Interspecies cDNA array CGH
(A) Human duplication of a cluster of genes at Chromosome 5q13.3. is shown by two separate, and sometimes multiple, red BAC probe (CTD-2288G5) signals in interphase cells, with only one green BAC probe signal (RP11-1077O1) for a flanking region. Metaphase FISH shows both probes at band 5q13. The third nucleus in (A) shows four signals of the control probe (green) and eight copies of the BAC probe duplicated in the aCGH assay, consistent with the pattern expected in an S/G2 nucleus.
(B–E) Bonobo (B), chimpanzee (C), gorilla (D), and orangutan (E) interphase FISH studies all show no increased signal for the human duplicated gene cluster, with signals of comparable size for the CTD-2288G5 (red) and the flanking RP11-107701 (green) probes. Metaphase FISH analyses show the gene cluster to be in the p arm of Chromosomes 4 (corresponding to the human Chromosome 5) in both the bonobo and chimpanzee, in the q arm of Chromosome 4 (corresponding to the human Chromosome 5) in the orangutan, and in the p arm of the gorilla Chromosome 19 (syntenic regions to human Chromosomes 5 and 17).
Image by Fortna, A.; Kim, Y.; MacLaren, E.; Marshall, K.; Hahn, G.; Meltesen, L.; Brenton, M.; Hink, R.; Burgers, S.; Hernandez-Boussard, T.; Karimpour-Fard, A.; Glueck, D.; McGavran, L.; Berry, R.; Pollack, J.; Sikela, J. M.
FISH18
In situ hybridization. 18p (green) and 18q (red) with subtelomeric probes showing 18p deletion in the patient with De Grouchy syndrome type I (deletion 18p)
Image by /Wikimedia
Kidney section, fluorescence microscopy
Kidney section. IHC stained with Cy3 (red), anti-GFP antibody stained with Alexa 488(green), nuclei stained with DAPI (blue). Fluorescence microscopy with ZEISS Axio Observer, Axiocam, Colibri 7. www.zeiss.com/axioobserver
Image by ZEISS Microscopy
Fish analysis di george syndrome
Figure 2. Result of FISH analysis using LSI probe (TUPLE 1) from DiGeorge/velocardiofacial syndrome critical region. TUPLE 1 (HIRA) probe was labeled in Spectrum Orange and Arylsulfatase A (ARSA) in SpectrumGreen as control. Absence of the orange signal indicates deletion of the TUPLE 1 locus at 22q11.2. Tonelli et al. Journal of Medical Case Reports 2007 1:167 doi:10.1186/1752-1947-1-167
Image by Adriano R Tonelli1 , Kalyan Kosuri1 , Sainan Wei2 and Davoren Chick1/Wikimedia
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Chromosomal Instability in Breast Cancer Cells
Visualization of the enormous degree of chromosomal instability in primary breast cancers using fluorescence in situ hybridization to identify copy number changes of specific chromosomes and oncogenes.
This image was originally submitted as part of the 2015 NCI Cancer Close Up project. This image is part of the NCI Cancer Close Up 2015 collection.
See also https://visualsonline.cancer.gov/closeup.
Image by NCI Center for Cancer Research / Thomas Ried
Mapping a Gene
Mapping the position of genes in the cell nucleus sheds light on basic principles governing the genome. Here, a single gene called Pem (purple) has been localized using fluorescence in situ hybridization. DNA is stained blue; the cell cytoplasm is stained green.
This image was originally submitted as part of the 2015 NCI Cancer Close Up project and selected for exhibit. This image is part of the NCI Cancer Close Up 2015 collection.
See also https://visualsonline.cancer.gov/closeup.
Image by NCI Center for Cancer Research / Tom Misteli
Prokaryotic Diversity
This (a) microbial mat, about one meter in diameter, grows over a hydrothermal vent in the Pacific Ocean in a region known as the “Pacific Ring of Fire.” The mat helps retain microbial nutrients. Chimneys such as the one indicated by the arrow allow gases to escape. (b) In this micrograph, bacteria are visualized using fluorescence microscopy. (credit a: modification of work by Dr. Bob Embley, NOAA PMEL, Chief Scientist; credit b: modification of work by Ricardo Murga, Rodney Donlan, CDC; scale-bar data from Matt Russell)
Image by CNX Openstax
Biofilm formed by a pathogen
A biofilm is a highly organized community of microorganisms that develops naturally on certain surfaces. These communities are common in natural environments and generally do not pose any danger to humans. Many microbes in biofilms have a positive impact on the planet and our societies. Biofilms can be helpful in treatment of wastewater, for example. This dime-sized biofilm, however, was formed by the opportunistic pathogen Pseudomonas aeruginosa. Under some conditions, this bacterium can infect wounds that are caused by severe burns. The bacterial cells release a variety of materials to form an extracellular matrix, which is stained red in this photograph. The matrix holds the biofilm together and protects the bacteria from antibiotics and the immune system. A biofilm is a highly organized community of microorganisms that develops naturally on certain surfaces. These communities are common in natural environments and generally do not pose any danger to humans. Many microbes in biofilms have a positive impact on the planet and our societies. Biofilms can be helpful in treatment of wastewater, for example. This dime-sized biofilm, however, was formed by the opportunistic pathogen Pseudomonas aeruginosa. Under some conditions, this bacterium can infect wounds that are caused by severe burns. The bacterial cells release a variety of materials to form an extracellular matrix, which is stained red in this photograph. The matrix holds the biofilm together and protects the bacteria from antibiotics and the immune system.
Image by Scott Chimileski, Ph.D., and Roberto Kolter, Ph.D., Harvard Medical School.
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Biofilm blocking fluid flow
This time-lapse movie shows that bacterial communities called biofilms can create blockages that prevent fluid flow in devices such as stents and catheters over a period of about 56 hours. This video was featured in a news release from Princeton University.
