Further tests for non Hodgkin's lymphoma

If the lymph node you had biopsied contained lymphoma cells your doctor will want you to have more tests. These tests are to find out whether the lymphoma has spread. The doctors will need to know which parts of your body are affected.

There are many different tests you may have. Most people will be asked to have

• Blood tests
• CT scan
• PET scan
• Bone marrow test
• Ultrasound scan

These tests will be repeated every so often during your treatment to check how you are doing.

Blood tests

Throughout your treatment you will be asked to have blood tests. These are to check

• Blood cell levels
• How well your liver is working
• How well your kidneys are working
• Blood levels of substances such as calcium and proteins
• LDH

LDH stands for lactate dehydrogenase. This is a normal substance in the blood but it is at higher than normal levels in some types of cancer. 

CT scan

You may have a CT scan of your chest, abdomen or pelvis. This is a type of X-ray that takes pictures from different angles. These feed into a computer and form a detailed picture of the inside of your body. The scan shows up any lymph nodes affected by lymphoma. The scan technician or doctor may ask you to drink a liquid called contrast medium before the scan. The liquid makes the scan pictures of your gut clearer. But unfortunately, it may give you diarrhoea afterwards. For more information about having a CT scan, look at the cancer tests section of CancerHelp UK.

PET scan

PET scans are a newer type of scan. PET scans are not useful for all types of lymphoma. Your doctor can tell you more about this. But they are being used more frequently these days for people with high grade lymphoma. They are useful for staging lymphoma and seeing how well treatment has worked. They show the difference between tissues that are actively growing (like cancer) and an old injury or scar. A CT scan can show an enlarged lymph node. It may not be enlarged because of cancer, but with fibrous scar tissue from an infection. A PET scan can also show if any remaining lumps are lymphoma that has not responded to the treatment. There is more information about having a PET scan in the cancer tests section of CancerHelp UK.

Bone marrow test

This test is to see whether there are cancer cells in your bone marrow. The doctor removes a tiny sample of bone marrow cells to look at under a microscope. The test only takes a few minutes and you can have it as an outpatient. There is more about having a bone marrow test in the cancer tests section of CancerHelp UK.

Ultrasound scan

Ultrasound scans are useful for looking at individual organs such as the liver and kidneys. There is more about having an ultrasound scan in the cancer tests section of CancerHelp UK.

 As well as the tests above most people have one or two other tests. You may have any of these tests

• Lumbar puncture
• Endoscopy
• X-ray of the stomach and gullet
• MRI scan
• Intravenous urogram
• Bone scan

Lumbar puncture

Your doctor may ask you to have a test called a lumbar puncture. This is to see whether there are any lymphoma cells in your cerebrospinal fluid (CSF). The CSF is fluid that circulates around your brain and spinal cord. There is more about having a lumbar puncture in the cancer tests section of CancerHelp UK.

Endoscopy

This is a test to look inside the body. An endoscope is a long thin bendy tube with a camera and a light inside it. You can have an

• Endoscopy of the stomach and gullet (oesophagus)
• Endoscopy of the upper airways
• Endoscopy of your bowel and back passage (rectum)

For non Hodgkin's lymphoma you are most likely to have endoscopy of your gullet and stomach or upper airways. There is more about having an endoscopy in the cancer tests section of CancerHelp UK.

Endoscopy of the stomach and gullet (oesophagus)

The doctor puts the tube down your throat into your stomach. It is usually done while you are awake. But to make you comfortable you may have a local anaesthetic sprayed onto the back of your throat. You may also have a sedative and will probably not remember the test afterwards. 

The tube goes into your mouth and down your throat. The doctor examines the inside of your gullet and stomach. If necessary, the tube can look into your small bowel as well.

Endoscopy of the upper airways

This is often called a bronchoscopy. If you have enlarged lymph nodes in your chest, your doctor may want to look inside your airways using an endoscope. This test is usually done while you are awake. But to make you comfortable you may have local anaesthetic sprayed onto the back of your throat. You may also have a sedative beforehand and will probably not remember the test afterwards. The tube goes up your nose or into your mouth. The doctor looks at the inside of your airways and takes samples of tissue (biopsies) if necessary.

Endoscopy of your bowel and back passage (rectum)

Endoscopic tests of your bowel have different names depending on which part of the bowel is being looked at. A proctoscopy just looks at the back passage, a sigmoidoscopy looks at the lower part of the large bowel, and a colonoscopy looks at the whole of the large bowel. You shouldn't need a sedative for a proctoscopy or a sigmoidoscopy. But you will probably be offered sedation before a colonoscopy, because this is more uncomfortable. Your doctor will ask you to lie on your side and will pass a flexible tube into your back passage and up into your bowel. As the tube bends easily, it can pass around the curves in the bowel. The light inside the tube helps the doctor to see any problem areas or swelling. Your doctor can take photographs and biopsies of the bowel lining during the test. There is more detailed information about having these tests in our bowel cancer tests section.

X-ray of the stomach and gullet

Lymphoma can sometimes affect the stomach.Your doctor may want to do X-rays of your gullet (oesophagus) and stomach to see whether there is any lymphoma there. This test is called a barium meal. There is more about having a barium meal in the cancer tests section of CancerHelp UK.

MRI scan

These scans may be done to give the doctor a clearer idea of where the lymphoma is in your body. MRI scans can sometimes show up soft flesh more clearly than CT scans.

There is more about having an MRI scan in the cancer tests section of CancerHelp UK.

Intravenous urogram

This test looks at the bladder and kidneys, and the tubes that connect them. It is sometimes called an IVU or IVP (intravenous pyelogram). There is more about having a urogram in the cancer tests section of CancerHelp UK.

Bone scan

This test looks for NHL in the bones. You will only have this if you have bone pain. Go to the cancer tests section of CancerHelp UK for information about having a bone scan.

You will have to go back to the hospital when your test results have come through. But this is will take a little time, maybe a week or so. This is a very anxious time for most people. While you are waiting for results, it may help to talk to a close friend or relative about how you are feeling. Or you may want to contact a cancer support group to talk to someone who has been through similar experiences.

If you would like to talk to someone outside your own friends and family, look at our counselling organisations page. To find out more about counselling, look in the counselling section.