History

Complete physical examination

Imaging

• - Computed tomography scan of thorax, abdomen and pelvis

Laboratory tests

• - Blood count (with peripheral blood smear)

• - LDH level

• - β2-microglobulin level

• - Serum electrophoresis and immunoelectrophoresis with immunofixation

• - Renal and liver functions

• - HIV serology

• - HCV serology

• - optional: albumin level

Bone marrow biopsy

Depending on the symptoms at diagnosis:

• - gastrointestinal tract locations

  • - Gastric location: endoscopy and echoendoscopy; Helicobacter pylori: systematic histologic examination

  • - Intestinal location: colonoscopy; +/− double-contrast X-ray of the small bowel; if small intestine Campylobacter jejuni: PCR in lymphoma biopsy; in situ hybridization and/or immunohistochemistry

• - non-gastrointestinal tract locations

  • - Lung: endoscopy + lavage

  • - Head and neck (salivary gland, tonsils, parotid): otolaryngologic investigation and echography

  • - Thyroid: neck echography +/− CT scan and functional thyroid tests

  • - Orbit (ocular adnexa): NMR and ophthalmologic examination; Chlamydia psittaci: PCR on lymphoma biopsy and peripheral blood mononuclear cells

  • - Skin: Borrelia burgdorferi: PCR in lymphoma biopsy

  • - Breast: computed tomography scan

Depending on the treatment proposed to the patient:

• - Echocardiography

• - Sperm conservation