Diffuse large B-cell lymphoma (DLBCL) symptoms and diagnosis
Diffuse large B-cell lymphoma (DLBCL) tests for diagnosis
You’ll have a number of tests to confirm whether you have DLBCL and check your general health.
You may any or all of these tests:
- Lymph node biopsy: This involves taking a small sample of a swollen lymph node to confirm the diagnosis of lymphoma.
- Full blood count: This is a blood test that checks if you have developed anaemia (a low level of red blood cells that can lead to tiredness and breathlessness).
- Liver function test: This is a blood test that checks how well your liver is working.
- Urea and electrolytes test: This is a blood test that checks how well your kidneys are working.
It might take several weeks for the full results to come back and for you to be given a final diagnosis. This is because it can take a while to take a biopsy, then analyse and interpret the results. If you have any questions or worries during this time, your healthcare team will be able to talk to you about them. Or you can contact our Support Services Team to talk things through.
We have more information on tests for blood cancer.
Staging
You’ll also need tests to show how much the lymphoma has grown and developed. Doctors call this staging.
Your doctor will use a number and a letter to describe the stage of your condition. The number states how many areas of your body are affected by lymphoma and the letter relates to your symptoms when you’re diagnosed. It's very important to understand the stage of the lymphoma as this is likely to influence the treatment that you’ll have.
Stages of DLBCL
Only one group of lymph nodes is affected, in one place in your body.
More than one group of nodes is affected but all of them are on the same side of the diaphragm, either above or below. The diaphragm is a sheet of muscle separating your chest from your stomach and hip areas (abdomen and pelvis).
Lymph nodes on both sides of the diaphragm are affected.
Lymphoma is found in organs such as the lungs, liver or bone marrow.
You have no B symptoms when you're diagnosed.
B symptoms are present:
- fever (higher than 38ºC)
- drenching night sweats
- unexplained weight loss in the last six months (at least 10% or a tenth of your previous weight).
You might also hear doctors referring to the letters E and X in your staging – these describe in more detail how your disease is progressing.
- E stands for extranodal, which means that a part of the body is affected outside of the lymph nodes.
- X means bulky disease, and is used to describe the lymphoma if one of your affected lymph nodes is more than 10cm across, or there’s a lump in your chest that takes up more than a third of its width.
Stages I (A) or II (A) are classed as early-stage NHL. All other stages, whether A or B, and stages I and II with bulky disease are classed as advanced-stage disease.
Many cases of DLBCL are diagnosed at an advanced stage. They can still be treated.
Staging tests
To stage your condition, you may have one or more of these scans:
- X-ray
- CT scan
- PET scan
- MRI scan
- Ultrasound scan
We have more information on scans.
Performance status
Your performance status is a way for doctors to describe how well you are when you’re diagnosed. Your doctor will use your performance status to help recommend the best treatment for you.
The most commonly used scale is called the ECOG (Eastern Cooperative Oncology Group) scale.
The ECOG scale
You’re fully active, and able to carry on more or less as you were before your illness.
You’re unable to do heavy physical work, but can do anything else you were able to do before your illness.
You’re up and about for more than half the day. You can look after yourself, but you’re not well enough to work.
You’re in bed or sitting in a chair for more than half the day. You need help to look after yourself – for example to wash and dress.
You’re not able to get out of bed or a chair, and you need lots of help to look after yourself.
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