Video by NIGMS/Knut Drescher, Princeton University
5 stages of biofilm development
Stage 1, initial attachment; stage 2, irreversible attachment; stage 3, maturation I; stage 4, maturation II; stage 5, dispersion. Each stage of development in the diagram is paired with a photomicrograph of a developing Pseudomonas aeruginosa biofilm. All photomicrographs are shown to same scale
Image by D. Davis
Toxins under microscope
This digitally colorized scanning electron microscopic (SEM) image of an untreated water specimen extracted from a wild stream mainly used to control flooding during inclement weather; revealed the presence of unidentified organisms; which included bacteria; protozoa; and algae. In this particular view; a microorganism is featured; the exterior of which is covered by numerous projections imparting an appearance of a sea urchin. This microscopic pin cushion; was tethered to its surroundings by a biofilm; within which many bacteria; and amoeboid protozoa could be seen enmeshed as well.
Image by CDC/ Janice Haney Carr
Toxins
Under a magnification of 2500X, this digitally colorized scanning electron microscopic (SEM) image of an untreated water specimen extracted from a wild stream mainly used to control flooding during inclement weather, revealed the presence of unidentified organisms, which included bacteria, protozoa, and algae. In this particular view, a microorganism is featured, the exterior of which is covered by numerous projections, imparting an appearance of a sea urchin. This microscopic pincushion was tethered to its surroundings by a biofilm, within which many bacteria and amoeboid protozoa could be seen enmeshed as well. See PHIL 11781 for a greater magnification of this organism’s exterior.
Image by CDC/ Janice Haney Carr
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confocal laser scanning microscope of biofilm of Salmonella enterica (pink) and Erwinia chrysanthemi (green)
Using a confocal laser scanning microscope, microbiologist Maria Brandl examines a mixed biofilm of Salmonella enterica (pink) and Erwinia chrysanthemi (green) in soft rot lesions on cilantro leaves (blue).
Image by USDA Agricultural Research Service/Photo by Peggy Greb.
Flourescence In Situ Hybridization (FISH)
Fluorescence in situ hybridization (FISH) provides researchers with a way to visualize and map the genetic material in an individual's cells, including specifc genes or portions of genes. This is important for understanding a variety of chromosomal abnormalities and other genetic mutations. Unlike most other techniques used to study chromosomes, FISH does not have to be performed on cells that are actively dividing. This makes it a very versatile procedure. Credit: Darryl Leja, NHGRI.
Image by National Human Genome Research Institute (NHGRI) from Bethesda, MD, USA/Wikimedia
Fluorescence in situ hybridization (FISH) image of bcr/abl positive rearranged metaphase
FISH method. The chromosomes are blue in the fluorescence microscope , except for a point on one of the chromosomes, which is green and red. This is where the sequence causing one of the types of leukemia is located
Image by Pmx
In situ hybridization of the Her2 gene (unamplified)
The image shows nuclei of neoplastic cells of a breast cancer with a normal number of copies of the Her2 gene (red signals) (in green, centromere labeling signals). Technique: in situ hybridization of interphase nuclei obtained from paraffin-embedded material from breast cancer.
Image by Manuel Medina Pérez/Wikimedia
Probe
A probe is a single-stranded sequence of DNA or RNA used to search for its complementary sequence in a sample genome.
Image by National Human Genome Research Institute (NHGRI)
FLUORESCENCE IN SITU HYBRIDIZATION (FISH)
National Human Genome Research Institute
HER2 FISH on Breast Cancer
Anistalista
Indian Muntjac fibroblast cells
ZEISS Microscopy/Flickr
Aspergillosis
CDC/ Dr. William Kaplan
FISH Confirmation of a Human-Specific Duplication of a Gene Cluster on Chromosome 5q13.3 Detected by Interspecies cDNA aCGH - journal.pbio.0020207.g003
Pepetps
Togopic
Ivan Akira
Magnus Manske
Timothy W. Ford/Wikimedia
Results of in situ hybridization of chromosome X and Y BAC probes
Joanne H. Hsu, Hui Zeng, Kalistyn H. Lemke, Aris A. Polyzos, Jingly F. Weier, Mei Wang, Anna R. Lawin-O’Brien, Heinz-Ulrich G. Weier and Benjamin O’Brien/Wikimedia
Hordeum vulgare stained by fluorescent in situ hybridization
Karol007 and Marcello002/Wikimedia
FISH versus CISH Detection
Escott16/Wikimedia
FISH (technique)
Thomas Ried/Wikimedia
Results of in situ hybridization of a chromosome 16 BAC probe
Joanne H. Hsu, Hui Zeng, Kalistyn H. Lemke, Aris A. Polyzos, Jingly F. Weier, Mei Wang, Anna R. Lawin-O’Brien, Heinz-Ulrich G. Weier and Benjamin O’Brien/Wikimedia
FISH human lymphocyte nucleus stained with DAPI with chromosome 13 (green) and 21 (red) centromere probes hybrydized (fluorescent in situ hybridization, FISH)
Gregor1976/Wikimedia
MicroRNA and mRNA visualization in differentiating C1C12 cells
Ryan Jeffs/Wikimedia
FISH Her2
IrinaPav/Wikimedia
PLoSBiol3.5.Fig7ChromosomesAluFish
Andreas Bolzer, Gregor Kreth, Irina Solovei, Daniela Koehler, Kaan Saracoglu, Christine Fauth, Stefan Müller, Roland Eils, Christoph Cremer, Michael R. Speicher, Thomas Cremer/Wikimedia
Q-FISH workflow
Jclam at English Wikipedia/Wikimedia
3:22
Fluorescence in Situ Hybridization (FISH)
Leukemia & Lymphoma Society/YouTube
8:57
Hybridization (microarray) | Biomolecules | MCAT | Khan Academy
khanacademymedicine/YouTube
5:01
Fluorescence In Situ Hybridization (FISH)
Abnova/YouTube
1:44
FISH Technique Fluorescent In Situ Hybridization HD Animation 1
Microbiology: Immunofluorescence Detection of Bacteria
biologycourses/YouTube
Fluorescence In Situ Hybridization (FISH)
National Human Genome Research Institute (NHGRI)
Hybridization
National Human Genome Research Institute (NHGRI)
FISH Confirmation of a Human-Specific Duplication of a Gene Cluster on Chromosome 5q13.3
Fortna, A.; Kim, Y.; MacLaren, E.; Marshall, K.; Hahn, G.; Meltesen, L.; Brenton, M.; Hink, R.; Burgers, S.; Hernandez-Boussard, T.; Karimpour-Fard, A.; Glueck, D.; McGavran, L.; Berry, R.; Pollack, J.; Sikela, J. M.
