Info

diagnostic and staging evaluation of overview of lymphoma and CLL

Physical exam:

  • lymph nodes,
  • liver/spleen size,
  • Waldeyer’s ring,
  • testes (~1% of NHL),
  • skin

Pathology:

  • excisional lymph node bx (not FNA b/c need surrounding architecture) with immunophenotyping and cytogenetics (Reed-Sternberg (RS) cells in HL)
  • BM bx if cytopenias
  • CLL by peripheral flow in patients w/ peripheral disease
  • LP if CNS involvement clinically suspected

Lab tests

  • CBC, BUN/Cr, LFTs, ESR, LDH, UA, Ca, alb;
  • ✓ HBV & HCV
  • (and must ✓ HBsAg & anti-HBc if planning rituximab Rx due to risk of HBV reactivation);
  • HIV

Imaging

  • PET-CT to assess disease burden and guide biopsy/therapy,
  • especially in HL, DLBCL.
  • Head CT/MRI only if neurologic symptoms.