From the Guidelines
Laboratory tests for lymphoma diagnosis should include a complete blood count (CBC), comprehensive metabolic panel, lactate dehydrogenase (LDH), and beta-2 microglobulin, as these tests help assess overall health and can indicate the presence of lymphoma 1.
Key Laboratory Tests
- Complete blood count (CBC) to assess blood cell counts
- Comprehensive metabolic panel to evaluate organ function
- Lactate dehydrogenase (LDH) to assess tumor activity
- Beta-2 microglobulin to evaluate disease severity
Additional Tests
- HBV testing is recommended due to increased risks of viral reactivation when immunotherapy regimens are being considered for treatment 1
- Bone marrow biopsy may be necessary to check if lymphoma has spread to the bone marrow, especially in cases where the PET-CT is negative and identifying a discordant histology is important for patient management 1
Imaging Studies
- PET-CT is the standard for FDG-avid lymphomas, whereas CT is indicated for nonavid histologies 1
- Imaging studies like CT scans, PET scans, and MRIs are essential to determine the extent of disease
Diagnosis and Staging
- Definitive diagnosis requires a lymph node biopsy, which examines tissue under a microscope to identify cancer cells
- Excisional biopsy is preferred for diagnosis, although core-needle biopsy may suffice when not feasible 1
- A modified Ann Arbor staging system is recommended, and patients are treated according to prognostic and risk factors 1
From the Research
Labs for Lymphoma
- Lymph node biopsy is the preferred method for diagnosis of lymphoma 2
- Laboratory studies such as complete blood count and peripheral blood flow cytometry can be used to diagnose lymphoma 3
- Serum markers such as lactate dehydrogenase (LDH), beta-2 microglobulin (B2M), and thymidine kinase (TK) can be used to classify the risk of large cell lymphoma 4
- LDH and B2M are incorporated in the serologic staging system to predict time to treatment failure and overall survival in aggressive non-Hodgkin's lymphoma patients 5
- Vascular endothelial growth factor (VEGF) has been associated with poor survival in diffuse large B cell lymphoma patients 5
Diagnostic Tests
- Positron emission tomography/computed tomography (PET/CT) can be used to stage lymphoma and determine the extent of the disease 2
- Imaging modalities such as CT scans and MRI can be used to monitor patients with lymphoma 3
- Flow cytometry can be used to diagnose and monitor lymphoma 3
Biomarkers
- LDH, B2M, and TK are significant independent prognostic factors for time to treatment failure and survival in large cell lymphoma patients 4
- Elevated levels of sVEGF have been associated with poor survival in diffuse large B cell lymphoma patients 5
- High serum LDH levels have been strongly associated with high tumor burden in diffuse large B cell lymphoma patients 5