FISH18
/Wikimedia
Kidney section, fluorescence microscopy
ZEISS Microscopy
Fish analysis di george syndrome
Adriano R Tonelli1 , Kalyan Kosuri1 , Sainan Wei2 and Davoren Chick1/Wikimedia
Sensitive content
This media may include sensitive content
Chromosomal Instability in Breast Cancer Cells
NCI Center for Cancer Research / Thomas Ried
Mapping a Gene
NCI Center for Cancer Research / Tom Misteli
Prokaryotic Diversity
CNX Openstax
Biofilm formed by a pathogen
Scott Chimileski, Ph.D., and Roberto Kolter, Ph.D., Harvard Medical School.
0:08
Biofilm blocking fluid flow
NIGMS/Knut Drescher, Princeton University
5 stages of biofilm development
D. Davis
Toxins under microscope
CDC/ Janice Haney Carr
Toxins
CDC/ Janice Haney Carr
Sensitive content
This media may include sensitive content
confocal laser scanning microscope of biofilm of Salmonella enterica (pink) and Erwinia chrysanthemi (green)
USDA Agricultural Research Service/Photo by Peggy Greb.
Flourescence In Situ Hybridization (FISH)
National Human Genome Research Institute (NHGRI) from Bethesda, MD, USA/Wikimedia
Fluorescence in situ hybridization (FISH) image of bcr/abl positive rearranged metaphase
Pmx
In situ hybridization of the Her2 gene (unamplified)
Manuel Medina Pérez/Wikimedia
Probe
National Human Genome Research Institute (NHGRI)
Cytogenetic Analysis
Cytogenetic Analysis
Also called: Cytogenetic Testing, Cytogenetics, Cytometric Flow Analysis
Cytogenetic analysis is a test in which the chromosomes of cells in a sample of blood or bone marrow are counted and checked for any changes, such as broken, missing, rearranged, or extra chromosomes. The test is used to help diagnose a genetic disorder or certain types of cancer, plan and monitor treatment.
Cytogenetic Analysis
Also called: Cytogenetic Testing, Cytogenetics, Cytometric Flow Analysis
Cytogenetic analysis is a test in which the chromosomes of cells in a sample of blood or bone marrow are counted and checked for any changes, such as broken, missing, rearranged, or extra chromosomes. The test is used to help diagnose a genetic disorder or certain types of cancer, plan and monitor treatment.
PDQ® Adult Treatment Editorial Board. PDQ Acute Myeloid Leukemia Treatment. Bethesda, MD: National Cancer Institute. [accessed on Feb 18, 2022]
510999: Chromosome Analysis, Leukemia/Lymphoma | Labcorp [accessed on Feb 18, 2022]
Ozkan E, Lacerda MP. Genetics, Cytogenetic Testing And Conventional Karyotype. [Updated 2021 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. [accessed on Feb 18, 2022]
Cytogenetic Analysis | NewsMedical [accessed on Feb 18, 2022]
Additional Materials (1)
Genomic Education Module (GEM): Cytogenetic Tests
Video by UC Davis MIND Institute/YouTube
3:43
Genomic Education Module (GEM): Cytogenetic Tests
UC Davis MIND Institute/YouTube
Bone Marrow Biopsy
Bone Marrow Tests
Also called: Bone Marrow Examination, Bone Marrow Aspiration and Biopsy
Bone marrow tests are used to diagnose and monitor bone marrow diseases, blood disorders, and certain types of cancer. There are two types of bone marrow tests: bone marrow aspiration and bone marrow biopsy, tests usually performed at the same time.
Bone Marrow Tests
Also called: Bone Marrow Examination, Bone Marrow Aspiration and Biopsy
Bone marrow tests are used to diagnose and monitor bone marrow diseases, blood disorders, and certain types of cancer. There are two types of bone marrow tests: bone marrow aspiration and bone marrow biopsy, tests usually performed at the same time.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative bone marrow biopsy results indicates that the bone marrow didn’t have any significant findings with all of the testing that was done. This may mean that certain diseases were not found. It may also mean that the bone marrow is functioning normally.
Related conditions
Bone marrow is a soft, spongy tissue found in the center of most bones. Bone marrow makes different types of blood cells, including:
Red blood cells (also called erythrocytes), which carry oxygen from your lungs to every cell in your body
White blood cells (also called leukocytes), which help you fight infections
Platelets, which help with blood clotting
Bone marrow tests check to see if your bone marrow is working correctly and making normal amounts of blood cells. The tests can help diagnose and monitor bone marrow disorders, blood disorders, and certain types of cancer.
There are two types of procedures used to collect bone marrow samples for testing:
Bone marrow aspiration removes a small amount of bone marrow fluid and cells
Bone marrow biopsy removes a small piece of bone and bone marrow
Bone marrow aspiration and bone marrow biopsy are usually done at the same time.
Other names: bone marrow examination
Bone marrow tests are used to:
Find out the cause of problems with red blood cells, white blood cells, or platelets
Diagnose and monitor blood disorders, such as:
Anemia (when the cause is unknown)
Polycythemia vera
Thrombocytopenia
Diagnose bone marrow disorders
Diagnose and monitor treatment for certain types of cancers, including leukemia, multiple myeloma, and lymphoma
Diagnose the cause of an unexplained fever, which could be from an infection in the bone marrow
Your health care provider may order a bone marrow aspiration and a bone marrow biopsy if other blood tests show your levels of red blood cells, white blood cells, or platelets are not normal.
Too many or too few blood cells may mean you have a medical condition, such as cancer that starts in your blood or bone marrow. If you are being treated for another type of cancer, these tests can find out if the cancer has spread to your bone marrow.
Bone marrow tests may also be used to see how well cancer treatment is working.
Bone marrow aspiration and bone marrow biopsy procedures are usually done at the same time. A health care provider will collect the marrow samples for testing. Usually, the samples can be collected in about ten minutes.
