Tests for Hodgkin lymphoma
You usually have several tests to check for Hodgkin lymphoma. This might include all or some of the following:
-
blood tests
-
taking samples of cells to test them for cancer (biopsies)
-
scans
Tests your GP might do
Most people start by seeing their GP. They can do some tests to help them decide whether you need a referral to a specialist. Depending on the symptoms, some people go to accident and emergency (A&E) first.
Tests your GP might do include:
- blood tests
- a
physical examination 
Blood tests
Blood tests can give you an idea of your general health and how your body is working.
Your GP can arrange blood tests to find out:
- the number of your
blood cells (full blood count) - how well your liver and kidneys are working
- if you have any signs of infection
Physical examination
Your GP will usually do a head to toe assessment. They will try to find the cause of your symptoms.
They will listen to your chest and tummy (abdomen) to find out if they sound normal. They will also feel your abdomen, neck and other areas where you have . This is to check if they are swollen or painful.
Tests your specialist might do
Depending on your symptoms and the results of your tests, your GP might refer you to a specialist. This is usually a doctor that treats blood conditions, called a haematologist.
Your specialist usually does more tests and repeats your blood tests.
The tests your specialist might do include:
-
PET-CT scan
-
lymph node biopsy
-
CT scan
-
blood tests
-
chest x-ray
-
bone marrow biopsy
PET-CT scan
A PET-CT scan combines a CT scan and a PET scan into one. It gives detailed information about your cancer. It can be used to measure the size of the lymph nodes and see if the Hodgkin lymphoma has spread to different areas of the body (staging). You usually have a PET-CT scan before starting treatment.
You will most likely also have PET-CT scans during treatment to check how well treatment is working. And that is often used to guide ongoing treatment. You usually have another PET-CT at the end of treatment to check how well the treatment has worked.
You have a PET-CT scan in the radiology or nuclear medicine department as an outpatient. It usually takes between 30 and 60 minutes.
These types of scans are usually only available in major cancer hospitals. So you might have to travel to another hospital to have one.
Lymph node biopsy
A lymph node biopsy is when your doctor removes all or part of a lymph node. This is the only way to find out for sure why a lymph node is swollen. This is the most important test in diagnosing Hodgkin lymphoma.
You usually have this test in the outpatient department with local anaesthetic. This means that you are awake and you have an injection to numb the area. If the lymph node is deeper in your body, you might need to have a general
Your doctor sends the sample to the laboratory to be looked at under a microscope. They check to see if a type of called B lymphocytes look abnormal.
People with Hodgkin lymphoma have abnormal types of B lymphocytes called Reed Sternberg cells.
Sometimes the biopsy doesn’t give enough information for your doctor to be certain of the diagnosis. If this happens you might need to have another biopsy.
CT scan
CT (or CAT) stands for computer (axial) tomography. It uses x-rays and a computer to create detailed pictures of the inside of your body. You might have a CT scan to help find out the cause of your symptoms. It can show swollen (enlarged) lymph nodes and whether the lymphoma has spread.
You usually have a type of dye called a contrast medium. This helps to make the scan clearer. You have this as a drink or as an injection through a small thin tube (cannula) into your arm.
You might not need a CT if you have already had a PET-CT scan.
Blood tests
Your specialist usually repeats the blood tests your GP has done to check your general health.
They might also want to check:
- how well your
thyroid is working - for infections such as HIV, hepatitis B or hepatitis C
- if you are pregnant
- if your red blood cells (erythrocytes) are sticking together (erythrocyte sedimentation rate or ESR)
Chest x-ray
An x-ray is a test that uses small amounts (doses) of radiation to take pictures of the inside of your body. They are a good way to look at bones and can show changes caused by cancer or other medical conditions. X-rays can also show changes in other parts of the body, such as the lungs.
In Hodgkin lymphoma, it is common to have enlarged lymph nodes in the middle of your chest. This is called the mediastinum.
Finding out about enlarged lymph nodes helps your doctor decide what treatment you need. A chest x-ray can also show if there is any fluid collecting around the lungs. This is called pleural effusion. It is a rare symptom in Hodgkin lymphoma. You might not need to have a chest x-ray if you already had a PET CT or CT scan.
You usually have x-rays in the imaging department of the hospital, taken by a radiographer.
Bone marrow biopsy
A bone marrow biopsy is a way of checking if there are any Hodgkin lymphoma cells in your bone marrow. Bone marrow is the spongy tissue and fluid inside your bones.
You don't usually need a bone marrow biopsy if you have had a PET-CT scan.
Other tests you may have
You may have other tests before starting treatment.
These include:
- an ultrasound of the heart (echo)
- lung function tests
Echo
An echocardiogram (echo) is an of the heart. It uses high frequency waves to create a picture of your heart. Doctors can look at the structure of your heart and see how well it is working.
Some cancer treatments can affect the heart, so you might need to have it checked before you have treatment.
You might have a test called a multigated acquisition (MUGA) instead. A MUGA looks at how well the heart pumps blood around your body. A doctor or radiographer injects a small amount of radioactive liquid into your vein. They then take pictures of your heart with a special camera. This shows the flow of blood in your heart.
Lung function tests
Lung function tests are breathing tests that show how well your lungs are working. They are sometimes called pulmonary function tests.
Some cancer drugs can change the way your lungs work. Your specialist may check that your lungs are healthy at the start, during and after treatment.
Treatments
The tests you have help your doctor find out if you have Hodgkin lymphoma and how far it has grown. This is the stage of the cancer.
This is important because doctors recommend your treatment according to the stage of the cancer.
Coping with Hodgkin lymphoma
Coping with a diagnosis of Hodgkin lymphoma can be difficult. There is help and support available to help you and your family.
