Follicular lymphoma diagnostic study of choice: Difference between revisions

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{{CMG}}; {{AE}}
{{CMG}}; {{AE}}
== Overview ==
== Overview ==
Laboratory tests for the diagnosis of follicular lymphoma include [[lymph node biopsy]], [[complete blood count]] (CBC), blood chemistry studies, cytogenetics studies, [[flow cytometry]], [[immunohistochemistry]], [[FISH]], [[genetic testing]], and [[immunophenotyping]]. [[CT]], [[MRI]], and [[PET]] may be helpful in the diagnosis and assessing the spread of follicular lymphoma. Other diagnostic studies for the diagnosis of follicular lymphoma include [[bone marrow aspiration]] and biopsy, [[laparoscopy]], and [[laparotomy]].


== Diagnostic Study of Choice ==
== Diagnostic Study of Choice ==
 
* [[Lymph node biopsy]] is the diagnostic study of choice<ref name="pmid25176983">{{cite journal| author=Ganapathi KA, Pittaluga S, Odejide OO, Freedman AS, Jaffe ES| title=Early lymphoid lesions: conceptual, diagnostic and clinical challenges. | journal=Haematologica | year= 2014 | volume= 99 | issue= 9 | pages= 1421-32 | pmid=25176983 | doi=10.3324/haematol.2014.107938 | pmc=4562530 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25176983  }} </ref><ref name="pmid29314206">{{cite journal| author=Freedman A| title=Follicular lymphoma: 2018 update on diagnosis and management. | journal=Am J Hematol | year= 2018 | volume= 93 | issue= 2 | pages= 296-305 | pmid=29314206 | doi=10.1002/ajh.24937 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29314206  }} </ref><ref name="pmid23691443">{{cite journal| author=| title=Guidelines for the diagnosis and treatment of follicular lymphoma in China. | journal=Cancer Biol Med | year= 2013 | volume= 10 | issue= 1 | pages= 36-42 | pmid=23691443 | doi=10.7497/j.issn.2095-3941.2013.01.006 | pmc=3643683 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23691443  }} </ref>.
=== Study of choice ===
* Histopathological, Immunohistochemistry, FISh and cytogenetic studies are conducted on the tissue sample.
[Name of the investigation] is the gold standard test for the diagnosis of [disease name].
* Other diagnostic tests that are done are :
 
** [[Complete blood count]] (CBC)
OR
** Complete metabolic panel
 
** [[Hepatitis B virus|HBV]], [[Hepatitis C|HCV]] and [[Human Immunodeficiency Virus (HIV)|HIV]] testing
The following result of [gold standard test] is confirmatory of [disease name]:
** Serum [[Lactate dehydrogenase|LDH]] levels and serum β<sub>2</sub>-microglobulin levels.
* [Result 1]
** [[Bone marrow biopsy]] and aspiration
* [Result 2]
** Chest x ray and abdominal ultrasound
 
** [[CT scan]]
OR
** [[PET scan]]
 
** Cytogenetics studies
[Name of the investigation] must be performed when:
** [[Flow cytometry]]
* The patient presents with [symptom/sign 1], [symptom/sign 2], and [symptom/sign 3].
** [[Immunohistochemistry]]
* A [name of test] is positive for [sign 1], [sign 2], and [sign 3] in the patient.
** [[FISH]]
 
** [[Genetic testing]]
OR
** [[Immunophenotyping]]: [[BCL-2]]+, BCL6+, [[CD5]]-, CD10+, [[CD19]], [[CD20]], [[CD22]], [[CD43]], [[CD79a]], heavy and light chains rearranged, t(14;18)(q32:q21)-85% with rearrangement of ''[[BCL-2]]'' gene.
 
** [[Endoscopy]] for gastrointestinal lymphoma<ref name="pmid26819532">{{cite journal| author=Iwamuro M, Kondo E, Takata K, Yoshino T, Okada H| title=Diagnosis of follicular lymphoma of the gastrointestinal tract: A better initial diagnostic workup. | journal=World J Gastroenterol | year= 2016 | volume= 22 | issue= 4 | pages= 1674-83 | pmid=26819532 | doi=10.3748/wjg.v22.i4.1674 | pmc=4721998 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26819532  }} </ref>
[Name of the investigation] is the gold standard test for the diagnosis of [disease name].
 
OR
 
The diagnostic study of choice for [disease name] is [name of the investigation].
 
OR
 
There is no single diagnostic study of choice for the diagnosis of [disease name].
 
OR
 
There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
 
OR
 
[Disease name] is primarily diagnosed based on the clinical presentation.
 
OR
 
Investigations:
* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.
 
==== The comparison of various diagnostic studies for [disease name] ====
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! style="background: #4479BA; color: #FFFFFF; text-align: center;" | Test
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sensitivity
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 1
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 2
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
|}
<small> [Name of test with higher sensitivity and specificity] is the preferred investigation based on the sensitivity and specificity</small>
 
===== Diagnostic results =====
The following finding(s) on performing [investigation name] is(are) confirmatory for [disease name]:
* [Finding 1]
* [Finding 2]
 
===== Sequence of Diagnostic Studies =====
The [name of investigation] must be performed when:
* The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
* A positive [test] is detected in the patient, to confirm the diagnosis.
 
OR
 
The various investigations must be performed in the following order:
* [Initial investigation]
* [2nd investigation]
 
=== Name of Diagnostic Criteria ===
 
'''It is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.'''
 
[Disease name] is primarily diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
 
OR
 
There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
 
OR
 
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
 
OR
 
The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
 
OR
 
[Disease name] may be diagnosed at any time if one or more of the following criteria are met:
* Criteria 1
* Criteria 2
* Criteria 3
 
OR
 
'''IF there are clear, established diagnostic criteria'''
 
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
 
OR
 
The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
 
OR
 
The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
 
OR
 
'''IF there are no established diagnostic criteria'''
 
There are no established criteria for the diagnosis of [disease name].


==References==
==References==

Latest revision as of 22:29, 22 January 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Laboratory tests for the diagnosis of follicular lymphoma include lymph node biopsy, complete blood count (CBC), blood chemistry studies, cytogenetics studies, flow cytometry, immunohistochemistry, FISH, genetic testing, and immunophenotyping. CT, MRI, and PET may be helpful in the diagnosis and assessing the spread of follicular lymphoma. Other diagnostic studies for the diagnosis of follicular lymphoma include bone marrow aspiration and biopsy, laparoscopy, and laparotomy.

Diagnostic Study of Choice

References

  1. Ganapathi KA, Pittaluga S, Odejide OO, Freedman AS, Jaffe ES (2014). "Early lymphoid lesions: conceptual, diagnostic and clinical challenges". Haematologica. 99 (9): 1421–32. doi:10.3324/haematol.2014.107938. PMC 4562530. PMID 25176983.
  2. Freedman A (2018). "Follicular lymphoma: 2018 update on diagnosis and management". Am J Hematol. 93 (2): 296–305. doi:10.1002/ajh.24937. PMID 29314206.
  3. "Guidelines for the diagnosis and treatment of follicular lymphoma in China". Cancer Biol Med. 10 (1): 36–42. 2013. doi:10.7497/j.issn.2095-3941.2013.01.006. PMC 3643683. PMID 23691443.
  4. Iwamuro M, Kondo E, Takata K, Yoshino T, Okada H (2016). "Diagnosis of follicular lymphoma of the gastrointestinal tract: A better initial diagnostic workup". World J Gastroenterol. 22 (4): 1674–83. doi:10.3748/wjg.v22.i4.1674. PMC 4721998. PMID 26819532.

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