Before the procedure, you may be asked to put on a hospital gown. Your blood pressure, heart rate, and temperature will be checked.
You may choose to have a mild sedative, which is medicine to help you relax. You may also have the choice to use stronger medicine that will make you sleep. Your provider can help you decide which option is best for you.
During the procedure:
You'll lie down on your side or your stomach, depending on which bone will be used to get the samples. Most bone marrow samples are taken from the back of the hip bone, called the iliac crest. But other bones may be used.
An area of skin over the bone will be cleaned with an antiseptic.
You will get an injection (shot) of medicine to numb the skin and the bone underneath. It may sting.
When the area is numb, the provider will make a very small incision (cut) in your skin and insert a hollow needle. You will need to lie very still during the procedure:
The bone marrow aspiration is usually done first. The provider will push the needle into the bone and use a syringe attached to the needle to pull out bone marrow fluid and cells. You may feel a brief, sharp pain. The aspiration takes only a few minutes.
The bone marrow biopsy uses a special hollow biopsy needle inserted through the same skin opening. The provider will twist the needle into the bone to take out a small piece, or core, of bone marrow tissue. You may feel some pressure or brief pain while the sample is being taken.
After the test, the health care provider will cover your skin with a bandage.
If you didn't use medicine to relax or sleep, you'll usually need to stay lying down for about 15 minutes to make sure that the bleeding has stopped. Afterwards, you can do your usual activities as soon as you are able. If you used medicine to relax or sleep, you'll need to stay longer before you can go home. You may also need to rest the next day.
Your provider will tell you whether you need to fast (not eat or drink) for a few hours before the procedure.
Plan to have someone take you home after the test, because you may be drowsy if you are given medicine to help you relax or sleep during the procedure.
You'll receive instructions for how to prepare, but be sure to ask your provider any questions you have about the procedure.
After a bone marrow aspiration and bone marrow biopsy you may feel stiff or sore where the sample was taken. This usually goes away in a few days.
Your provider may recommend or prescribe a pain reliever to help. Don't take any pain medicine your provider hasn't approved. Certain pain relievers, such as aspirin, could increase your risk of bleeding.
Serious symptoms are very rare, but may include:
Increased pain or discomfort where the sample was taken
Redness, swelling, bleeding, or other fluids leaking from at the site
Fever
If you have any of these symptoms, call your provider.
It may take several days or even weeks to get your bone marrow test results. Your provider may have ordered many different types of tests on your marrow sample, so the results often include a lot of complex information. Your provider can explain what your results mean.
In certain cases, if your test results are not normal, you may need to have more tests to confirm a diagnosis or to decide which treatment would be best.
If you have cancer that affects your bones and marrow, your test results may provide information about your cancer stage, which is how much cancer you have in your body and how fast it may be growing.
If you are already being treated for cancer, your test results may show:
How well your treatment is working
Whether your treatment is affecting your bone marrow
Bone Marrow Tests: MedlinePlus Medical Test [accessed on Feb 16, 2024]
Additional Materials (22)
Bone marrow: location and labeled histology (preview) | Kenhub
Video by Kenhub - Learn Human Anatomy/YouTube
What to expect when you have a Bone Marrow Test | Cancer Research UK
Video by Cancer Research UK/YouTube
Having a bone marrow test
Video by Design Science/YouTube
Bone Marrow Transplant - Mayo Clinic
Video by Mayo Clinic/YouTube
Bone Marrow Diseases - What You Need To Know
Video by Rehealthify/YouTube
What Does Bone Marrow Actually Do?
Video by Seeker/YouTube
Aplastic Anemia-Bone Marrow
Image by doctorssupport.org
Bone Marrow Procedure Site
A 3D medical animation still showing preferred Sites for Bone Marrow Aspiration. The preferred sites for the procedure.
Image by Scientific Animations, Inc.
Image of a bone marrow harvest
Georgetown University Hospital, Washington, D.C. -- Surgeon Dr. Hans Janovich performs a bone marrow harvest operation on Aviation Electronics Technician 1st Class Michael Griffioen. The procedure consists of inserting a large-gauge syringe into an area of the hip and extracting the bone marrow. It is transfused into the recipient, and helps to recreate and replenish T-cells and the white and red blood cells killed while undergoing chemotherapy. Griffioen is assigned to the Pre-commissioning Unit Ronald Reagan (CVN 76) and was matched with an anonymous cancer patient through the Department of Defense Marrow Donor Program.
Image by Photographers Mate 2nd Class Chad McNeeley
Diagram showing the process of red blood cell production in the body with healthy and diseased kidneys. On the top half of the diagram, on the left side, a kidney labeled “Healthy kidney” starts the process by producing EPO. Six drops represent “Normal EPO.” An arrow beneath the EPO drops points from the kidney to a cross-section of a bone. Several cells labeled “Normal red blood cells” emerge from the bone marrow. Above the red blood cells, the label “Normal oxygen,” with three arrows pointing
Healthy kidneys produce a hormone called erythropoietin, or EPO, which stimulates the bone marrow to make red blood cells needed to carry oxygen throughout the body. Diseased kidneys don’t make enough EPO, and bone marrow then makes fewer red blood cells.
Image by NIDDK Image Library
Red Blood Cells, Bone Marrow
A skeleton may have a dry and lifeless Halloween image, but bone is actually dynamic, living tissue. Bone is not uniformly solid; within its interior is a network of cavities that house blood vessels and marrow. Bone marrow, particularly in larger bones, is where stem cells give rise to red blood cells (erythrocytes) as well as white blood cells (leukocytes) and blood clotting agents (platelets). As the source of blood cells, the bone marrow is critical to health. Disease or damage to bone marrow can result in either too many or too few blood cells.
Image by TheVisualMD
Erythropoiesis in Bone Marrow
Bone is dynamic, living tissue; within its interior is a network of cavities that house blood vessels and marrow. Bone marrow, particularly in larger bones, is where stem cells give rise to red blood cells (erythrocytes) as well as white blood cells (leukocytes) and blood clotting agents (platelets). Specialized cells in the kidney, which are sensitive to low oxygen levels, produce a hormone called erythropoietin (EPO), which in turn promotes the production of red blood cells. The boost in red blood cell production (erythropoiesis) in turn increases the oxygen-carrying capacity of the blood.
