How to check lymphoma? How to diagnose lymphoma

Speaking of lymphoma, it is a local pathological disease. In current clinical practice, the changes in each disease are different. Some are multiple, and some are primary. Therefore, once the disease is diagnosed, it may spread and even complications may occur. When examining lymphoma, the first step is to confirm the diagnosis. First, the cause is confirmed through various tests, and then check whether there is Hodgkin's disease. The condition is complicated and requires careful confirmation.

Confirmation

Due to the different locations and extent of the lesions, the clinical manifestations are very inconsistent. The primary site may be in the lymph nodes or in extranodal lymphoid tissues, such as the tonsils, nasopharynx, gastrointestinal tract, spleen, bones, or skin. Extranodal lymphoid tissue primary sites are more common in NHL. The disease spreads from the primary site to adjacent lymph nodes, such as HD, or it spreads beyond the adjacent lymph nodes to distant lymph nodes, which is common in NHL. NHL can also have multiple centers of origin. Therefore, once the disease is clinically diagnosed, it has often spread throughout the body. The main clinical manifestations of HD and NH are described below:

Hodgkin disease

It is more common in young people and less common in children. The first symptom is often painless swollen lymph nodes in the neck or above the clavicle (accounting for 60%~80%), more on the left than on the right, followed by swollen lymph nodes in the armpit. The swollen lymph nodes may be movable or adhere to each other and fuse into lumps, which may feel like cartilage when palpated. If lymph nodes press on nerves, it can cause pain. A small number of patients have only deep but no superficial lymphadenopathy. Enlarged deep lymph nodes can compress adjacent organs, resulting in symptoms of compression. For example, enlarged mediastinal lymph nodes can cause cough, chest tightness, shortness of breath, atelectasis, and superior vena cava compression; enlarged retroperitoneal lymph nodes can compress the ureter and cause hydronephrosis; and epidural masses can lead to spinal cord compression.

Some other HD patients (30%~50%) have persistent or periodic fever of unknown cause as the main symptom. This type of patients is generally older, more likely to be male, have more diffuse lesions, and often have retroperitoneal lymph node involvement. After the fever occurs, some patients experience systemic symptoms such as night sweats, fatigue and weight loss. Periodic fever (Pel-Ebstein fever) occurs in about 1/6 of patients. Some patients may experience local and systemic skin itching, mostly young patients, especially women. Generalized pruritus may be the only systemic symptom of HD.

Splenomegaly is not common during physical examination, occurring in only about 10% of cases. Splenic involvement suggests hematogenous dissemination. Invasion of the liver parenchyma causes enlargement and tenderness in the liver area, and in a few cases, jaundice. Liver disease is spread from the spleen through the veins, so the liver is less enlarged than the spleen.

HD can also invade various systems or organs: for example, infiltration of the lung parenchyma, pleural effusion, bone pain caused by the bone marrow, destruction of the lumbar or thoracic vertebrae, and spinal cord compression. Herpes zoster is common in HD, accounting for about 5% to 16%.