What tests might I have after being diagnosed?
After a diagnosis of non-Hodgkin lymphoma, you will likely have other tests. These tests help your healthcare providers learn more about your cancer. They can help show if the cancer has grown into nearby areas or spread to other parts of your body. The test results help your healthcare providers decide the best ways to treat the cancer. If you have any questions about these or other tests, talk with your healthcare team.
The tests you may have can include:
This test uses a small amount of radiation to create images of tissues inside your chest. It's used to look for swollen lymph nodes in your chest.
You may need a CT scan of your chest, belly (abdomen), pelvis, head, or neck. This test uses a series of X-rays from many angles. A computer puts the images together to make 1 detailed image.
You may need to drink a special X-ray dye (contrast medium) just before the scan. Or it may be injected into your blood through an IV (intravenous) line. The dye helps images show up more clearly on the X-rays. The dye often causes a warm feeling all over your body. Tell your healthcare provider if you are allergic to or have had a reaction to X-ray dye. A CT scan can show groups of lymph nodes, a swollen spleen, or abnormal growths in your liver.
An MRI uses large magnets and radio waves (instead of radiation) to take detailed pictures of the inside of your body. It's not commonly used. But an MRI can help show if the cancer has spread to your brain and spinal cord. Or it may be used if the results of an X-ray or CT scan aren’t clear.
For this test, you lie still on a table as it slides into a narrow tube-like scanner. If you're not comfortable in small spaces, you may be given a medicine to help you relax before the test. This is called a sedative. The scanner directs a beam of radio waves at the area that is being checked. You may need more than 1 set of images. Each one may take 2 to 15 minutes. This test may take an hour or more depending on the number of images needed.
A PET scan looks at your whole body. For this test, a radioactive sugar is put into your blood. Cancer cells use this sugar faster than normal cells do. So after about an hour it collects in cancer cells. A special camera is then used to see where the radioactive sugar is in your body.
Sometimes a PET scan can show lymphomas in different parts of the body, even when they can’t be seen with other tests. It can also show if lymphoma treatment is working. This test is often used along with a CT scan. This is called a PET/CT scan.
This test uses sound waves and a computer to create a picture of tissues inside your body. No radiation is used. You will lie on a table. A technician will move a probe (transducer) along your skin over part of your body. The echoes that bounce back are picked up and made into an image on a computer screen.
Your doctor may use an ultrasound to find swollen lymph nodes or enlarged organs (such as the liver or spleen) in your belly. The ultrasound can also show if your kidneys are swollen because urine outflow has become blocked by swollen lymph nodes.
Spinal tap (lumbar puncture)
A spinal tap can help find out if the lymphoma has spread to your spinal cord or brain. This test is not needed for most people with lymphoma. But it may be used with certain types of lymphoma. Or it may be used if you have symptoms that may mean the cancer has reached your brain.
For this test, a doctor puts a thin, hollow needle between the bones in your lower spine or back. This is done to take out some cerebrospinal fluid (CSF). This is the fluid that cushions and protects your brain and spinal cord. A doctor called a pathologist then tests the fluid to see if there are lymphoma cells in it.
Bone marrow aspiration and biopsy
Bone marrow is the soft, spongy, inner part of certain bones. Non-Hodgkin lymphoma can spread to the bone marrow. So your doctor may want to check a sample of the bone marrow for cancer cells.
To do this, a thick needle is used to take out small amounts of your liquid bone marrow. This is called aspiration. A small piece of the bone is also taken. This is the biopsy. The aspiration and biopsy is often done in the bone in the back of your hip (pelvic) bone. You lie on your stomach, curl up on your side, or sit and lean over a table for this test. You will be awake, but medicines will be used to make your skin and hip bone numb before the test is done.