Here I am discussing diagnostic tests and staging of non-Hodgkin’s disease, which is also known as non-Hodgkin’s lymphoma.
The diagnosis is done most directly by biopsy of affected lymph nodes. Immunophenotyping is also very helpful.
This is a method, which determines through the use of monoclonal antibodies, which surface antigens the leukemia cell is carrying. A certain constellation of markers is typical and very specific for a non- Hodgkin’s lymphoma.
A different constellation is typical for Hodgkin’s lymphoma. Some of the more rare forms of these lymphomas can be classified by using these tumor markers.
Staging of Non-Hodgkin’s Lymphoma
As with Hodgkin’s disease, so also with non- Hodgkin’s disease, also known as non- Hodgkin’s lymphoma (NHL), the Ann Arbor staging system is used to assess the extent of the disease prior to treatment. This needs to be somewhat modified as the subtypes of NHL do not only have a different prognosis according to the spread of the NHL, but also according to the cell type that is present.
The International Non-Hodgkin’s Prognostic Index divides the NHL into low-grade lymphomas, intermediate-grade lymphomas and high-grade lymphomas. This is based on risk group analysis. The following table is a simplified version of an article in the New England Journal of Medicine (Ref.1):
Outcome according to risk group (International Prognostic Index)
|NHL risk group:||Remission rate:||2-year survival:||5-year survival:|
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