Diagnosis and staging of lymphoma

Lymphoma is usually diagnosed through examination of swollen lymph node prints and pathological sections or lymph node puncture smears. Patients suspected of skin lymphoma can undergo skin biopsy and prints. When there are abnormal blood cell counts, increased serum alkaline phosphatase, or bone lesions, bone marrow biopsy and smears can be performed to look for RS cells or lymphoma cells and understand the bone marrow involvement. The diagnosis and typing of lymphoma are made based on the results of histopathological examinations.

After the diagnosis and classification of lymphoma are confirmed, it is divided into four stages according to the distribution range of lymphoma: Stage I: the lesion is limited to 2 lymph node areas or a single extranodal organ is locally involved; Stage II: the lesion involves two or more lymph node areas on the same side of the diaphragm, or the lesion is limited to invade organs other than lymph nodes, with more than one lymph node area on the same side of the diaphragm; Stage III: there are lymph node lesions above and below the diaphragm, involving the spleen or other extranodal organs; Stage IV: one or more extranodal organs are extensively or disseminatedly invaded, with or without lymphadenopathy, or involvement of the liver or bone marrow.

To improve the accuracy of clinical staging, enlarged lymph nodes can also be punctured and smeared for cell morphology, immunology and molecular biology examinations as evidence for staging. Each clinical stage is divided into two groups, A and B, according to the presence or absence of symptoms. Asymptomatic patients are group A and symptomatic patients are group B. Systemic symptoms include: fever over 38°C for 3 days, weight loss of more than 10% within 6 months, and night sweats.