	<table summary="" class="data">
    <tr>
      <td class="left">ECOG:</td><td class="short">[0 - 4]</td>
      <td class="left">Hb:</td><td class="short">[g/dL]</td>
    </tr>
    <tr>
      <td class="left">BM biopsy:</td><td class="gray">[Y/N]</td>
      <td class="left">WBC:</td><td class="gray">[x10<sup>9</sup>/L]</td>
    </tr>
    <tr>
      <td class="left">Sweats:</td><td class="gray">[Y/N]</td>
      <td class="left">Lymphs:</td><td class="gray">[x10<sup>9</sup>/L]</td>
    </tr>
    <tr>
      <td class="left">Fever:</td><td class="gray">[Y/N]</td>
      <td class="left">Albumin:</td><td class="gray">[g/L]</td>
    </tr>
    <tr>
      <td class="left">Wt. loss:</td><td class="gray">[Y/N]</td>
      <td class="left">&beta;<sub>2</sub>m:</td><td class="gray">[mg/L]</td>
    </tr>
    <tr>
      <td class="left">CT Scan:</td><td class="gray">[Y/N]</td>
      <td class="left">LDH:</td><td class="gray">[range]</td>
    </tr>
    <tr>

  <!-- CLL gets Binet + platelets, rest get Ann-Arbour -->
  [% IF case.request_report.diagnosis.icdo3.match('9823/3') %]
    <td class="left">Binet:</td><td class="gray">[A, B, C]</td>
		<td class="left">Platelets:</td><td class="gray">[x10<sup>9</sup>/L]</td>
	[% ELSE %]
    <td class="left">Ann-Arbor:</td><td class="gray">[I - IV]</td>
		<td colspan="2">&nbsp;</td>
  [% END %]

	</tr>
    <tr>
      <td class="left">Paraprotein:</td><td class="gray">[range]</td>
      <td class="left">Paraprotein lvl:</td><td class="gray">[g/L]</td>
    </tr>
    <tr>
      <td class="left">PCV:</td><td class="gray">%</td>
      <td class="left">Neutrophils:</td><td class="gray">[x10<sup>9</sup>/L]</td>
    </tr>
    <tr>
      <td class="left">Monocytes:</td><td class="gray">[x10<sup>9</sup>/L]</td>
      <td class="left">Immunoglobulins:</td><td class="gray">[range]</td>
    </tr>
	</table>

    <h4>Comments:</h4>

	<div class="break-after"></div>

    [% # UNLESS case.request_report.diagnosis.diagnostic_category.description.match('T-lympho') %]
  <!-- nodal/extranodal involvement tables -->
  [% BLOCK patient_summary %]
 	<p class="pid">
        [% case.patient_case.patient.last_name  | upper %],
        [% case.patient_case.patient.first_name | ucfirst %] ::
        [% INCLUDE site/lab_number.tt data = case %] ::
        [% case.patient_case.referral_source.display_name %]
    </p>
  [% END %]

	[% INCLUDE patient_summary %]
	<h3>CT scan imaging data:</h3>
	<table class="data indent">
	  <tr>
		<td class="left">Date:</td><td></td>
	  </tr>
	  <tr>
		<td class="left">Sequence:</td><td class="gray">[ Initial / Follow-up ]</td>
	  </tr>
	</table>
	[% INCLUDE hmrn/data/collection/imaging.tt %]

	<div class="break-after"></div>

	[% INCLUDE patient_summary %]
	<h3>PET scan imaging data:</h3>
	<table class="data indent">
	  <tr>
		<td class="left">Date:</td><td></td>
		<td class="left">SUV<sub>max</sub>:</td><td></td>
	  </tr>
	  <tr>
		<td class="left">Sequence:</td><td class="gray">[ Initial / Follow-up ]</td>
		<td class="left">Deauville:</td><td class="gray">[ Follow-up only ]</td>
	  </tr>
	</table>
	[% INCLUDE hmrn/data/collection/imaging.tt %]

[% # END %]
