Non-Hodgkin's Lymphoma - Screening & Diagnosis

Your doctor will inquire about your symptoms and medical history. A physical exam will be conducted, in which your doctor will pay special attention to your lymph nodes. Most enlarged or swollen lymph nodes result from an infection. If infection is suspected, you may be given medication. If swelling persists, your doctor may order more tests to determine whether there is cancer and what type of cancer is present.

Tests may include the following:

• Excisional or incisional biopsy: During this procedure, the entire lymph node (excisional) or part of the tumor (incisional) is removed for further examination in the lab.
• Fine needle aspiration (FNA) biopsy: During this test, a sample of tissue from the tumor is removed with a needle for closer examination in the lab.
• Bone marrow aspiration and biopsy:  A small amount of bone marrow (aspiration) and bone are removed during this procedure for further examination. The bone marrow and bone that are removed in this procedure are often used to determine the extent of lymphoma.
• Spinal tap: A spinal tap is a procedure in which a small amount of cerebrospinal fluid is removed and examined. This test is often used to determine the extent of lymphoma.
• Immunohistochemistry: Antibodies are used to distinguish between different types of non-Hodgkin’s lymphomas.
•  Flow cytometry: Biopsy samples are treated with fluorescent antibodies and exposed to a laser beam to determine the cause of lymph node swelling and/or determine the exact type of non-Hodgkin’s lymphoma.
• Cytogenetics and/or molecular genetic studies: DNA in a lymphoma cell is examined for abnormalities.
• Blood tests: Blood tests are used to help determine the advancement of the lymphoma.
• Chest X-ray: During this type of X-ray, pictures of structures inside the chest are taken to determine if lymph nodes are enlarged.
• Computed tomography (CT) scan: Pictures are taken of structures inside the body to look for lymphomas in the abdomen, head, pelvic, chest and neck.
• Magnetic resonance imaging (MRI) scan: This exam utilizes magnetic waves to create pictures of structures inside the brain and spinal cord.
• Positron emission tomography (PET): Radioactive solution is injected into a vein which enables a special camera to look for lymphoma throughout your body and/or determine if an enlarged lymph node contains lymphoma.
• Gallium scan: During this procedure, radioactive solution is injected into a vein to enable a special camera to detect non-Hodgkin’s lymphoma in bones and other organs. This test is useful in finding tumors that may be missed by a PET scan.
• Bone scan: During a bone scan, a radioactive solution is injected and travels to damaged parts of the bone.
• Ultrasound: During an ultrasound examination, sound waves are used to examine internal organs and locate masses.

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