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How is Merkel cell carcinoma diagnosed?

Donna Hill Howes, RN
Family Medicine

The doctor may use the following procedures and tests to diagnose Merkel cell carcinoma (MCC). Some of these tests are also used to help determine the stage of the disease. Stage is a description of the extent of cancer.

A biopsy is the removal of cells or tissue from a tumor for examination by a pathologist. The pathologist may study tissue samples under a microscope or perform other tests on the cells or tissue. Biopsies are used for both diagnosis and staging. The surgeon may also remove lymph nodes to help determine the stage of the disease.

Sentinel lymph node (SLN) biopsy is a procedure in which the sentinel lymph node is removed and examined under a microscope to determine whether cancer cells are present. The sentinel lymph node is the first lymph node to which cancer is likely to spread from the primary tumor. SLN biopsy is used to help determine the stage of the disease. SLN biopsy may cause fewer side effects than standard lymph node removal because fewer lymph nodes are taken out.

Immunohistochemistry (staining of cells with agents that react with antibodies on the surface of cancer cells) is a laboratory technique used to tell the difference between MCC and other types of cancer.

Computed tomography (CT), a procedure that uses special x-ray equipment to obtain cross-sectional pictures of the body, can distinguish MCC from small cell lung cancer and show whether the disease has spread to other parts of the body.

In an octreotide scan, the doctor injects a small amount of a radioactive drug into a vein. The drug travels through the bloodstream and attaches to tumor cells. A machine called a scanner detects the radioactive material and creates scans showing where the tumor cells are located in the body. For MCC, this test can be used for both diagnosis and staging.

A PET scan uses radioactive sugar, which is absorbed by cancer cells and appears as dark areas on the scan. It can be used for both diagnosis and staging of MCC.

This answer is based on source information from the National Cancer Institute.

The first step in diagnosing Merkel cell carcinoma is usually a physical exam that includes an inspection of your skin and a review of your medical history. If doctors think that the tumor is caused by Merkel cell carcinoma, they will perform a biopsy, which involves removing a part of the tumor and analyzing it under a microscope. If doctors think that the cancer has already spread, they may perform several other tests to find out how far it's spread. Doctors may biopsy nearby lymph nodes to check for cancerous cells. They may also do other tests, such as computerized tomography (CT) scans, x-ray scans, and positron emission tomography (PET) scans to create images check your organs for Merkel cell carcinoma.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.