Choosing a DLBCL Care Team: Compare Pathology Review, Treatment Plans, and Emergency Care First

After a diagnosis of diffuse large B-cell lymphoma (DLBCL), tell hospitals whether you need a second pathology opinion, an initial treatment assessment, or reassessment after treatment. Send the same medical summary to the hospitals you are considering, then compare the receiving departments, how soon you can be seen, and follow-up care. DLBCL grows quickly. Your current hematologist should first assess whether you can wait for a consultation abroad and how you should be treated while waiting.[1]

Key points

• A hospital’s reply that it “can see lymphoma patients” is only a starting point. Confirm the specific team, campus, and questions this visit can address.
• Pathology review, infusion treatment, and relapse assessment require different records and teams. Start with questions that match your current stage of care.
• Before booking travel, clarify treatment intervals, which emergency department to use for fever, the cost range, and who will take over after you return home. Mark anything without a clear answer as “to be confirmed.”

Decide What You Need This Visit to Address

Your situation	What to confirm with the hospital first
You have just been diagnosed and have not started treatment	Which hematology or lymphoma team will review the pathology, staging, and your overall health together and recommend initial treatment? When can you expect to see a doctor?
Two pathology opinions disagree	Can a pathologist experienced in lymphoma review the findings? Are the original slides, tissue blocks, or other materials needed, and who will explain the results?
You have questions during treatment or after completing treatment	Can the doctor review the original images from before treatment and now, along with complete medication and response records, and explain the next assessment steps?
The disease has relapsed or treatment has not worked as expected	Can the team assess which further options are appropriate to discuss, including referral for transplantation, CAR-T, other medicines, or trials when needed? If the hospital cannot provide them, who will it refer you to?

The clinical team needs to consider tissue pathology and staging information together. PET can be used for initial staging and assessment after treatment. Doctors should decide how to interpret imaging results and whether further sampling is needed based on your circumstances.[1] The Pathology Review Guide explains how to borrow tissue materials; the Initial Treatment and Response Assessment Guide explains questions to ask during treatment.

Send the Same Table to Each Hospital

You can copy the items below and send them to two or more hospitals. Record the reply date and the person responding, and keep marking unanswered items as “to be confirmed.”

Item to compare	Questions for the hospital	Hospital A / Hospital B
Acceptance for care	Do you accept international patients? Is this a remote records review, an outpatient visit, or a possible hospital admission? Which department is responsible for the medical opinion?
Location	At which campus will consultations, tests, treatment, and emergency care each take place?
Records and materials	Which languages and formats do you accept? Who receives original imaging files (DICOM), slides, or tissue blocks, and how will you confirm everything has arrived?
Timing	What is the earliest assessment date, when are pathology and imaging reports expected, and how will the next appointment be arranged? Who will notify me if results are delayed?
Ongoing care	Who arranges infusions, blood count checks, and any necessary transfusions or hospital admissions? Who will you refer me to if your hospital cannot provide them?
Emergencies	Who should I contact at night or on weekends? Which emergency department should I use for fever or a worsening condition, and can it receive my current treatment records?
Costs and communication	Which tests, medicines, hospital beds, interpreting services, and follow-up checks does the estimate cover? What are the terms for deposits, cancellations or postponements, complications, and refunds? If cell manufacturing fails, how will charges be settled?
Returning home	How can I obtain the discharge summary, medication administration records, and imaging? Who will track pending results, and who will hand over care to my local doctor?

Information from Shanghai Jiao Tong University School of Medicine describes Ruijin Hospital’s Clinical Medical Center for Blood Diseases and lists its address as 197 Ruijin Second Road. This can be a starting point for inquiries.[2] It does not mean that your outpatient visits, treatment, and emergency care will all take place at that address: the hospital has multiple campuses, so check each location in your appointment confirmation. The hospital must confirm your eligibility for care, bed availability, medicines, and personal costs.