Image by TheVisualMD
Bone Marrow
Red bone marrow fills the head of the femur, and a spot of yellow bone marrow is visible in the center. The white reference bar is 1 cm.
Image by CNX Openstax
This browser does not support the video element.
Femur Bone Marrow Revealing Lacunae and Trabeculae
Camera descending into bone marrow dataset. Within the bone matrix that is shown one can see the spaces in the matrix which are called lacunae and the trabeculae which is a the mesh work of bone tissue
Video by TheVisualMD
Hematopoietic System of Bone Marrow
Hemopoiesis is the proliferation and differentiation of the formed elements of blood.
Image by CNX Openstax
Bone Marrow Biopsy
Bone Marrow Biopsy
Image by Blausen Medical Communications, Inc.
White Blood Cell Count: Bone
White blood cells (WBCs) and red blood cells (RBCs), as well as the cell fragments called platelets, are constantly being produced by bone marrow. Disease, cancer and genetic disorders of bone marrow can, in turn, affect the production of blood cells.
Image by TheVisualMD
Bone marrow core biopsy microscopy panorama
Section of bone marrow core biopsy as seen under the microscope.
Image by Gabriel Caponetti
Bone Marrow Biopsy
Bone Marrow Biopsy
Image by John Doe
Bone Marrow Biopsy
Diagram showing a bone marrow biopsy.
Image by Cancer Research UK / Wikimedia Commons
White Blood Cell Count: Bone Marrow
Disease or damage to the bone marrow, caused by infection, cancer, radiation treatment, or chemotherapy can lower white blood cell count by impairing the marrow's ability to produce new white blood cells.
Image by TheVisualMD
Sensitive content
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Blood Cells
This is a scanning electron microscope image from normal circulating human blood. One can see red blood cells, several white blood cells including lymphocytes, amonocyte, a neutrophil, and many small disc-shaped platelets. Red cells are nonnucleated and contain hemoglobin, an important protein that contains iron and allows the cell to carry oxygen to other parts of the body. They also carry carbon dioxide away from peripheral tissue to the lungs where it can be exhaled. The infection-fighting white blood cells are classified in two main groups: granular and agranular. All blood cells are formed in the bone marrow. There are two types of agranulocytes: lymphocytes, which fight disease by producing antibodies and thus destroying foreign material, and monocytes. Platelets are tiny cells formed in bone marrow and are necessary for blood clotting.
Image by Bruce Wetzel (photographer). Harry Schaefer (photographer), National Cancer Institute
3:24
Bone marrow: location and labeled histology (preview) | Kenhub
Kenhub - Learn Human Anatomy/YouTube
2:12
What to expect when you have a Bone Marrow Test | Cancer Research UK
Cancer Research UK/YouTube
5:56
Having a bone marrow test
Design Science/YouTube
2:20
Bone Marrow Transplant - Mayo Clinic
Mayo Clinic/YouTube
1:38
Bone Marrow Diseases - What You Need To Know
Rehealthify/YouTube
4:03
What Does Bone Marrow Actually Do?
Seeker/YouTube
Aplastic Anemia-Bone Marrow
doctorssupport.org
Bone Marrow Procedure Site
Scientific Animations, Inc.
Image of a bone marrow harvest
Photographers Mate 2nd Class Chad McNeeley
Diagram showing the process of red blood cell production in the body with healthy and diseased kidneys. On the top half of the diagram, on the left side, a kidney labeled “Healthy kidney” starts the process by producing EPO. Six drops represent “Normal EPO.” An arrow beneath the EPO drops points from the kidney to a cross-section of a bone. Several cells labeled “Normal red blood cells” emerge from the bone marrow. Above the red blood cells, the label “Normal oxygen,” with three arrows pointing
NIDDK Image Library
Red Blood Cells, Bone Marrow
TheVisualMD
Erythropoiesis in Bone Marrow
TheVisualMD
Bone Marrow
CNX Openstax
0:06
Femur Bone Marrow Revealing Lacunae and Trabeculae
TheVisualMD
Hematopoietic System of Bone Marrow
CNX Openstax
Bone Marrow Biopsy
Blausen Medical Communications, Inc.
White Blood Cell Count: Bone
TheVisualMD
Bone marrow core biopsy microscopy panorama
Gabriel Caponetti
Bone Marrow Biopsy
John Doe
Bone Marrow Biopsy
Cancer Research UK / Wikimedia Commons
White Blood Cell Count: Bone Marrow
TheVisualMD
Sensitive content
This media may include sensitive content
Blood Cells
Bruce Wetzel (photographer). Harry Schaefer (photographer), National Cancer Institute
Sentinel Lymph Node Biopsy
Sentinel Lymph Node Biopsy
Also called: SLNB, Biopsy of the Sentinel Lymph Node, Lymph Node Biopsy, Sentinel Node Biopsy, Sentinel Lymph Node Mapping and Biopsy
A sentinel lymph node biopsy is a test that checks lymph nodes for cancer cells. Some cancers, such as breast cancer and melanoma, can spread through the lymphatic system. The sentinel lymph node is the first node where a cancer usually spreads. The test can show whether your cancer is likely to spread.
Sentinel Lymph Node Biopsy
Also called: SLNB, Biopsy of the Sentinel Lymph Node, Lymph Node Biopsy, Sentinel Node Biopsy, Sentinel Lymph Node Mapping and Biopsy
A sentinel lymph node biopsy is a test that checks lymph nodes for cancer cells. Some cancers, such as breast cancer and melanoma, can spread through the lymphatic system. The sentinel lymph node is the first node where a cancer usually spreads. The test can show whether your cancer is likely to spread.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
If your results are negative, it means no cancer cells were found, and it's unlikely that the cancer has spread. You will not need to have any more lymph nodes removed.
