Diagnosing and staging

Diagnosis: symptoms and tests

What are the symptoms of indolent B-cell NHL?

Indolent B-cell NHL is often asymptomatic (there are no symptoms). In this case, it may be discovered during a routine checkup. For example, a blood test may show something out of the ordinary. In other instances, there could be physical signs and symptoms that last for an unusually long time.

Common symptoms of indolent B-cell NHL may include:

  • Enlarged lymph nodes/swollen glands
  • Fevers and/or soaking night sweats
  • Chills
  • Itching
  • Unexplained weight loss
  • Unexplained fatigue

How is indolent B-cell NHL diagnosed?

Tests commonly used to diagnose indolent B-cell NHL include:

  • Physical exam—to check for swollen glands (lymph nodes)
  • Biopsy—to confirm whether abnormal cells are in lymph nodes or other lymph tissues. A biopsy is the only way to positively diagnose NHL, to identify chromosomal abnormalities, and to find out if it is a B-cell or T-cell lymphoma (see biopsy)
  • Blood tests—to assess white blood cell counts and a substance called lactate dehydrogenase (LDH), which can become high from NHL
  • Imaging tests—such as CT scan, MRI, and PET scan, to check for swollen lymph nodes or other signs of NHL

Staging for indolent B-cell NHL that has progressed

After the diagnosis is made, the next step is to find out the stage of the disease. Your doctor may perform imaging tests, such as a CT scan, MRI, ultrasound, or PET scan. In addition, a bone marrow biopsy or spinal tap may be performed.

Based on the results of the tests, your doctor will classify the indolent B-cell NHL by one of the following stages:

In addition, your doctor may use the letters A, B, or E to further classify the stage of NHL.

  • A means no symptoms are present (e.g., fever, chills, night sweats, itching, and weight loss)
  • B means symptoms such as fever, chills, night sweats, itching, and weight loss are present
  • E means involvement of a part of your body other than the lymph nodes