Further tests for Hodgkin lymphoma
This page tells you about the tests you may have after your doctor has diagnosed Hodgkin lymphoma (or Hodgkin's disease, as it used to be called). There is information about
Further tests for Hodgkin lymphoma
If Hodgkin lymphoma cells are found in your lymph node biopsy, you will need to have other tests to find out if there is lymphoma in other areas of your body. You may have
- Blood tests
- A chest X-ray
- Scans (CT, MRI, PET, PET-CT or ultrasound)
- A bone marrow test
- Other tests, depending on your symptoms
After the tests
Your doctor will ask you to go back to the hospital when your test results have come through. This is bound to take a little time, even if only a day or two. It is a very anxious time for most people. 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. You can find out about counselling in our coping with cancer section.
You can view and print the quick guides for all the pages in the Diagnosing Hodgkin lymphoma section.
If Hodgkin lymphoma cells are found in your biopsy you will need to have other tests to find out whether there is lymphoma in any other areas of your body. Your doctor may ask you to have some of the tests mentioned below. You may have some of these tests again during your treatment, to find out how well the treatment is working. As you will probably have to wait around at the hospital when you are having these tests it is a good idea to take something with you to pass the time.
You will have regular blood tests throughout your treatment. Mostly, this will be to check your blood count. But your doctor can also use blood tests to check how well your liver and kidneys are working. Your doctor will probably also do blood tests called
- Serum albumin level
- ESR (erythrocyte sedimentation rate)
- LDH (lactic dehydrogenase)
- Screening for hepatitis and HIV (human immunodeficiency virus)
These tests are used as prognostic factors. This means they may indicate how you will respond to treatment. So they are used to help work out how much treatment you are likely to need for a particular stage of Hodgkin lymphoma.
You may have a chest X-ray to look for enlarged lymph nodes in your chest. In Hodgkin lymphoma, it is quite common to have very enlarged lymph nodes in the middle of your chest, in an area called the mediastinum.
Finding enlarged lymph nodes helps your doctor to decide what treatment you should have. A chest X-ray can also show if there is any fluid collecting around the lung. This is called a pleural effusion. It is a rare symptom in Hodgkin lymphoma, but it can happen.
A PET-CT scan is a combination of a PET scan and a CT scan. It takes CT pictures of the structures of your body. At the same time, a mildly radioactive drug shows up areas of your body where the cells are more active than normal. The scanner combines both of these types of information. This allows your doctor to see any changes in the activity of cells and know exactly where the changes are happening. PET-CT scans can also be used during or after your treatment. There is more information about PET-CT scans in the cancer tests section.
CT scans can show up enlarged lymph nodes in the body. If you have already had a CT scan as part of your tests to diagnose Hodgkin lymphoma you won't need to have another one. But if your lymphoma was diagnosed by biopsy you may need to have a CT scan to see whether you have enlarged lymph glands in other parts of the body. CT scanners take a series of X-rays of part of your body and feed them into a computer to make a detailed picture. You may be asked to drink a liquid called a contrast medium before the scan. This helps to make the gut show up more clearly. But it may cause diarrhoea afterwards. There is more about having a CT scan in the cancer tests section.
Your doctor might suggest a PET scan to try to tell whether an enlarged lymph node is scar tissue or lymphoma. A lymph node can sometimes be enlarged because of past infections. For a PET scan you have an injection into a vein of a mildly radioactive substance. Cells that are active take up the radioactivity and show up on the scan. Lymph nodes that are swollen due to past infections are not active and do not show up on the scan. Lymphoma cells do take up the radioactivity.
PET scans are also sometimes used during or after lymphoma treatment. If it looks as though there are still enlarged nodes after your treatment, a PET scan may be able to show whether this is left over scar tissue or whether there are still live lymphoma cells there. There is information about having a PET scan in the cancer tests section.
MRI scans use magnetism to build up a picture. They can also pick out enlarged lymph nodes anywhere in the body. MRI scans are particularly good at showing up the soft tissues of the body and are also good for showing up the brain and central nervous system. You cannot have an MRI if there is any metal in your body. So make sure your doctor knows if you have had joint replacement surgery, have a pacemaker or know of any other metal in your body. There is more about having an MRI scan in the cancer tests section.
About 1 in 25 people with Hodgkin lymphoma have cancer in their bone marrow when they are diagnosed. It is important to know if Hodgkin lymphoma cells are in your bone marrow as this affects the treatment that you may need. A PET/CT scan can detect cancer in the bone marrow. But if you were unable to have a PET/CT scan, then you will need a bone marrow test.
You usually have the test under local anaesthetic. Children can have a general anaesthetic if necessary. The test can be uncomfortable, or even painful, for a minute or two. For more information about having a bone marrow test look at our cancer tests section.
You may have other tests that are not mentioned here. The exact tests will vary from one person to another depending on their symptoms and exact medical situation. For example, you may have an X-ray of your urinary system (urogram), if you have urinary symptoms.
You will be asked to go back to the hospital when your test results have come through. But this is bound to take a little time, at least a day or two, but usually longer. 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.
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