Related conditions
Breast cancer
Melanoma
Penile cancer
Endometrial cancer
A sentinel lymph node biopsy is a test that checks lymph nodes for cancer cells. Lymph nodes are part of the lymphatic system, a network of organs and vessels that help the body fight infections and other diseases. Lymph nodes are located throughout the body, including the underarms, neck, chest, abdomen, and groin.
Certain cancers, such as breast cancer and melanoma (the most dangerous form of skin cancer), can spread through the lymphatic system. Cancers spread when cells break off from the original tumor and are carried to other parts of the body. The sentinel lymph node is the first node where these types of cancers are most likely to spread. The node is usually located near the site of the original tumor. Sometimes there is more than one sentinel lymph node.
A sentinel lymph node biopsy can show how likely it is that your cancer is spreading (metastasizing).
Other names: lymph node biopsy, sentinel node biopsy, sentinel lymph node mapping and biopsy
A sentinel lymph node biopsy is used to find out whether an early-stage cancer has spread through the lymphatic system. It's most often used for people who have breast cancer or melanoma.
You may need this test if you've been diagnosed with breast cancer, melanoma, or certain other types of cancer. It can show whether your cancer is spreading.
A sentinel lymph node biopsy may be done in a hospital or an outpatient surgical center. The procedure usually includes a special type of imaging test called lymphoscintigraphy. Lymphoscintigraphy takes pictures of the lymphatic system and is used to locate the sentinel lymph node. The procedure includes the following steps:
A health care provider will apply medicine to numb the skin over the procedure area.
You will be injected with a small amount of a radioactive substance called a tracer near the tumor. The tracer will travel and collect in the sentinel lymph node, or nodes. You may also be injected with a blue dye that stains the lymph node, making it easier to see.
You will be given general anesthesia. General anesthesia is a medicine that makes you unconscious. It makes sure you won't feel any pain during the surgery. A specially trained doctor called an anesthesiologist will give you this medicine.
Once you're unconscious, a camera will take images of the area. The camera finds and records the location of the tracer, which will have settled in the sentinel node.
The node will be removed and sent to a lab, where it will be checked for cancer cells. This part of the test is known as a biopsy.
The original tumor is also usually removed during the procedure.
You will probably need to fast (not eat or drink) for several hours before the test. You may also need to stop taking blood thinners, such as aspirin, for a certain time before your test. Your provider will let you know when you need to stop taking your medicine and anything else you need to do to prepare for the test.
In addition, be sure to arrange for someone to drive you home. You may be groggy and confused after you wake up from the procedure.
You may have a little bleeding, pain, or bruising at the biopsy site. There is also a small risk of infection, which can be treated with antibiotics. Allergic reactions to the tracer are rare and usually mild.
There is very little exposure to radiation in a sentinel lymph node biopsy. While radiation exposure from the tracer in a sentinel lymph node biopsy is safe for most adults, it can be harmful to an unborn baby. So be sure to tell your provider if you are pregnant or think you may be pregnant.
The results will be given as positive or negative.
If your results are positive, it means cancer was found and may have spread to nearby lymph nodes and/or other organs. Your provider may recommend removing and testing more lymph nodes to check for cancer cells.
If your results are negative, it means no cancer cells were found, and it's unlikely that the cancer has spread. You will not need to have any more lymph nodes removed.
If you have questions about your results, talk to your health care provider.
While sentinel lymph node biopsies are mostly used for people with breast cancer or melanoma, it is currently being studied for use with other types of cancer, including:
Colon cancer
Stomach cancer
Thyroid cancer
Non-small cell lung cancer
Sentinel Lymph Node Biopsy: MedlinePlus Medical Test [accessed on Feb 03, 2024]
Sentinel Lymph Node Biopsy - NCI. National Cancer Institute. Jun 25, 2019 [accessed on Feb 03, 2024]
Melanoma: Tests After Diagnosis - Health Encyclopedia - University of Rochester Medical Center [accessed on Feb 03, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (50)
Sentinel Lymph Node Biopsy of the Breast
Sentinel lymph node biopsy of the breast. The first of three panels shows a radioactive substance and/or blue dye injected near the tumor; the middle panel shows that the injected material is followed visually and/or with a probe that detects radioactivity to find the sentinel nodes (the first lymph nodes to take up the material); the third panel shows the removal of the tumor and the sentinel nodes to check for cancer cells.
Sentinel lymph node biopsy of the breast. A radioactive substance and/or blue dye is injected near the tumor (first panel). The injected material is detected visually and/or with a probe that detects radioactivity (middle panel). The sentinel nodes (the first lymph nodes to take up the material) are removed and checked for cancer cells (last panel).
Sentinel Lymph Node & Axillary Lymph Node Procedures for Breast Cancer - Mayo Clinic
Video by Mayo Clinic/YouTube
Surgery for Melanoma Patients: Sentinel Lymph Node Biopsy and Complete Lymph Node Dissection
Video by American Cancer Society/YouTube
Sentinel Node Biopsy: Breast Cancer Lymph Node Surgery
Video by Breast Cancer School for Patients/YouTube
Sentinel Lymph Node Mapping for Gynecologic Cancers
Video by Memorial Sloan Kettering/YouTube
Introduction to the Lymphatic System
Video by Osmosis/YouTube
Lymphatic System, Part 2
Video by Tammy Moore/YouTube
The Lymphatic System, Part 1
Video by Tammy Moore/YouTube
The lymphatic system's role in immunity | Lymphatic system physiology | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
lymphatic system
Diagram of the lymphatic system.
Image by Cancer Research UK / Wikimedia Commons
Lymphatic System
Lymphatic System
Image by NIH
Lymph Node of Head and Neck
3D visualization reconstructed from scanned human data of male revealing lymphatic structures (lacrimal glands, tonsils, salivary glands, thymus, subclavian veins axillary nodes, stomach, cisterna chyli). The lymphatic system works in concert with the immune system. It can be described as an extensive network of vessels that shuttle molecular waste-filled fluid (lymph) through purifiying centers called lymph nodes.
