Contents
1. How to make the correct diagnosis of lymphoma?
2. What are the common symptoms that should be considered in the diagnosis of lymphoma?
3. What are the other possible symptoms to be considered in the diagnosis of lymphoma?
4. What are the common tests for lymphoma? What is the role of each test?
5. Can all lymphomas be staged?
6. What is the staging of Hodgkin’s lymphoma?
7. What are the key points in the diagnosis of lymphoma?
I. How to make the correct diagnosis of lymphoma?
Lymphoma is a complex disease, and only on the basis of thorough examination can we accurately classify the type and stage of the disease and develop the most appropriate treatment plan. Your doctor needs to ask you some questions about your symptoms as well as help you make an appointment for some tests. The most accurate diagnosis can be made based on the relevant symptoms and laboratory tests.
What are the common symptoms to consider when diagnosing lymphoma?
Lymphoma is divided into Hodgkin’s lymphoma and non-Hodgkin’s lymphoma according to medical pathology.
(a) What are the common symptoms of Hodgkin’s lymphoma?
1. It is mostly seen in young people. The first symptom often seen is swollen lymph nodes in the neck or supraclavicular area, but no pain is felt (60% to 80% of cases).
2, The next commonly seen is the presence of swollen axillary lymph nodes.
3.Some other patients with Hodgkin’s lymphoma (30%~50%) have persistent or periodic fever of unknown origin as the main starting symptom.
(B) What are the common symptoms of non-Hodgkin’s lymphoma?
1. Non-Hodgkin’s lymphoma can be seen in people of all ages, but there are more male patients than female patients, and more elderly patients than young patients.
Most non-Hodgkin’s lymphomas also have painless enlargement of the neck or supraclavicular lymph nodes as the first manifestation. However, unlike Hodgkin’s lymphoma, the lymph nodes of non-Hodgkin’s lymphoma are enlarged in a jumpy and irregular manner, and all lymph nodes may be enlarged, and tissues or organs without lymphoid tissue may be easily invaded.
3. If there is persistent fever or periodic fever of unknown cause, and the condition does not improve or further worsens after anti-inflammatory or anti-tuberculosis treatment, it should be highly suspected at this time.
What are the other possible symptoms to be considered in the diagnosis of lymphoma?
Lymphoma can originate in or invade various organs, thus showing a variety of clinical manifestations associated with them.
1. The gastrointestinal tract is the most common, and may include gastrointestinal symptoms such as epigastric pain, vomiting, and diarrhea.
2. Invasion of the liver and spleen may cause hepatosplenomegaly and jaundice.
3.Bone invasion may manifest as local pain and fracture.
4.Skin invasion can have pruritus and itchy rash.
5. Invasion of tonsils, mouth, nose and throat may cause difficulty in swallowing, nasal congestion and rhinorrhea.
Of course, you may not have all the above symptoms, or you may not have any of the above symptoms, that may be because the disease is relatively insidious and does not have any obvious symptoms.
What are the common tests for lymphoma? What does each one do?
Important tests that your doctor may book for you include bone marrow aspiration, imaging and pathology.
1.Bone marrow aspiration examination: Lymphoma is prone to invade the bone marrow so bone marrow aspiration examination is routinely done.
2.Imaging examination: It plays an important role in determining the stage of lymphoma.
Chest frontal and lateral radiographs and tracheal bifurcation body films: mainly to understand whether the lymph nodes in the chest, lungs and trachea are invaded.
Gastrointestinal tract imaging: This test is necessary if you have invasion of the pharyngeal lymphatic ring to find out the condition of the gastrointestinal tract.
Radiologic bone scan: Your doctor may perform this test for you if he or she suspects bone involvement.
Ultrasound: Ultrasound of the upper abdomen and pelvis is performed as a routine examination, focusing on the liver, spleen, retroperitoneal and abdominal lymph nodes, and ovaries.
Computed tomography (CT): If financial conditions allow, CT of the head and chest level abdomen should be performed to observe lymph node and organ involvement in more detail.
Magnetic resonance imaging (MRI) or positron emission tomography (PET-CT): the doctor will arrange it according to the needs of the disease and provide a basis for disease staging and diagnosis.
Pathological examination: If you are suspected of having lymphoma, your doctor may arrange a pathological biopsy, which is the gold standard for lymphoma diagnosis. Hodgkin’s lymphoma (HL) is divided into four subtypes: lymphocyte predominant (LP), nodular sclerosis (NS), mixed cell (MC), and lymphocyte decompensated (LD). The classification of non-Hodgkin’s lymphoma (NHL) is more complicated.
V. Can all lymphomas be staged?
The staging of lymphoma is mainly used for Hodgkin’s lymphoma, which is divided into 4 stages. Non-Hodgkin’s lymphoma can be staged with reference, but because non-Hodgkin’s lymphoma does not metastasize sequentially along the lymph node area, but spreads jumpily and has more extra-nodal invasion, so the clinical value of staging is not as good as Hodgkin’s. The tendency of non-Hodgkin’s lymphoma to occur in multiple centers determines that its treatment strategy should be based on chemotherapy.
VI. What is the staging of Hodgkin’s lymphoma?
The current medical community usually classifies lymphoma into stages I-IV according to the clinical staging scheme proposed by Ann Arbor in 1966.
Stage I – The lesion is limited to one lymph node area (I) or one organ outside the lymph node receives localized involvement of the lesion (IE).
Stage II – The lesion involves 2 or more lymph nodes on the same side of the diaphragm (upper or lower) (IIE).
Stage III- Lymph node lesions are present both above and below the diaphragm (III). This may be accompanied by splenic involvement (IIIS), limited involvement of organs other than lymph nodes (IIIE), or involvement of the spleen with limited involvement of organs other than lymph nodes (IIISE).
Stage IV – Extensive or disseminated invasion of 1 or more organs other than lymph nodes, with or without lymph node enlargement. Any involvement of the liver or bone marrow by the lesion is considered stage IV.
Each stage is subdivided into A and B. A: no systemic symptoms; B: one of the following systemic symptoms: unexplained fever above 38°C, night sweats, and unexplained weight loss of 10% within 6 months.
The accurate staging of lymphoma is closely related to both the formulation of the treatment plan and the prognosis. Your doctor will consult with you and your family, follow the procedure in a planned manner, and take the necessary selective diagnostic steps and ancillary measures.
7.What are the key points when diagnosing lymphoma?
1. Typical symptoms are painless progressive enlargement of the lymph nodes in Chambio;
2.Bone marrow aspiration examination is beneficial to confirm the diagnosis and staging;
3.X-ray, CT, MRI, ultrasonic examination and radionuclide bone scan are helpful for clinical staging;
4.Pathological examination and early biopsy of intact enlarged lymph nodes can be obtained, and pathological biopsy can generally confirm the diagnosis by typing.