Non-Hodgkin's Lymphoma - Diagnosis

The Procedure. The doctor removes the node and checks the surrounding areas. The tissue in the node is then examined under a microscope for signs of infection and abnormalities indicating cancer or other conditions.

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Results. Even if biopsies do notshow any problems, disease may still be present in some cases. The doctor should continue to observe the patient until swelling or other signs of disease are gone. Biopsied tissue samples should be frozen in case special tests are later required. Such tests may include detection of particular antibodies, genetic and immune factors, and certain markers (substances that are indicative of disease) located on the surface of the cells. If lymphoma has been diagnosed, the tissue will be examined for its histology, the cellular structures that will determine the lymphoma type.

Bone Marrow Aspirate and Biopsy

Bone marrow aspirate and biopsy are routinely performed to determine whether the disease has spread. With bone marrow aspirate, bone marrow cells are sucked out through a special needle. A biopsy may be performed before or after the aspiration. In this procedure, a special needle removes a core of the marrow that is structurally intact.

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Imaging Techniques

Chest X-Ray. A chest x-ray shows the lymph nodes in the chest and neck area. It is particularly useful in detecting Hodgkin's disease and enlarged lymph nodes.

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Computer Tomography. Computed tomography (CT) scans are more accurate than x-rays. They can detect abnormalities in the chest and neck area, as well as revealing the extent of the cancer and whether it has spread. In one study, CT scans provided evidence of disease in 15% of sites that were considered normal on chest x-ray. A CT scan also is important in detecting lymphomas in the abdominal and pelvic areas if a chest x-ray is normal and lymphomas are still suspected.

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Lymphangiography. Lymphangiography is an x-ray of the lymph glands and vessels after injection of a dye. It provides additional information on lower parts of the body and is a good complement to CT scans if the latter does not reveal abnormal lymph nodes but they are still suspected. On its own, however, lymphangiography misses cancer in 20% of cases. There is a slight risk that the dye will affect the lungs, so this test should not be used in patients with severe lung disease. Lymphangiography is not commonly used for staging non-Hodgkin's lymphomas.