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Non-Hodgkin's lymphoma

How do doctors diagnose non-Hodgkin's lymphoma?

Non-Hodgkin's lymphoma is difficult to diagnose. It can be mistaken for many other diseases, including simple infections and other types of cancer.

To get a definite diagnosis, you will need a biopsy or surgery.

Source:
Theodossiou C, Schwarzenberger P.
Non-Hodgkin's lymphomas.
Clinical Obstetrics and Gynecology. 2002; 45: 820-829.

During a biopsy, doctors remove a small piece of tissue, for example, from your bone marrow or from a lump. They then look at it carefully for signs of cancer.
During surgery doctors usually remove a swollen

lymph nodes
Lymph nodes (also called glands) are small, bean-shaped lumps that you cannot usually see or easily feel. They are located in various parts of the body, such as the neck, armpit and groin. Lymph nodes filter the lymph fluid and remove unusual things, such as bacteria and cancer cells.

lymph node. Doctors then look at it under a microscope.

Source:
Theodossiou C, Schwarzenberger P.
Non-Hodgkin's lymphomas.
Clinical Obstetrics and Gynecology. 2002; 45: 820-829.

¹ See Surgery to test for non-Hodgkin's lymphoma for more.

Lymphoma is a complicated disease. Make sure your diagnosis is made by experienced doctors working in a hospital where lots of people with non-Hodgkin's lymphoma are treated.

Once you are diagnosed with non-Hodgkin's lymphoma, you will need lots of tests to find out if it has spread. This is called staging. Doctors need to know the stage of your lymphoma and the type before they can decide what treatment you need.

To learn more, see:

What your doctor might do

Before diagnosis

Your doctor will probably ask you lots of questions to try to find out what symptoms you have, how long you have had them, and whether they might be signs of lymphoma. Your doctor will also ask about other health problems that might affect your diagnosis or treatment. This will help the doctor to plan the best treatment for you.

Here are some questions you might be asked.

Source:
Theodossiou C, Schwarzenberger P.
Non-Hodgkin's lymphomas.
Clinical Obstetrics and Gynecology. 2002; 45: 820-829.

When did you first notice the swelling?
Have you noticed lumps or swellings anywhere else?
Does the swelling come and go or just get bigger?
Does it hurt?
Does it hurt anywhere else?
How are you feeling?
Do you get bad sweats at night? Bad enough to soak your night clothes or sheets?
Have you lost weight?
Do you have any medical problems, such as

diabetes
Diabetes is a condition that causes too much sugar to circulate in your blood. It happens when your body stops making a hormone called insulin (type 1 diabetes) or when insulin stops working (type 2 diabetes).

diabetes,

kidney
Your kidneys are organs that filter your blood to make urine. You have two of them, on either side of your abdominal cavity, toward your back.

kidney problems or

heart disease
You get heart disease when your heart isn't able to pump blood as well as it should. This can happen for a variety of reasons.

heart disease?
Have you noticed any other changes recently? For example, any change in your bowel movements? Are you getting more out of breath going up stairs? Have you been getting more headaches?

Your doctor will also examine you for lumps, swellings and other signs of non-Hodgkin's lymphoma. Your doctor will feel any lumps you have noticed, then look for signs of lymphoma in other parts of your body. He or she might:

Source:
Theodossiou C, Schwarzenberger P.
Non-Hodgkin's lymphomas.
Clinical Obstetrics and Gynecology. 2002; 45: 820-829.

Source:
Armitage J, Mauch PM, Harris NL.
Lymphomas.
In: DeVita V, Hellman S, Rosenberg S (editors). Cancer: Principles and Practice of Oncology. 6th edition. Lippincott Williams and Wilkins, New York, USA; 2001.

