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PubMed This is a summary of 18 peer-reviewed journal articles Updated
Hematology

Building Your Care Team and Preparing for Your First Visit

At a Glance

Managing Non-Hodgkin lymphoma requires a multidisciplinary team led by a hematologist-oncologist. For your first visit or second opinion, bring your complete pathology reports, imaging scans in DICOM format, and ensure your biopsy slides are safely transferred.

Successfully managing Non-Hodgkin Lymphoma (NHL) requires more than just one doctor. Because NHL is a complex family of over 60 different diseases, you need a multidisciplinary team (MDT)—a group of specialists who coordinate their expertise to tailor a plan for your specific subtype [1][2].

Your Core Care Team

A high-functioning team for NHL should include several key roles:

  • Hematologist-Oncologist: This is your “quarterback.” They specialize in blood cancers and will manage your systemic treatments, such as chemotherapy, immunotherapy, or targeted drugs [1].
  • Hematopathologist: This doctor works behind the scenes in the lab. Their role is critical: they must accurately “sub-classify” your lymphoma, which directly dictates your treatment [3][4].
  • Radiation Oncologist: Some NHL patients require targeted radiation to shrink specific tumors or manage symptoms in localized areas [1].
  • Oncology Nurse Navigator: This person helps you coordinate appointments, explains side effects, and ensures you don’t get lost in the healthcare system [5].
  • Oncology Social Worker: They provide emotional support and help you navigate practical challenges like insurance, transportation, or financial toxicity [5][6].

Preparing the “Evidence”: What to Bring

If you are visiting a specialist for the first time or seeking a second opinion, providing the right “artifacts” is essential for an accurate review [7]. Do not rely on digital portals alone; bring physical copies of the following:

  1. Biopsy Slides and Blocks: Ensure your new doctor’s office requests the physical glass slides and, if possible, the paraffin “blocks” containing your tissue directly from the original pathology department. Due to strict chain-of-custody protocols, you usually cannot transport these yourself, but verifying this transfer happens is essential for a second opinion [8][9].
  2. Imaging Discs: Bring your PET/CT, CT, or MRI scans on a CD-ROM or flash drive. Ensure the files are in DICOM format—this allows the specialist to perform their own measurements rather than just reading a typed report [10][11].
  3. Pathology and Operative Reports: Bring the full, multi-page pathology report and the “operative note” describing how the biopsy was performed [7].
  4. Blood Work: A copy of your most recent labs, specifically looking for your LDH (Lactate Dehydrogenase) levels, which are vital for staging [12].

Assessing Expertise

Not all oncologists specialize in every type of lymphoma. For rare or complex subtypes, like Mantle Cell Lymphoma (MCL) or T-cell Lymphoma, you want a physician who understands the latest molecular drivers of that specific disease [13][14].

  • For MCL: Ask if they use specialized prognostic tools like the MIPI score or testing for the TP53 mutation, which can change the choice of therapy [13][15].
  • For T-cell: Ask if they have experience with specialized regimens like Brentuximab Vedotin or advanced interventions like allogeneic transplantation [16][17].
  • For All Subtypes: Ask if your case will be discussed at a Tumor Board—a meeting where a panel of various specialists reviews individual patient cases to reach a consensus on the best treatment path [18][17].

Common questions in this guide

Who should be on my Non-Hodgkin lymphoma care team?
Your core team should be led by a hematologist-oncologist and include a hematopathologist, radiation oncologist, oncology nurse navigator, and an oncology social worker to help coordinate your care.
What medical records should I bring to my first oncology appointment?
You should bring physical copies of your full pathology report, operative notes, recent blood work including LDH levels, and your imaging scans in DICOM format on a disc or flash drive.
How do I transfer my biopsy slides for a second opinion?
Because of strict chain-of-custody rules, you usually cannot transport biopsy slides yourself. You need to provide your new doctor's office with the information of the original lab so they can request the physical glass slides directly.
What is a lymphoma tumor board?
A tumor board is a meeting where a panel of various specialists, including oncologists and pathologists, reviews your individual case to reach a consensus on the best treatment plan.
Why is a hematopathologist important for NHL diagnosis?
A hematopathologist works in the lab to accurately sub-classify your specific type of lymphoma. Since there are over 60 subtypes of NHL, this precise diagnosis is critical for determining the right treatment plan.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.How many patients with my specific NHL subtype (e.g., Mantle Cell, T-cell, or Follicular) do you treat each year?
  2. 2.Does this center have a dedicated 'Lymphoma Tumor Board' where my case will be reviewed by multiple experts, including a specialized hematopathologist?
  3. 3.Are there any ongoing clinical trials for my specific subtype and stage available at this institution?
  4. 4.If my lymphoma is aggressive, what is your facility's experience with intensive therapies like CAR-T or stem cell transplantation?
  5. 5.Who will be my primary point of contact (like a nurse navigator) for questions between appointments?

Questions For You

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References

References (18)
  1. 1

    Case Report: Epididymal NK/T-cell lymphoma and adrenal diffuse large B-cell lymphoma are misdiagnosed as tuberculosis: two case reports and literature review.

    Ye D, Liu X, Yang Y, et al.

    Frontiers in oncology 2025; (15()):1529049 doi:10.3389/fonc.2025.1529049.

