Fast Five Quiz: Follicular Lymphoma

Emmanuel C. Besa, MD


January 05, 2021

CT allows a search for adenopathy of the abdomen or pelvis during the workup of follicular lymphoma. The European Society for Medical Oncology (ESMO) recommends that scans include the neck.

MRI is not typically recommended for the initial workup of follicular lymphoma. On the other hand, PET-CT can distinguish between tumor and fibrosis after therapy, though the results may not always change management. PET-CT is recommended by ESMO to improve staging.

Inflammatory markers are not specifically recommended as part of initial workup. Instead, in addition to complete blood cell count, routine chemistries, and lactate dehydrogenase, lab tests should include immunoglobulin levels, beta-2 microglobulin, and uric acid, according to ESMO. The society also recommends screening for HIV, hepatitis B virus, and hepatitis C virus. The National Comprehensive Cancer Network recommends immunophenotyping.

Fine-needle aspiration is not sufficient to give a reliable diagnosis, which requires a surgical specimen/excisional lymph node biopsy. Storing extra biopsy material may facilitate future investigation.

Learn more about follicular lymphoma.


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