Blood disease lymphoma

The diagnosis of lymphoma relies on clinical manifestations, pathological examination and the necessary supporting inspection. Pathological diagnosis should include the type and extent of disease (staging). Deep lesions on only superficial lymph nodes were without diagnosis is often difficult, need the help of laboratory examinations, described as follows:

Laboratory

First, the blood as early general no special. Anemia seen in late or in combination hemolytic anemia. In addition to white blood cells than normal bone marrow involvement, increased eosinophils, common to HD. About 1/3HD absolute reduction in lymphocytes. Plasma cells and Reed-sternberg cells even found in the peripheral blood. Bone marrow involvement thrombocytopenia, or hypersplenism secondary to splenic function.

Second, bone marrow before bone marrow were not lymphoma, generally without exception. Bone marrow smears in HD to find support Reed-sternberg cells diagnose valuable. This cell size large, a diameter of 15 ~ 20μ, nucleus large, can lobulated, dual-core (Mirror cell) or multi-core. Uneven distribution of chromatin, dense integrated block. Thick, deeply stained nuclear membrane. Nucleolus large garden, up to 8μ, free halo zone around the nucleolus.

Third, biochemical examination of rapid ESR prompted active disease; lactate dehydrogenase increased tumor cell proliferation reflects the speed,> 500 units / L suggest poor prognosis NHL. Progression of serum copper and ferritin increased, decreased remission; zinc opposite. Elevated alkaline phosphatase may be liver or bone involvement. They also may be associated with liver involvement of 5 - nucleotide enzymes. Hypercalcemia prompted a bone violations, such changes can occur before X-ray changes. Increased cerebrospinal fluid β2-microglobulin have prompted the central nervous system involvement.

Fourth, immune abnormalities in patients with HD and other stimuli on the original tuberculin reactivity decreased in vitro lymphocyte transformation rate reduction, the degree of progression of the disease. Normal humoral immunity, immune globulin is usually normal or elevated, to reduce late. NHL, humoral immune abnormalities in some patients, manifested as autoimmune hemolytic anemia, immune thrombocytopenia. Coombs test was positive, a small number of patients have monoclonal hypergammaglobulinemia. Treatment of patients achieved remission, return to normal immune function.

V. biopsy to diagnose the inspection methods are essential. General should be chosen under the neck or axillary lymph nodes, submandibular and groin lymph node due to chronic inflammation often affecting the diagnostic accuracy. Scalene fat pad biopsy of mediastinal or lung lesions have a certain diagnosis.

6, mediastinoscopy mediastinoscopy can be made by biopsy of mediastinal extrapleural access, more convenient security.

7, lower extremity lymphangiography in retroperitoneal lymphoma diagnosis, staging, to judge the efficacy and accuracy of observation of recurrence is a high security simple and examination technique with few complications, and in some ways superior to CT and Sound like a plan, it found that normal-sized lymph node lesions of the internal structural changes.

8, CT, MRI examination can sound like the map found within the chest, retroperitoneal, mesenteric lymph node lesions and the liver and spleen lesions.

9, abdominal examination can clearly spleen, liver and abdominal lymph node involvement, radiation therapy is used to determine the radiation field is essential (pathologic stage). If the same time for splenectomy, but also can avoid the spleen in radiation injury to nearby tissues and organs.

Malignant lymphoma, large cell type, the magnification

About half of the adult non-Hodgkin's lymphoma is the occurrence of large cell lymphoma. As seen in this magnification. They may be related to immunosuppression (eg AIDS), may be T cells or B cell origin. Cell volume, and have a distinct nucleus and abundant cytoplasm. The disease tends to be localized, (lower phase), but the rapid expansion of low-level lymphoma than extranodal greater tendency.