Lymphoma Diagnosis

Lymphoma is a malignant tumor derived from abnormal proliferation of lymphocytes, mainly presenting as painless lymph node enlargement, which can occur in the neck, armpit, groin, and other areas. Without timely diagnosis and intervention, it may rapidly progress to multiple systems, threatening life. The diagnosis of lymphoma relies on imaging, blood tests, and pathological biopsy to determine the pathological subtype, which guides treatment strategies.

Diagnostic Basis

1. Clinical symptom evaluation (initial clues)
Patients often present with painless lymph node enlargement, with or without fever, night sweats, and weight loss (the "B symptoms"). Persistent fatigue, skin itching, or local compression symptoms should also be noted. In the early stage, only localized enlargement may be present, which is not easily detected, requiring detailed medical history and physical examination to raise suspicion.

2. Imaging examination (detecting lesions)
Ultrasound can serve as a primary screening tool for superficial lymph nodes, observing size, morphology, and blood flow. CT and MRI are used to evaluate deep or multiple regional lymph nodes and organ involvement. PET-CT has more advantages in staging and recurrence monitoring, providing functional metabolic imaging.

3. Lymph node biopsy (key to definitive diagnosis)
The "gold standard" for diagnosing lymphoma is histopathological examination after biopsy. Complete excisional lymph node biopsy is recommended to preserve tissue structure for pathological classification, immunophenotyping, and molecular genetic testing. Fine-needle aspiration or core needle biopsy is only used for patients unsuitable for surgery.

4. Bone marrow aspiration (assessing infiltration)
Some lymphomas, especially in advanced stages, are often associated with bone marrow involvement. Bone marrow aspiration provides samples for morphology, immunohistochemistry, and molecular testing to determine bone marrow disease, which is an important basis for formulating treatment plans.

5. Blood and biochemical tests (auxiliary assessment)
Routine blood tests may indicate anemia, leukocyte abnormalities, or thrombocytopenia. Elevated lactate dehydrogenase (LDH) often suggests active disease, and β2-microglobulin is another prognostic marker. Additionally, liver and kidney function tests help evaluate overall condition and treatment tolerance.

6. Immunophenotyping (identifying cell origin)
Flow cytometry or immunohistochemistry can detect surface antigens of lymphocytes, helping to distinguish between B-cell and T-cell lymphomas. Different immunotypes determine treatment directions and drug choices, which is a key step in precision medicine.

7. Molecular and genetic testing (supporting classification)
Some patients require PCR, FISH, or gene sequencing to analyze specific mutations or chromosomal rearrangements such as BCL2, BCL6, or MYC. These aid in prognosis assessment and determining whether the lymphoma is highly aggressive, with some mutations also linked to immunotherapy response.

8. Staging system (Ann Arbor staging)
The Ann Arbor system is widely used for lymphoma staging, ranging from stage I (localized) to stage IV (multi-organ involvement), and incorporates B symptoms. Accurate staging is critical for evaluating treatment efficacy and selecting treatment intensity.

9. Multidisciplinary consultation (treatment planning)
After diagnosis, an MDT (multidisciplinary team) including hematology, pathology, radiology, and immunotherapy experts should develop the most suitable treatment strategy. For different types and stages, consideration may be given to combining immune reconstruction cell therapy and other advanced treatments.

Conclusion

Experts at United Life International Medical Center remind us: Lymphoma is diverse and progresses rapidly, making early and accurate diagnosis crucial. It is recommended that patients with persistent lymph node enlargement or unexplained fever seek medical attention promptly, undergo comprehensive evaluation, and begin standardized treatment as soon as possible. Immune reconstruction cell therapy and other new technologies may also be considered to improve long-term survival.