Laboratory tests for lymphoma

Lymphoma laboratory and other tests:

1. Blood picture is usually normal in the early stage. Anemia is seen in the late stage or combined with hemolytic anemia. White blood cells are generally normal except for bone marrow involvement, and eosinophilia is common in HD. About 1/3 of HL patients have a decrease in the absolute value of lymphocytes. Plasma cells and RS cells can occasionally be seen in peripheral blood. A decrease in platelets indicates bone marrow involvement or secondary to hypersplenism.

2. Bone marrow image Before the bone marrow is invaded by lymphoma, there is generally no abnormality. Finding RS cells in the bone marrow smear of HL is valuable for a clear diagnosis. This cell is large in size, with a diameter of 15-20pm, and a large nucleus, which can be lobed, binucleated (mirror cell) or multinucleated. The chromatin is unevenly distributed and concentrated into clumps. The nuclear membrane is thick and darkly stained. The nucleolus is large and round, up to 8pm, and there is a halo area around the nucleolus.

3. Laboratory examinations: Erythrocyte sedimentation rate and serum lactate dehydrogenase activity increase during the active stage of the disease. Increased lactate dehydrogenase indicates a poor prognosis. Increased serum alkaline phosphatase activity or blood calcium indicates bone involvement. B-cell NHL may be complicated by hemolytic anemia with positive or negative anti-human globulin test, and monoclonal IgG or IgM may appear in a few cases. Cerebrospinal fluid examination should be performed if necessary.

4. Pathological examination: Lymph node biopsy pathological sections should be examined to look for RS cells, but it should be noted that RS cells may also appear in patients with infectious mononucleosis, Epstein-Barr virus infection, and when taking phenytoin sodium.

5. Radiology and radionuclide examinations When mediastinal hilar lymph nodes and lungs are suspected to be invaded, posterior-anterior and lateral chest X-rays can be taken. For suspicious areas, tomographic films can be taken for further confirmation. When retroperitoneal lymph node enlargement is suspected, lymphangiography can be performed. Radionuclide liver, spleen, bone scans or scintigraphy can reveal corresponding lesions.

6. Ultrasonic examination of abdominal masses can be used to explore their range, nature and relationship with surrounding organs.

7. Lower limb lymph node angiography is mainly used to understand whether the pelvic and para-aortic lymph nodes are invaded, so as to perform normal clinical staging, judge the efficacy of radiotherapy or chemotherapy, and detect disease recurrence.

8. CT scan is of diagnostic significance for lesions of the diaphragmatic angle, mediastinum, paratracheal, hilar, paraaortic, mesenteric, peripancreatic, hilar, and para-celiac artery lymph nodes, as well as organ lesions.

9. Laparotomy and splenectomy can be performed if necessary.