Tests to help diagnose Non-Hodgkin Lymphoma
Physical exam and history: The health care provider will check general signs of health, assess for any lumps or anything else that seems unusual. They will also get history of past illnesses, health habits and any family
history of illness or cancer.
CT scan: A computer assisted X-ray that shows detailed pictures inside the body, such as neck, chest, abdomen and pelvis. A dye may be injected into a vein or swallowed to help the organ and tissues show up more clearly.
PET scan (positron emission tomography): An X-ray that helps to show where the malignant tumor cells are in the body. A small amount of radioactive glucose (sugar) is injected into the vein. The scanner will then make pictures
where the glucose is being used in the body. Cancer cells show up brighter in the picture because they take up more glucose than normal cells. The PET scan has three steps:
Injection of radioactive glucose
A waiting period of 30-60 minutes
Scanning by the PET machine.
Chest X-ray: An X-ray of the organs and bones inside the chest.
CBC (complete blood count) checks the number of red blood cells (oxygen carriers), platelets (cells that help the blood clot properly) and white blood cells (infection fighters)
Sedimentation rate can help measure how much inflammation is in the body
Blood chemistry studies measures amounts of certain substances released into the blood by organs and tissues in the body
All these tests are usually done at time of diagnosis to rule out other diseases, and are also done throughout treatment to monitor response and to monitor for possible side effects of treatment.
A pathologist will look at the tissue under the microscope to look for cancer cells. Reed - Sternberg cells are common in classical Hodgkin lymphoma.
Bone marrow aspiration and biopsy: Sometimes done to help determine if the Hodgkin lymphoma cells are in the bone marrow, the blood producing factory in the body. A special needle is inserted into one of the bones (typically
the back of the hip bone) and a small amount of marrow (liquid part) is aspirated into a syringe. The biopsy includes taking a small piece of bone and sending it to lab for review. Since the procedure is uncomfortable most patients are given
pain medicine or sedated during procedure.
Lumbar puncture: This is a procedure done to collect a sample of cerebral spinal fluid from the spinal column. This procedure is typically done under sedation but can also be done awake with local anesthesia. The sample of
cerebral spinal fluid is checked for the presence of non-Hodgkin lymphoma cells.
Pleural or peritoneal fluid assessment: Sometimes non-Hodgkin lymphoma can spread to the thin membranes inside the pleural (chest) or peritoneal (abdomen) cavities, causing fluid to accumulate. Testing is done by inserting needle
through skin into the chest or abdomen and withdrawing small amount of fluid. Most patients are sedated for this. Sometimes this test is done in place of a tumor biopsy in some situations.