    PMID: 40530019
  2. 2

    Non-Hodgkin lymphoma in Southern Africa: review of 487 cases from The International Non-Hodgkin Lymphoma Classification Project.

    Perry AM, Perner Y, Diebold J, et al.

    British journal of haematology 2016; (172(5)):716-23 doi:10.1111/bjh.13885.

    PMID: 26898194
  3. 3

    The application of antigen receptor gene rearrangement of BIOMED-2 in the pathologic diagnosis of 348 cases with non-Hodgkin lymphoma in a single institution in Southwest of China.

    Liu X, He H, Li Y, et al.

    Pathology, research and practice 2019; (215(11)):152615 doi:10.1016/j.prp.2019.152615.

    PMID: 31562020
  4. 4

    Diffuse large B-cell lymphoma: 2019 update on diagnosis, risk stratification, and treatment.

    Liu Y, Barta SK

    American journal of hematology 2019; (94(5)):604-616 doi:10.1002/ajh.25460.

    PMID: 30859597
  5. 5

    Acquired hemophilia A and delta storage pool deficiency in a patient with indolent non-Hodgkin lymphoma.

    Rossio R, Cassin R, Lecchi A, et al.

    Platelets 2022; (33(1)):168-170 doi:10.1080/09537104.2020.1869928.

    PMID: 33426985
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    Pathogenesis and management of immune dysfunction secondary to B cell haematological malignancies.

    Crassini K, Gibson J

    Internal medicine journal 2024; (54(1)):16-25 doi:10.1111/imj.16279.

    PMID: 38066723
  7. 7

    Rituximab combined with GDP regimen can effectively improve the efficacy and immune function of non-Hodgkin lymphoma.

    Song C, Feng Y, Ge F, et al.

    American journal of translational research 2022; (14(9)):6313-6322.

    PMID: 36247246
  8. 8

    Primary non-Hodgkin lymphoma of the extra-hepatic bile duct: A case report.

    Pararas N, Foukas PG, Pikoulis A, et al.

    Molecular and clinical oncology 2022; (17(1)):115 doi:10.3892/mco.2022.2548.

    PMID: 35747593
  9. 9

    Non-Hodgkin lymphoma.

    Armitage JO, Gascoyne RD, Lunning MA, Cavalli F

    Lancet (London, England) 2017; (390(10091)):298-310 doi:10.1016/S0140-6736(16)32407-2.

    PMID: 28153383
  10. 10

    PET/CT in Non-Hodgkin Lymphoma: An Update.

    Zanoni L, Bezzi D, Nanni C, et al.

    Seminars in nuclear medicine 2023; (53(3)):320-351 doi:10.1053/j.semnuclmed.2022.11.001.

    PMID: 36522191
  11. 11

    Baseline PET/CT imaging parameters for prediction of treatment outcome in Hodgkin and diffuse large B cell lymphoma: a systematic review.

    Frood R, Burton C, Tsoumpas C, et al.

    European journal of nuclear medicine and molecular imaging 2021; (48(10)):3198-3220 doi:10.1007/s00259-021-05233-2.

    PMID: 33604689
  12. 12

    Lymphoma of the female genital tract: a clinicopatholngical analysis of 25 cases.

    Wang J, Zeng L, Chen S, et al.

    American journal of translational research 2019; (11(9)):5800-5811.

    PMID: 31632549
  13. 13

    Efficacy of venetoclax monotherapy in patients with relapsed, refractory mantle cell lymphoma after Bruton tyrosine kinase inhibitor therapy.

    Eyre TA, Walter HS, Iyengar S, et al.

    Haematologica 2019; (104(2)):e68-e71 doi:10.3324/haematol.2018.198812.

    PMID: 30190341
  14. 14

    Aggressive T-cell lymphomas: 2024: Updates on diagnosis, risk stratification, and management.

    Ong SY, Zain JM

    American journal of hematology 2024; (99(3)):439-456 doi:10.1002/ajh.27165.

    PMID: 38304959
  15. 15

    Lenalidomide plus bendamustine-rituximab does not overcome the adverse impact of TP53 mutations in mantle cell lymphoma.

    Eskelund CW, Albertsson-Lindblad A, Kolstad A, et al.

    Haematologica 2018; (103(11)):e541-e543 doi:10.3324/haematol.2018.194399.

    PMID: 29794145
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    Dose-adjusted EPOCH chemotherapy for untreated peripheral T-cell lymphomas: a multicenter phase II trial of West-JHOG PTCL0707.

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    Haematologica 2017; (102(12)):2097-2103 doi:10.3324/haematol.2017.167742.

    PMID: 28971899
  17. 17

    Allogeneic haematopoietic cell transplant in cutaneous T-cell lymphomas: Recommendations from the EBMT PH&G Committee.

    Damaj G, de Masson A, Dreger P, et al.

    Journal of the European Academy of Dermatology and Venereology : JEADV 2025; doi:10.1111/jdv.70042.

    PMID: 41031482
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    Tackling Mantle Cell Lymphoma in Europe.

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    PMID: 36141294

This page is for informational purposes only and does not replace professional medical advice. Always consult your healthcare provider or oncology team about your specific situation.

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