Tests for Hodgkin's lymphoma

If you are worried about an unexplained lump anywhere in your body, you are most likely to start by going to see your GP. Many people go to their GP with unexplained lumps in the neck, armpit or groin but most of them will not have Hodgkin's lymphoma (Hodgkin’s disease) or non Hodgkin's lymphoma (NHL).

As Hodgkin's lymphoma is rare and symptoms can be similar to other medical conditions, the National Institute for Health and Clinical Excellence (NICE) have produced referral guidelines for GPs to help them decide which patients need to be seen urgently by a specialist.

Your doctor will ask you about your health and examine you. You may have a blood test to check your general health. As most causes of enlarged glands are not serious, your doctor may suggest examining you again in a couple of weeks. Most enlarged glands will have gone down by then. Your doctor may give you a course of antibiotics if they think you could have a bacterial infection.

If the lymph glands stay enlarged with no other obvious cause, your GP may refer you to a hospital for tests. At the hospital the doctor will examine you again and ask you questions about any other illnesses you have had recently or in the past. You will probably have a chest X-ray and blood tests to check your general health and see how your liver and kidneys are working.

The only way to find out for sure why a lymph node is enlarged is to remove it and look at it under the microscope. This is called a lymph node biopsy. It is a small operation. If the lymph node is close to the surface of the body and is easy to remove you may have a local anaesthetic. The procedure may take place in the outpatient department or day surgery clinic. If the lymph node is deeper in the body you usually have the biopsy in hospital under a general anaesthetic. 

After the biopsy, you will have a few stitches where the doctor has removed the lymph node. The stitches will be covered by a dressing. You will usually be able to go home the same day, or as soon as you have recovered from the anaesthetic. You will probably have to go to your GP surgery to have your stitches removed, about a week to 10 days later.

If you have any other symptoms, apart from enlarged nodes in your neck, armpit or groin, your doctor may arrange for you to have a CT scan. This is a scan that takes a series of X-rays. The pictures feed into a computer and form a detailed picture of the inside of your body. You may have a CT scan of your chest, abdomen or pelvis. The scan shows up any lymph nodes affected by lymphoma. The scan technician or your doctor may ask you to drink a liquid called a contrast medium before the scan. The liquid makes the scan pictures clearer. For detailed information about having a CT scan, look at the cancer tests section of CancerHelp UK.

For most people, waiting for the biopsy result can be a very anxious time. It may take a week or so to come through. Do talk to your GP in the meantime if you are worried. Your result may be sent to your GP or you may be asked to go back to the hospital to an outpatient clinic.

If your tests show that you have Hodgkin's lymphoma you may need to have further tests to find out exactly which type and where it is in the body.