Image by TheVisualMD
Lymphatic, circulatory and nervous systems
The systems of the human body consist of: circulatory, digestive, endocrine, immune/lymphatic, integumentary, muscular, reproductive, skeletal, urinary. This image depicts the circulatory, endocrine, immune/lymphatic, nervous
Image by TheVisualMD
Babies Sitting Showing Respiratory Lymphatic Circulatory and Skeletal Systems
One of the most obvious ways that we notice the overall immune health of a baby is through the presence or absence of respiratory infections. Respiratory illness is the leading cause of hospitalization among young children. Lymph nodes and vessels are a direct component of the immune system. Lymph nodes are encapsulated bundles of lymph tissue found throughout the body especially in the neck, axillae, groin, and thoracic regions. Lymph tissue aids the immune system by collecting and breaking down toxins and other waste products of the body. Lymph vessels transport lymph, a clear fluid derived from intercellular spaces around the body, eventually back into the blood. An infant's circulatory system will face an olympian job over the course of the individual's lifetime; the heart will beat 2.5 billion times and pump millions of gallons of blood through the body's vast network of arteries and veins. An infant's heart doubles in size the first year of life. Nutrition plays a key role in the development and maintenance of a healthy circulatory system by providing building blocks such as iron needed for red blood cell production.
Image by TheVisualMD
Lymphatic System
Lymphatic Trunks and Ducts System
Image by OpenStax College
Babies Sitting Showing Respiratory Lymphatic Circulatory and Skeletal Systems
One of the most obvious ways that we notice the overall immune health of a baby is through the presence or absence of respiratory infections. Respiratory illness is the leading cause of hospitalization among young children. Lymph nodes and vessels are a direct component of the immune system. Lymph nodes are encapsulated bundles of lymph tissue found throughout the body especially in the neck, axillae, groin, and thoracic regions. Lymph tissue aids the immune system by collecting and breaking down toxins and other waste products of the body. Lymph vessels transport lymph, a clear fluid derived from intercellular spaces around the body, eventually back into the blood. An infant's circulatory system will face an olympian job over the course of the individual's lifetime; the heart will beat 2.5 billion times and pump millions of gallons of blood through the body's vast network of arteries and veins. An infant's heart doubles in size the first year of life. Nutrition plays a key role in the development and maintenance of a healthy circulatory system by providing building blocks such as iron, needed for red blood cell production.
Image by TheVisualMD
In Defense of You: Your Immune System
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Lymph Node and Lymph interstitial fluid
Lymph Node and Vasculature: The image shows a human lymph node and its vasculature (blood vessels). Lymph nodes are encapsulated bundles of lymph tissue found throughout the body, especially in the neck, armpit, groin, lung, and aortic areas. These aggregations of lymph tissue aid the immunological system by collecting and breaking down toxins and other waste products of the body.
Image by TheVisualMD
Lymph Node with Vasculature
Computer generated illustration of a human lymph node and its vasculature. Lymph nodes are encapsulated bundles of lymph tissue found throughout the body especially in the neck, axillae, groin, lung and aortic areas. These aggregations of lymph tissue aid the immunological system by collecting and breaking down toxins and other waste products of the body.
Image by TheVisualMD
Immune System and Autoimmune Diseases
Normally, an individual's immune system learns to identify and ignore all of the distinctive little structures found on that individual's own cells. Sometimes, however, it will make a mistake and identify its own body as foreign. If that happens, the immune system produces antibodies that attempt to destroy the body's own cells in the same way it would try to destroy a foreign invader.
Lymph Node Biopsy : When breast cancer spreads beyond the primary tumor site, it usually spreads first to the sentinel lymph node or nodes, the first lymph nodes to receive drainage from a cancer-containing area of the breast. From there, breast cancer generally spreads to the axillary lymph nodes under the arm. So an important part of the breast cancer staging process is to determine whether the cancer has spread from the primary tumor to the sentinel lymph node, and from there into the axillary lymph nodes.
Image by TheVisualMD
Lymph Node Biopsy
Lymph Node Biopsy : When breast cancer spreads beyond the primary tumor site, it usually spreads first to the sentinel lymph node or nodes, the first lymph nodes to receive drainage from a cancer-containing area of the breast. From there, breast cancer generally spreads to the axillary lymph nodes under the arm. So an important part of the breast cancer staging process is to determine whether the cancer has spread from the primary tumor to the sentinel lymph node, and from there into the axillary lymph nodes.
Image by TheVisualMD
Lymph Node Biopsy
Lymph Node Biopsy : When breast cancer spreads beyond the primary tumor site, it usually spreads first to the sentinel lymph node or nodes, the first lymph nodes to receive drainage from a cancer-containing area of the breast. From there, breast cancer generally spreads to the axillary lymph nodes under the arm. So an important part of the breast cancer staging process is to determine whether the cancer has spread from the primary tumor to the sentinel lymph node, and from there into the axillary lymph nodes.
Image by TheVisualMD
Sentinel Lymph Node Biopsy
This is a picture of the first radio-guided sentinel lymph node biopsy using real-time imaging by means of a portable gamma camera (Sentinella) in a patient with colon cancer
The lobes and ducts of the breast, and nearby lymph nodes (above) are areas that cancer can attack. The temporary inconvenience of a mammogram can save you from troublesome and costly treatment and surgery by catching breast cancer early, when it is easiest to treat.
Image by NIH
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Breast Cancer Surgery
Breast surgeon Dr. Nora Jaskowiak of The University of Chicago Medical Center explains how far mastectomies and other breast surgeries have come and the impact on the patient's life.
Image by TheVisualMD
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Mastectomy (Simple)
Title Mastectomy (Simple) Description Treatment for breast cancer - removal of breast and a sample of underarm lymph nodes.
Image by National Cancer Institute / Linda Bartlett (Photographer)
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Mastectomy
Total (simple) Mastectomy Description Total (simple) mastectomy; drawing shows removal of the breast and lymph nodes. The dotted line shows where the entire breast is removed. Some lymph nodes under the arm may also be removed.
Image by National Cancer Institute
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Radical Mastectomy
Mastectomy (Radical) Description Halsted radical mastectomy. Removal of the entire breast and chest muscles, as well as lymph nodes in underarm area for the treatment of breast cancer.
Image by National Cancer Institute / Linda Bartlett (Photographer)
Front view of the breast
Diagram showing the front view of the breast.
