These Tests Can Determine Non-Hodgkin's Lymphoma

by Katherine Malmo Health Writer

One of every 47 of Americans will be diagnosed with non-Hodgkin’s lymphoma during their lifetime. This risk may be greater for people who have had other cancers, smoke, or have a family history of lymphoma. How will your doctor learn if you have this cancer type or if it has advanced? Here are the testing types you might undergo.

Doctor checking lymph nodes during exam.

Your doctor will likely do a medical exam

If doctors suspect lymphoma, they will conduct a medical examination to look for signs such as swollen lymph nodes or an enlarged spleen. They’re also likely to ask you about other symptoms. Do you have night sweats or fevers? Your doctor will want to know because these can be indications of the cancer type.

Lymph node biopsy concept.

Biopsy: Removing tissue to look for cancerous cells

During a biopsy, tissue is removed and inspected for cancerous cells. The doctor may take part or all of a lymph node. If the node is near the skin, the procedure is simpler and may only require local anesthesia. If the node is deeper, it may require surgery. Or, the doctor may choose to do a fine needle aspiration or a core needle biopsy. In both of these procedures, a needle is inserted into the node to remove tissue for a pathologist to examine.

Blood vial labeled for CBC test.

Blood test can help doctors determine how advanced lymphoma is

Once non-Hodgkin’s lymphoma is diagnosed, a simple blood draw, where a phlebotomist inserts a needle into your vein, may help determine the extent of the disease. A complete blood count (CBC) measures the levels of different cells in the blood. Blood chemistry tests can also provide information on how the kidney and liver are functioning.

Bone marrow aspiration/biopsy concept.

Bone marrow aspiration and biopsy performed following diagnosis

These tests are done after diagnosis and often at the same time. They determine the extent of disease and if the cancer cells have reached the bone marrow. For the aspiration, the doctor numbs the surface of the backside of your hip, a hollow needle is inserted into the bone, and a small marrow sample is removed. During the bone marrow biopsy, a small piece of the bone is removed. Both of these procedures can cause brief pain.

Doctor examining chest x-ray.

Chest X-ray can help doctors stage non-Hodgkin’s lymphoma

X-rays provide images of the bones, organs, and tissue. These images, and the other scans, help identify causes of certain symptoms, determine the stage of the disease, help show if treatment is working, and watch for signs of recurrence. For the test, you’re asked to lie still on a stationary table while a technician positions a camera to capture images.

Radiologist viewing CT scan.

CT scan helps show how much cancer has spread

A CT scan uses X-ray images taken at different angles to create a 3D view of an area. Before the scan, you’re given an oral or intravenous contrast dye that improves the quality of the image. A CT machine is shaped like a large donut on its side, and you’re asked to lie on an adjacent table that slides into the center of the scanner while pictures are taken. This type of scan can help determine how much your cancer has spread.

Doctor talking with patient before MRI

MRI scan often done when doctors suspect advance of disease

As with a CT scan, you’re given a contrast dye with an MRI scan. Then radio waves and magnetic fields are used to create detailed images of the body’s soft tissues. Usually, MRIs are used for lymphoma patients when the doctor is concerned about spread of the disease to the spinal cord or brain. Patients are asked to lie on a table that moves inside a donut-shaped machine. The MRI machine also makes a loud noise, and patients are often provided with earphones to listen to music.

PET scan instrument.

PET scans can also show how much cancer has spread

For this test, patients are injected with a small amount of radioactive sugar that is taken up by cancer cells. The scanner images show the areas where this substance is concentrated in tumors. Like the CT scanner, the PET scan machine is shaped like a donut on its side and the table slides into the center. It does not make the loud noise like an MRI machine. These images are not as detailed as CT scans or MRI’s, but they can identify how far the disease has spread.

Doppler echocardiogram of heart.

Other tests are possible, too

These are the most common tests used to diagnose lymphoma. Sometimes bone scans are done if the patient is having bone pain. And echocardiogram, multigated acquisition (MUGA) scan, or pulmonary function tests are often requested for patients who require chemotherapy and may be at risk for heart or lung problems.

Katherine Malmo
Meet Our Writer
Katherine Malmo

Katherine Malmo is a freelance writer and author who was diagnosed with inflammatory breast cancer 13 years ago. Her memoir, “Who in This Room: The Realities of Cancer, Fish, and Demolition,” was published in 2011 and a finalist for the Washington State Book Award. These days, she lives in Seattle and writes mostly about cancer and advances in cancer treatments.