Key points for the diagnosis of lymphoma

The key points for diagnosing lymphoma are as follows:

1. Medical history

Ask about the medical history in detail, including the first symptoms, the time of onset of lymph node enlargement and the subsequent rate of increase, and whether there are systemic symptoms such as fever, night sweats, itchy skin, weight loss, etc. For non-Hodgkin's lymphoma, ask about the presence of gastrointestinal symptoms.

2. Physical signs

(1) Check whether the superficial lymph nodes in the whole body are swollen and whether the skin and appendages are invaded. Pay attention to whether the pharyngeal lymph ring, breast, testicles, etc. are invaded.

(2) Other venous or lymphatic drainage is affected, each vessel is compressed, and the superior vena cava syndrome, etc.

3. Special inspection

(1) Routine blood examination, including hemoglobin, white blood cell count and classification, platelet count, erythrocyte sedimentation rate, etc.

(2) Blood chemistry examination, including measurement of urea nitrogen, creatinine, alkaline phosphatase, total protein and albumin, globulin, transaminase and transpeptidase.

(3) Serum immunoglobulin examination.

(4) Routine urine examination.

(5) Iliac bone puncture smear or biopsy.

(6) Radiological examination, including anteroposterior and lateral chest X-rays and lymph node angiography of both lower limbs.

(7) Pathological examination, including lymph node and skin biopsy and, if necessary, liver puncture biopsy.

(8) Cellular immunity examination, including E rosette, lymphocyte transformation, macrophage test, skin test, etc.

(9) Abdominal ultrasound or CT scan, MRI, and gastrointestinal barium meal fluoroscopy, etc.

(10) Laparotomy should only be performed in selected cases, especially for non-Hodgkin's lymphoma.