Image by Centers for Disease Control and Prevention (CDC)
Side view of the breast
Diagram showing the side view of the breast.
Image by Centers for Disease Control and Prevention (CDC)
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Breast and adjacent lymph nodes
Illustration of Breast and Adjacent Lymph Nodes Description: The female breast along with lymph nodes and vessels. An inset shows a close-up view of the breast with the following parts labeled: lobules, lobe, ducts, nipple, areola, and fat.
Image by National Cancer Institute, Don Bliss (Illustrator)
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Breast and Adjacent Lymph Nodes
The female breast (nipple, areola, ducts, lobes, lobules, and fatty tissue) and adjacent lymph nodes and lymph vessels (no labels appear in the illustration).
Image by National Cancer Institute (NCI) / Don Bliss (Illustrator)
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Human Epidermal Growth Factor Receptor 2 (HER2): Aggressive Breast Cancers
Most breast cancers begin in the lobules or ducts of the breast, which produce breast milk and carry it to the nipples after pregnancy. Invasive cancers spread outside of the lobules and ducts and penetrate into the surrounding breast tissue. From there, cancer cells may travel to lymph nodes in the armpit area. In stage IV breast cancer, cancer cells have spread into other parts of the body, such as the lungs or bones. HER2-positive breast cancer is aggressive and is likely to spread quickly. It is also resistant to hormone therapy. However, treatment with the drugs trastuzumab and/or lapatinib may help women who test positive for HER2.
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Metastatic Breast Cancer in Pleural Fluid
Image by Ed Uthman/Flickr
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Diagram showing the network of lymph nodes in and around the breast.
Diagram showing the network of lymph nodes in and around the breast.
Image by Cancer Research UK / Wikimedia Commons
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Breast lobes and ducts
Diagram showing the lobes and ducts of a breast.
Image by Cancer Research UK / Wikimedia Commons
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Breast
Breast and Adjacent Lymph Nodes Description The female breast along with lymph nodes and vessels. An inset shows a close-up view of the breast with the following parts labeled: lobules, lobe, ducts, nipple, areola, and fat.
Image by National Cancer Institute
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Breast Anatomy
Breast Anatomy; observe lobes, lobules, ducts, areola, nipple, fat, lymph nodes and lymphatic vessels.
Image by National Cancer Institute / Don Bliss (Illustrator)
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External and Internal Anatomy of Breast
The breast is made up of a variety of tissues and structures, including fat, blood vessels, lymph vessels, ligaments, and nerves. The mammary gland is embedded in the breast's fatty tissue and contains 15-20 lobes, each of which is subdivided into smaller lobules. The breast milk that is produced drains from the lobes into the nipple via the lactiferous ducts.
Image by TheVisualMD
Lymph Nodes
Lymph Nodes
Lymph Nodes
Lymph Nodes
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Breast Lymph Nodes
Lymph vessels form a network in each breast, draining into lymph nodes in the underarm and along the breast bone. Cancer cells may break away from the main tumor and spread to other parts of the body through the lymphatic system.
Interactive by TheVisualMD
Sentinel Lymph Node Biopsy of the Breast
Sentinel lymph node biopsy of the breast. The first of three panels shows a radioactive substance and/or blue dye injected near the tumor; the middle panel shows that the injected material is followed visually and/or with a probe that detects radioactivity to find the sentinel nodes (the first lymph nodes to take up the material); the third panel shows the removal of the tumor and the sentinel nodes to check for cancer cells.
Sentinel lymph node biopsy of the breast. A radioactive substance and/or blue dye is injected near the tumor (first panel). The injected material is detected visually and/or with a probe that detects radioactivity (middle panel). The sentinel nodes (the first lymph nodes to take up the material) are removed and checked for cancer cells (last panel).
Ball-and-stick model of the bortezomib molecule, C19H25BN4O4, as found in the crystal structure of its complex with the yeast 20S proteasome reported in Structure (2006) 14, 451-456 (PDB entry: 2F16; PDB ligand entry: BO2; PDBe ligand entry: BO2).
Colour code:
Carbon, C: grey
Hydrogen, H: white
Boron, B: pink
Nitrogen, N: blue
Oxygen, O: red
Model manipulated and image generated in CCDC Mercury 3.8.
Image by Ben Mills/Wikimedia
How Might Mantle Cell Lymphoma Be Treated?
Treatment of Mantle cell lymphoma (MCL) most often involves a combination of chemotherapy and immunotherapy. Additionally, hematopoietic stem cell transplantation may be considered in some cases. Surgery is usually not helpful.
Source: Genetic and Rare Diseases (GARD) Information Center
Additional Materials (5)
Current and future therapies in mantle cell lymphoma
Video by VJHemOnc – Video Journal of Hematological Oncology/YouTube
Immunotherapy Fights Cancer
Video by The Cancer Immunotherapy Channel/YouTube
IMMUNOTHERAPY: The Path to a Cancer Cure (For Clinicians)
Video by Society for Immunotherapy of Cancer/YouTube
What you should know about stem cell transplants
Video by MD Anderson Cancer Center/YouTube
Stem Cell Transplants: Offering Hope in Blood Cancer Treatment
Video by uvahealth/YouTube
2:01
Current and future therapies in mantle cell lymphoma
VJHemOnc – Video Journal of Hematological Oncology/YouTube
2:26
Immunotherapy Fights Cancer
The Cancer Immunotherapy Channel/YouTube
8:42
IMMUNOTHERAPY: The Path to a Cancer Cure (For Clinicians)
Society for Immunotherapy of Cancer/YouTube
17:32
What you should know about stem cell transplants
MD Anderson Cancer Center/YouTube
1:52
Stem Cell Transplants: Offering Hope in Blood Cancer Treatment
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Mantle Cell Lymphoma
Mantle cell lymphoma (MCL) belongs to a group of diseases known as non-Hodgkin's lymphomas (NHL). NHL's are cancers that affect the the lymphatic system (part of the immune system). MCL is aggressive (fast-growing) and usually occurs in middle-aged or older adults. Explore causes, symptoms, and treatment of MCL.