Look in your throat with a small flashlight
Examine your chest and listen to your breathing with a stethoscope
Feel your neck, armpits and groin area
Feel your

thyroid gland
Your thyroid gland is a small organ that sits in your neck, just in front of your windpipe. It sends out a hormone called thyroxine. This acts on receptors within cells. By acting on the receptors it gives the cells a message to speed up their metabolism and work harder.

thyroid gland (this is a small organ at the front of your neck)
Feel your abdomen for unusual lumps, a large

spleen
Your spleen is an organ that sits on the left side of your body just below your ribs. It helps your body fight infections.

spleen or a large

liver
Your liver is a large organ that sits on the right side of your body, just below your rib cage. It does several important things, including processing and storing nutrients from food, and breaking down chemicals, such as alcohol.

liver
Examine both your testicles if you are a man
Take a good look at your skin, especially any red or itchy areas.

If your doctor thinks you could have non-Hodgkin's lymphoma, he or she might send you for Surgery to test for non-Hodgkin's lymphoma.

After diagnosis

If you are diagnosed with non-Hodgkin's lymphoma, your doctor will probably do some tests to find out if your cancer has spread. Here are the kinds of tests you might have. Click on the links to read more.

Blood tests: These check your blood for different blood cells. They will also show how well your

liver
Your liver is a large organ that sits on the right side of your body, just below your rib cage. It does several important things, including processing and storing nutrients from food, and breaking down chemicals, such as alcohol.

liver, bone marrow and

kidney
Your kidneys are organs that filter your blood to make urine. You have two of them, on either side of your abdominal cavity, toward your back.

kidneys are working.

Source:
Theodossiou C, Schwarzenberger P.
Non-Hodgkin's lymphomas.
Clinical Obstetrics and Gynecology. 2002; 45: 820-829.

¹
Imaging tests: These tests take pictures of the inside of your body to look for non-Hodgkin's lymphomas.

Source:
Theodossiou C, Schwarzenberger P.
Non-Hodgkin's lymphomas.
Clinical Obstetrics and Gynecology. 2002; 45: 820-829.

¹

Source:
Mounter PJ, Lennard AL.
Management of non-Hodgkin's lymphomas.
Postgraduate Medical Journal. 1999; 75: 2-6.

³

Source:
CancerBACUP.
Further tests for non-Hodgkin lymphoma.
Available at http://www.cancerbacup.org.uk (accessed on 16 January 2008).

⁴
Surgical tests: You might need surgery to check some parts of your body for non-Hodgkin's lymphoma, such as your bone marrow.

Source:
Theodossiou C, Schwarzenberger P.
Non-Hodgkin's lymphomas.
Clinical Obstetrics and Gynecology. 2002; 45: 820-829.

¹

Source:
Mounter PJ, Lennard AL.
Management of non-Hodgkin's lymphomas.
Postgraduate Medical Journal. 1999; 75: 2-6.

³

Source:
CancerBACUP.
Further tests for non-Hodgkin lymphoma.
Available at http://www.cancerbacup.org.uk (accessed on 16 January 2008).

⁴

Waiting for the results of tests can make some people anxious. If the tests show that you have non-Hodgkin's lymphoma, your doctor will advise you on the best treatment. Many types of non-Hodgkin's lymphoma can be cured, even if the cancer has spread.

Sources for the information on this page:

Theodossiou C, Schwarzenberger P.Non-Hodgkin's lymphomas.Clinical Obstetrics and Gynecology. 2002; 45: 820-829.

Armitage J, Mauch PM, Harris NL.Lymphomas.In: DeVita V, Hellman S, Rosenberg S (editors). Cancer: Principles and Practice of Oncology. 6th edition. Lippincott Williams and Wilkins, New York, USA; 2001.

Mounter PJ, Lennard AL.Management of non-Hodgkin's lymphomas.Postgraduate Medical Journal. 1999; 75: 2-6.

CancerBACUP.Further tests for non-Hodgkin lymphoma.Available at http://www.cancerbacup.org.uk (accessed on 16 January 2008).

This information was last updated on Jan 08, 2009

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.

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