Ask Additional Questions for Your Treatment Stage

If you need a pathology review: Ask the receiving team which original materials are required, whether previous test results are acceptable, and how long additional testing and the written report are expected to take. Confirm borrowing and return arrangements with the original hospital. Sending materials for testing does not mean the hospital has accepted you for treatment. NCI recommends that biopsy specimens from another hospital be reviewed by a hematopathologist experienced in diagnosing lymphoma.[1] If the original report mentions MYC or BCL2, ask whether protein staining and genetic tests such as FISH have been completed, which results are still pending, and who will explain their effect on the diagnosis. The pathology team should decide whether additional testing is needed.

If you are preparing for initial treatment: Ask how the team will arrange pathology and staging assessments, the first treatment, later cycles, blood tests, and response assessments, and whether other specialists need to be involved. If only one consultation can be arranged, first establish which hospital will manage later cycles. If you plan to have children, ask before treatment whether a timely referral for fertility counseling is possible. If you have difficulty eating, pain, or emotional distress, you can also ask about nutrition, pain management, or psychological support. Your treating doctor will decide the drug combination, number of cycles, and need for radiotherapy based on your circumstances.

If you need assessment for later treatment options: Provide every previous medicine and its start and end dates, your best response, the timing of relapse, and any serious side effects. Clarify which options the hospital can assess or provide, referral requirements, and who will care for you while you wait. If CAR-T—a treatment using modified immune cells—is discussed, ask who is responsible for care during cell collection, manufacturing, and infusion. Ask where you will be monitored after infusion for cytokine release syndrome, changes in awareness or speech, infection, and low blood cell counts, and how to obtain emergency and intensive care support if problems occur. Also ask about caregiver requirements, how close your accommodation must be to the hospital, and when you can travel home. Requirements may differ by product and patient; the treatment team should explain them.[4][5] Being offered an assessment does not mean you already meet treatment or trial eligibility requirements.[1]

If bispecific antibodies are discussed, ask the hospital where the specific medicine’s initial step-up doses will be given, which doses require hospital admission or outpatient observation afterward, when reassessment will take place, and how to obtain urgent treatment for fever, low blood pressure, or changes in awareness or speech. Also ask about infection and blood count monitoring, whom to contact on days off, and whether later doses can be given where you live. Observation requirements may vary by bispecific antibody and individual circumstances. The receiving team should explain them according to the specific product and local requirements.[6]

If the hospital recommends radiotherapy, ask how the hematology, imaging, and radiotherapy teams will jointly review images from before and after treatment, and where follow-up assessments will take place. If a clinical trial is mentioned, request the study number, current recruitment status, costs, and official contact person. The research team must screen you to determine whether you can enroll. Before deciding, also clarify your routine treatment options, who will be responsible for your care if you do not pass screening or withdraw, and who will pay for additional tests and subsequent treatment.[7]

Send Your Records and Confirm the Hospital Can Open Them

First prepare a one-page medical summary: diagnosis date, current symptoms, most recent treatment date, previous regimens and responses, current medicines, and the main question you want addressed. Attach pathology reports and supplementary reports, recent laboratory results, imaging reports from before and after treatment, and the original images. Before arranging to borrow slides or tissue blocks, ask both hospitals how the materials should be transferred.

Before sending anything, ask the receiving team about approved secure channels, translation requirements, and file size limits. After sending, ask them to confirm that the files can be opened, what is still missing, and who has received them. Do not book flights based only on a successful upload. Agree with your current treating doctor who will manage ongoing treatment and symptoms if new reports do not arrive in time or the appointment is postponed.

