Anson Wong, 40, noticed a small, painless lump on the right side of his neck but paid it little attention as it did not bother him. He ignored the lump, which was 2cm to 3cm in diameter, for about six months.
Wong (whose name has been changed for reasons of patient confidentiality) noticed that the lump sometimes shrank and at other times increased in size. When it remained enlarged, he decided to seek medical attention.
His doctor did not like the look of it. Enlarged lymph glands on relatively young men can indicate a number of medical concerns, including tuberculosis and some cancers. Nasopharyngeal cancer is a particular concern as it is 25 per cent more prevalent among southern Chinese than it is among people in other parts of the world. Wong was given a blood test and had a biopsy using a procedure called fine needle aspiration. Unfortunately, the test results were inconclusive.
However, Wong was referred to Dr Raymond Liang Hin-suen, director of the Comprehensive Oncology Centre at Hong Kong Sanatorium and Hospital, for further investigation. Liang decided to remove the affected lymph gland for a biopsy. It showed that a type of immune cell - B cells - in Wong's body had gone awry and were multiplying uncontrollably. He had lymphoma, or cancer of the lymphatic system.
There are as many as 35 types of lymphoma. Although some of them may appear similar, they function differently and respond to different therapies.
Liang found Wong was suffering from follicular lymphoma, where cells group together to form follicles, or spherical structures with a cavity within.