Hodgkin Lymphoma: Tests After Diagnosis

What tests might I have after being diagnosed?

After a diagnosis of Hodgkin lymphoma, you will likely need more tests. These tests help your healthcare providers learn more about the cancer. They can help show if it has grown into nearby areas. Or if it has spread to other parts of your body. The test results help your providers provide you with a prognosis and decide the best way to treat the cancer. If you have any questions about these or other tests, talk with your healthcare team.

The tests you may have can include:

• Bone marrow aspiration and biopsy

• Chest X-ray

• CT scan

• PET scan

• MRI

Bone marrow aspiration and biopsy

A bone marrow aspiration and biopsy are not always needed. But they might be used to see if the lymphoma has spread to your bone marrow. (The 2 tests are done at the same time.) Bone marrow is the thick liquid center of certain bones. It's where your blood cells are made. To do the aspiration, a needle is put through your skin and through the back of your hip bone. Then a syringe is used to pull out some of the bone marrow. Then another needle is used to take out a piece of your bone.

You'll lie on your belly or side. Your skin is cleaned. A thin needle is used to numb your skin and the surface of your hip bone. Then a thicker needle is pushed through the bone and into the marrow. You may feel some pain when the bone marrow is pulled out. You may feel pressure when the bone biopsy is done.

The bone marrow is then sent to a lab for testing. You'll lie on your back with some ice on your hip after this test. Your hip may ache for a few days.

Imaging tests

Chest X-ray

This test uses a small amount of radiation to create images of the inside of your chest. Swollen lymph nodes in the chest may be seen on a chest X-ray. 

CT scan

This may be done of your chest, belly (abdomen), and pelvis. This test uses a series of X-rays from many angles. A computer puts the X-rays together into one detailed image.

You may need to drink a special dye, or contrast medium, just before the scan. Or the dye may be injected into your vein through an IV (intravenous) line, or both. The dye helps images show up more clearly on the X-rays. The dye may cause a warm flushing feeling to move through your body. Tell your healthcare provider if you are allergic to or have had a reaction to the dye.

A CT scan can show swollen lymph nodes, swelling in your spleen, or growths in your liver.

PET scan

For this test, a radioactive sugar is put into your bloodstream. Cancer cells use more sugar than normal cells, so the sugar will quickly collect in cancer cells. A special camera is then used to see where the radioactive sugar is in your body.

A PET scan can sometimes spot lymphomas in different parts of the body, even when they can’t be seen with other tests. It can also show if lymphoma treatment is working. This test is often used along with a CT scan. This is called a PET/CT scan.

MRI

An MRI uses large magnets and radio waves to take detailed pictures of the inside of your body. An MRI is not as useful as a CT scan to find lymphoma. But it can help show if the cancer has spread to your brain and spinal cord. 

For this test, you lie still on a table as it slides into a tube-like scanner. If you're not comfortable in small spaces, you may be given a medicine (sedative) to relax you before the test. The scanner directs a beam of radio waves at the area that is being checked. You usually need more than one set of images.

This test is painless, but it may take an hour or more depending on the number of images needed.

Working with your healthcare provider

Your healthcare provider will talk with you about which tests you’ll need. Make sure to get ready for the tests as directed. Ask questions and talk about any concerns you have.