Diagnosis

The diagnosis is made up of various methods. First of all, typical findings can be determined by talking to the patient and a clinical examination, such as enlarged but not painful lymph nodes on the neck or in the groin region. B-symptoms (the combination of fever, night sweats and weight loss) also indicate the presence of a malignant disease. In addition, a blood test is performed and a conspicuous lymph node is removed and then examined microscopically. Under certain circumstances, an imaging examination is performed to complete the diagnosis.

What do the blood values show?

The normal blood count is used to determine whether there is an increase or decrease in lymphocytes. Furthermore, it is checked whether the other blood cells show abnormalities, which can lead to anemia with fatigue, for example. One reason for anemia is a decay of the red blood cells, which can also be detected in the blood count.

There are also specific values in the blood values, which increase with inflammation. In this case the inflammation parameters, such as CRP (C-reactive protein), would be increased. Specific blood tests can also be performed to determine the exact subtype of non-Hodgkin lymphoma. For this purpose, a biochemical method is used to determine certain surface proteins that help to differentiate whether non-Hodgkin’s lymphoma originates from B-lymphocytes or T-lymphocytes. These two groups are subgroups of lymphocytes that perform various tasks for the immune system.

Which stadiums are there?

The stages are classified according to the Ann-Arbor classification. In stage I, only one lymph node region is affected, or there is an infestation outside the lymph nodes (extranodal infestation), but within certain regions. A lymph node region refers to defined groupings of lymph nodes, such as those found on the neck, in the armpit or in the groin.

As an organ of the immune system, the spleen is also considered a lymph node region. One speaks of an extranodal infestation when degenerated cells spread to other tissues through neighborhood relationships. In stage II, at least two lymph node regions or adjacent regions outside the lymph nodes are affected.

However, these are all located either above or below the diaphragm. This is a membrane of muscles and tendons that separates the thorax from the abdomen. If the affected lymph nodes or extranodal infestation are located on both sides of the diaphragm, the disease is called stage III according to Ann-Arbor. Stage IV is independent of the status of the lymph nodes and is awarded when at least one organ is affected and this cannot be explained by neighborhood relations.