Confirm Scheduling and Emergency Arrangements Before Arrival

First ask your current doctor whether travel and waiting are appropriate. If your condition worsens, you have difficulty breathing, or you develop bleeding that cannot be controlled, seek care immediately at a local emergency department. Do not wait for an appointment abroad. Before treatment, ask the team to provide written instructions on when to seek help for fever, daytime and nighttime contact numbers, and the designated emergency department. If you develop fever, chills, or other signs of infection during treatment, contact the treatment team or seek medical care immediately. If you have not received instructions or cannot reach the team, go immediately to a local emergency department; do not wait for a reply. For emergencies such as severe difficulty breathing, contact local emergency services directly. NCI lists a temperature of 38°C or higher as one warning sign of infection. Even below this temperature, seek help immediately if you have chills or other signs of infection.[3]

In the written appointment confirmation, check the purpose of each visit, the campus, the provisional order of tests, expected waiting times, and the cost range. When choosing accommodation, consider actual transport from where you will stay to the treatment location and designated emergency department. If there is a delay, first ask the treatment team whether it is medically acceptable to wait and who will adjust the arrangements, then change flights or accommodation.

Before leaving, ask the receiving doctor to provide your diagnosis, treatment timeline, medicines and doses, test results, unresolved problems, and the next follow-up plan. Confirm whether the doctor where you live will take over care, and how prescriptions and tests will be coordinated. For pending reports, list the person responsible for tracking them and how you should expect to receive the results.

Frequently Asked Questions

If a hospital can only review reports remotely, does that mean it has accepted me for treatment?

No. Confirm acceptance separately for a remote opinion, an in-person outpatient visit, and inpatient treatment. Each step may still depend on records, bed availability, and medical assessment.

Will I definitely need another biopsy?

Not necessarily. Ask the pathology team first whether the existing slides and tissue can answer the questions. The clinical team will decide whether another biopsy is needed based on your circumstances.

Can I apply with only photos of the pathology report?

You can first ask whether the hospital accepts photos for initial screening, but photos may not be enough for a pathology review. Ask for a list of the reports, slides, or tissue materials still needed and how to submit them.

If a hospital needs to send tests elsewhere, should I rule it out?

Sending tests elsewhere does not by itself determine whether a hospital is suitable. Ask who manages the samples, when results are expected, how you will be notified of delays, and who will review and explain the results together.

If CAR-T is mentioned, do I definitely need a hospital that provides it?

Not necessarily. First ask the hematology team whether an assessment is worthwhile, then ask who will be responsible for assessment, treatment, and any complications. A hospital’s ability to provide the treatment does not mean it is suitable for everyone.

Can a family member replace a medical interpreter?

First ask whether the hospital provides medical interpreting and how much it costs. Important treatment choices and informed consent require accurate understanding. If a family member helps, you can still ask the clinical team to check that the patient understands the key information.

Does a lower quote mean a lower total cost?

You cannot judge this directly. First check whether both quotes cover the same tests, medicines, medication administration, hospital beds, and follow-up checks. Ask how complications, additional tests, deposits, and refunds are handled.

Can the original hospital remain responsible after I return home?

Ask both teams first. Clarify whether the doctor where you live will take over care, which follow-up checks can be done locally, and how the receiving team in China will provide records and respond to unfinished matters.

Sources

1. US National Cancer Institute: Aggressive B-Cell Non-Hodgkin Lymphoma Treatment (Health Professional Version), checked 2026-11-06.

2. Shanghai Jiao Tong University School of Medicine: Shanghai Clinical Medical Center for Blood Diseases (Ruijin), checked 2026-11-06; the institutional profile does not represent a current commitment to accept an individual patient.

3. US National Cancer Institute: Infection and Neutropenia During Cancer Treatment, checked 2026-11-06.

4. US National Cancer Institute: CAR T-Cell Therapy and Side Effects, checked 2026-11-06.

5. US National Cancer Institute: Low Blood Cell Counts and Other Side Effects of CAR T Therapy, checked 2026-11-06; this article concerns a myeloma product. The receiving team must explain the details for the specific product.

6. US FDA: Safety Information on Epcoritamab for Certain Relapsed or Refractory DLBCL, checked 2026-11-06; this is information about a specific product in the United States. It does not establish approval or medicine availability in China, or observation requirements for all bispecific antibodies.

7. US National Cancer Institute: What to Expect When Taking Part in a Clinical Trial, checked 2026-11-06; the research team must confirm costs for the specific trial and arrangements after withdrawal.