The diagnosis of malignant lymphoma

By | May 1, 2012

The diagnosis of malignant lymphoma, the diagnosis made for the complete inspection includes the following steps:
(1) lymph node biopsy.
(2) a history of carefully collected, special attention to whether the "B" symptoms.
(3) a comprehensive physical examination, special attention to regional and Wei pharyngeal lymphoid ring, liver and spleen size and the presence of bone tenderness.
(4) laboratory tests: whole blood, urine, stool, ESR, serum electrolytes, liver and kidney functions, including routine blood biochemistry, serum lactate dehydrogenase, alkaline phosphatase, uric acid, such as from 2 microglobulin as a routine examination before treatment. Some patients may be associated with autoimmune hemolytic anemia, anemia if it is required to be Coombs testing. Conditional immune function tests should be done, including IgG, IgA, IgM quantitative, T cell subsets, NK cells. HL of the low incidence of bone marrow involvement, usually found in advanced cases; NHL is subject to bilateral bone marrow aspiration or biopsy ruled out bone marrow involvement.
(5) X-ray examination: the present as a routine X-ray examination including chest posteroanterior and lateral radiographs, if necessary, supplemented by radiographs. The main purpose is to observe chest hilar, mediastinal, tracheal carina, and internal mammary lymph nodes under, and to observe whether lung involvement. Pain in patients with bone pain should be part of photo, with gastrointestinal symptoms, gastrointestinal Dayton recommended meal examination.
(6) CT, B Super, MRI examination and lymphangiography: chest CT in the diagnosis of lymphoma lesions than the conventional chest X-ray examination is more sensitive to lymphoma has been recommended as a routine examination before treatment. B-abdomen, CT or MRI examination can be found in the abdominal cavity lesions, but also necessary to check one of the pre-treatment and conditions shall be selected in CT or MRI. MRI examination can also be used to detect central nervous system, bone or bone marrow disease, not recommended for routine inspection, only when symptoms appear involvement. Lymphangiography on the diagnosis of abdominal and pelvic lesions also have a role, but its accuracy is limited by the experience, the current number is not recommended for routine checks.
(7) 67 (Gallium 67) PET :67(98%),(60 % "'-'70 %)can be checked before and after treatment compared to that on found that after treatment, residual disease on the brain will certainly help. body fluorodeoxyglucose positron emission tomography (Flu-orodeoxy glucose FOG-PET scan) in staging of lymphoma treatment and found residual disease after treatment have a greater role. FOG-PET scanning in lymphoma is about 71% -96% sensitivity, combined with CT examination of the PET-CT scan to further improve the diagnosis rate, but high costs limit in clinical routine use.
The diagnosis of malignant lymphoma (8) endoscopic diagnosis: a gastrointestinal tract, gastrointestinal symptoms in addition to the lock or lock enema meal, the further to the stomach, colonoscopy. Isolated mediastinal or abdominal mass can be applied to mediastinoscopy and laparoscopy for biopsy to clarify the pathological, the treatment of pathological type of pre-treatment evaluation of residual disease after a certain significance.

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