What tests do patients with lymphoma need?

When you encounter swollen lymph nodes or suspect that you have lymphoma, what tests are needed to make a diagnosis? Generally speaking, the diagnosis of lymphoma is relatively complicated. If you want to make a clear diagnosis and fully evaluate the condition, you need to undergo multiple tests.

Routine blood test

The blood count of patients with early or newly diagnosed lymphoma is mostly normal, but with disease progression, bone marrow involvement, hypersplenism, and after multiple chemotherapy and radiotherapy, the patient's blood routine examination may show a decrease in the three lineages.

Bone marrow examination

The bone marrow invasion rate can be as high as 30% when diagnosing lymphoma, and it is inconsistent for different histological subtypes and different clinical stages. Patients with high-grade or advanced lymphoma are more likely to have bone marrow involvement. The invaded bone marrow cells have the characteristics of nuclear distortion and obvious nuclear division. Since about 70% of patients with lymphoma have focal involvement of the bone marrow, and 30% have diffuse and interstitial invasion. Therefore, multiple punctures and biopsies are expected to increase the positive rate of the examination.

Imaging tests

X-rays are of great reference value in the diagnosis of malignant lymphoma. At present, routine X-ray examinations include posterior-anterior and lateral chest films, supplemented by tomography when necessary, in order to observe the hilar, mediastinal, and subcarinal lymph nodes of the trachea, and also to observe whether there is any invasion in the lungs. CT, magnetic resonance imaging, and color Doppler ultrasound examinations are very helpful in discovering lesions in the mediastinum, retroperitoneum, and other hidden parts.

Histopathological examination

Pathological examination of lymph nodes or other affected tissues is the main basis for confirming lymphoma and pathological type. Malignant lymphoma generally needs to be confirmed by pathological examination. Optical microscopic examination of lymph nodes not only observes the morphology of cells, but also the structure of the entire lymph node and the reaction of interstitial cells. Therefore, it is best to take complete lymph nodes for examination and avoid taking partial lymph nodes as much as possible.