How Do You Test For Non-Hodgkin's Lymphoma?
Many patients presents to the doctor with a swollen lymph node/s with other symptoms. Your doctor will take a thorough history and examine you completely. The relevant test will be ordered to make a diagnosis.
How Do You Test For Non-Hodgkin's Lymphoma?
Biopsy Test For Non-Hodgkin's Lymphoma
Biopsy is the definitive test to confirm or rule out non-Hodgkin’s lymphoma (NHL). A small piece or the entire lymph node will be taken out for testing. The common reason for a swollen lymph node is an infection, so your doctor might prescribe you medicine to cure the infection. If the lymph node/s doesn’t go away your doctor might order a biopsy. If your history and examination of the lymph nodes is suggestive of a malignancy/lymphoma your doctor might order a biopsy at once.
Excisional or Incisional Biopsy: This is the preferred biopsy type to diagnose non-Hodgkin’s lymphoma. It almost always provide adequate sample to provide accurate results.
- Excisional – the entire lymph node is cut and taken out
- Incisional – a small part of the affected lymph node is cut out
If the lymph node is just under the skin, the procedure can be done with local anesthesia. But if the affected lymph node is deep in the chest or abdomen, then the procedure has to be done with deep sedation or general anesthesia by using a computer tomography or ultrasound scan to direct the needle.
Needle Biopsy: Needle biopsies are less invasive than excisional or incisional biopsies, the problem is adequate sample might not be present to diagnose and stage non Hodgkin’s lymphoma. Therefore, needle biopsies are not commonly done to diagnose non-Hodgkin’s lymphoma. But your doctor might do a needle biopsy if he/she thinks it’s due to an infection. There are 2 main types of needle biopsies:
- Fine Needle Aspiration (FNA) Biopsy - a very thin needle attached to a syringe is made use to withdraw small amounts of tissue from the lymph node.
- Core Needle Biopsy – a large needle is used to withdraw much larger piece of tissue form the lymph node.
Imaging Test For Non-Hodgkin's Lymphoma
Imaging tests are done for several reasons, the reasons are:
- To determine the stage of non-Hodgkin’s lymphoma
- To check if treatment is working
- To determine the cause of certain symptoms like shortness of breath, chest pain
- To check if non-Hodgkin’s lymphoma is relapsing
Chest X-Ray: To check if there are enlarged lymph nodes in the area.
Computed Tomography (CT) Scan: It can detect enlarge lymph nodes or organs. It’s helpful in detecting non-Hodgkin’s lymphoma in the chest, abdomen pelvis, head and neck
Ultrasound Scan: It is useful in detecting enlarge lymph nodes just below your skin, in the abdomen and to detect enlarged liver, spleen, and kidney.
Positron Emission Tomography (PET) Scan: PET/CT scan is more accurate in detecting non-Hodgkin’s lymphoma than a CT scan alone. PET scan might be helpful in:
- To see if enlarged lymph nodes contains non-Hodgkin’s lymphoma
- If non-Hodgkin’s lymphoma is responding to treatment
- Find small areas that might be non-Hodgkin’s lymphoma which might have looked normal in a CT scan.
Blood Test For Non-Hodgkin's Lymphoma
Blood tests are not helpful in diagnosing lymphoma but it can help in determining how advanced the non-Hodgkin’s lymphoma is.
- Complete Blood Count – a diagnosed patient with non-Hodgkin’s lymphoma, low blood counts means the lymphoma is growing and affecting the bone marrow.
- Lactate Dehydrogenase – levels are often increased in patients with non-Hodgkin’s lymphoma
- Liver Function/ Kidney Function Tests – to detect the function
There are several tests that can be done for non-Hodgkin’s lymphoma (NHL), but the confirmative test to diagnose non-Hodgkin’s lymphoma is an incisional or excisional biopsy of the enlarged lymph node. This can give the type and stage of non-Hodgkin’s lymphoma. Other biopsy methods include needle biopsies which are not very accurate. Imaging studies can be done to determine the stage of non-Hodgkin’s lymphoma, to check if treatment is working, to determine the cause of certain symptoms like shortness of breath, chest pain and to check if lymphoma is relapsing. Blood test also can be done to determine the complexity of non-Hodgkin’s lymphoma.
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