Which Department Should I See For Swollen Lymph Nodes? How is Lymphoma Treated?

Compared with other cancers, lymphoma usually has a good survival rate and prognosis as long as it is treated properly. Of course, the time of diagnosis still has a huge impact.

Learn more about the diagnosis, staging and treatment of lymphoma.

Diagnosis and examination of lymphoma

Enlarged lymph nodes are the main sign of lymphoma. During a doctor’s examination, they usually first palpate areas with a large number of lymph nodes such as the neck, armpit, or groin, and then make further diagnosis through the following methods:

  1. Blood test: Compared with the general population, patients with lymphoma have elevated levels of white blood cells, alkaline phosphatase (Alkaline phosphatase) and lactate dehydrogenase (LDH), and reduced platelet and red blood cell counts.
  2. Film degree exam:

For example, X-ray, computed tomography (CT scan), positron tomography (PET scan) and ultrasound examination, etc.

  1. Bone marrow aspiration: A fine needle is used to penetrate the bone to take a sample of the bone marrow to check whether lymphoma has invaded the bone marrow.
  2. Biopsy:

Part of the lymphoid tumor tissue is collected and observed under a microscope to determine whether the patient has lymphoma and the stage of the lymphoma.

Which department should I see for lymphoma?

We usually decide which specialist to go to for treatment based on the uncomfortable part of the body. If we feel swollen lymph nodes under the arm, we go to the hematology and oncology department or general surgery. If we find an inexplicable lump in the neck, we go to the otolaryngology department.

The following departments can assist in the diagnosis of lymphoma. If you are not sure, you can contact a medical department first, and the doctor will make a decision on further treatment or referral after diagnosis.

  1. Family Medicine
  2. Hematology and Oncology
  3. Otolaryngology
  4. General surgey
  5. Internal Medicine
  6. Department of Oncology

Lymphoma stages: stage 1, stage 2, stage 3, stage 4

The staging of lymphoma is usually based on the diaphragm and is divided into the following four stages:

Stage 1: Lymphoma only appears in 1 lymphatic area, or lymphoma only appears in 1 organ outside the lymphatic system.

Stage 2: More than two lymphatic areas on the same side of the diaphragm are invaded by tumors, or lymphoma appears in an organ outside the lymphatic system and other lymphatic areas on the same side.

Stage 3: Lymphatic areas on both sides of the diaphragm or spleen are invaded.

Stage 4: The tumor invades organs outside the lymphatic system, such as bone marrow, liver, lungs, and bones.

In addition, if the clinical symptoms are fever exceeding 38 degrees, night sweats, and weight loss of more than 10% within 6 months, the doctor will add a “B” after the stage. If there are no symptoms above, add an “A” to assist Determine the condition.

How is lymphoma treated?

The treatment of lymphoma varies depending on the type of tumor. Hodgkin’s lymphoma responds well to radiotherapy, so radiotherapy will be given priority; however, if the stage has progressed to the third or fourth stage , may be performed together with chemotherapy. Because Hodgkin’s lymphoma responds well to radiation therapy and is less likely to metastasize to other organs, patient prognosis and survival rates are generally good.

However, lymphoma patients in UK are usually Non-Hodgkin’s lymphoma, which can be divided into low malignancy, intermediate and high malignancy according to the speed of disease progression:

  1. Low malignancy: The tumor develops slowly and is difficult to detect in the early stage. The main treatment methods include radiotherapy and chemotherapy. However, low-malignancy non-Hodgkin’s lymphoma does not respond well to chemotherapy, so it often relapses; antibiotics may be considered. CD20 monoclonal antibody treatment. Monoclonal antibodies can bind to the structure of cancer cells, allowing immune cells to recognize and kill them.
  2. Medium and high malignancy: Non-Hodgkin’s lymphoma develops rapidly, but its structure is relatively unstable; it responds well to chemotherapy, and is usually treated with a combination of four chemotherapy drugs including CHOP (Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone). However, Only 30-40% of patients can be cured with chemotherapy.

For relapsed patients, local radiotherapy combined with chemotherapy can be considered, or the dose of chemotherapy can be increased, combined with bone marrow or stem cell transplantation, or treatment with anti-CD20 monoclonal antibodies.

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