Imaging tests
Chest X-ray
This test uses a small amount of radiation to create images of tissues inside your chest. It's used to look for swollen lymph nodes in your chest.
For the test, you stand in front of a rectangular target area where the X-ray film is held. You may be asked to hold your arms to the side or over your head. You take a breath and stay still for a few seconds. An X-ray will be done from the front and from the side. The test takes only a few minutes and is painless.
CT scan
You may need a CT scan of your chest, belly (abdomen), pelvis, head, or neck. This is done to look for groups of lymph nodes, a swollen spleen, or abnormal growths in your liver.
During the test, you lie still on a table as it slides through the center of the ring-shaped CT scanner. Then the scanner takes a series of X-rays from many angles. A computer puts the images together to make detailed 3-D pictures of the inside of your body.
You may be asked to hold your breath once or more during the scan. You also may need to drink a special X-ray dye (contrast medium) just before the scan. It may also be injected into your blood through an IV (intravenous) line. The dye helps get clearer X-rays. It will pass out of your body over the next day or so through your bowel movements. The IV dye often causes a warm feeling all over your body for a few minutes after it is first put in. In rare cases, it can also cause hives or other allergic reactions. Tell your healthcare provider if you are allergic to or have ever had a reaction to X-ray dye.
MRI
An MRI uses large magnets and radio waves (instead of radiation) to take detailed pictures of the inside of your body. It's not often used for lymphoma. But an MRI can help show if the cancer has spread to your brain and spinal cord. It may also be used if the results of an X-ray or CT scan are not clear.
For this test, you lie still on a table as it slides into a narrow tube-like scanner. If you are not comfortable in small spaces, you may be given a medicine to help you relax before the test. This is called a sedative. The scanner sends beams of radio waves to the area that is being checked. A computer uses the radio waves to create a 3-D picture of the inside of your body. You may need more than one set of images. Each one may take 2 to 15 minutes. This test may take 1 hour or more depending on the number of images needed.
A contrast dye might be put into a vein in your hand or arm before this scan. It helps get even clearer images of the inside of your body. You might be given earplugs because there's loud thumping and buzzing noises during the scan.
PET scan
A PET scan looks at your whole body. For this test, a radioactive sugar is put into your blood through a vein in your hand or arm. Cancer cells use this sugar faster than other cells. So after about 1 hour, it collects in cancer cells. A special machine is then used to take a picture of your whole body to see where the radioactive sugar has collected. The places where the solution collects show up as "hot spots" on the scan.
Sometimes a PET scan can show lymphoma 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, called a PET/CT scan.
Ultrasound
This test uses sound waves and a computer to create pictures of the inside of your body. No radiation is used. You will lie on a table. A technician will move a probe (transducer) along your skin over part of your body. The echoes that bounce back are picked up and made into an image on a computer screen.
Your healthcare provider may use an ultrasound to find swollen lymph nodes or enlarged organs (like the liver or spleen) in your belly. The ultrasound can also show if your kidneys are swollen. This can happen when urine outflow is blocked by swollen lymph nodes.
Procedures
Spinal tap (lumbar puncture)
A spinal tap can help find out if the lymphoma has spread to your spinal cord or brain. This test is not needed for most people with lymphoma. But it still may be used for certain types of lymphoma. It also may be used if you have symptoms that may mean the cancer has reached your brain.
For this test, a healthcare provider puts a thin, hollow needle between the bones in your lower spine or back. This is done to take out some cerebrospinal fluid (CSF). This is the fluid that cushions and protects your brain and spinal cord. A healthcare provider called a pathologist then tests the fluid to see if there are lymphoma cells in it.
Bone marrow aspiration and biopsy
Bone marrow is the soft, spongy, inner part of certain bones. Non-Hodgkin lymphoma can spread to the bone marrow. So your healthcare provider may want to check a sample of the bone marrow for cancer cells.
To do this, a thick needle is used to take out small amounts of your liquid bone marrow. This is called aspiration. A small piece of the bone is also taken. This is the biopsy. The aspiration and biopsy are most often done in the back of your hip or pelvic bone. You lie on your stomach, curl up on your side, or sit and lean over a table for this test. You will be awake, but medicines will be used to make your skin and hip bone numb before the test is done.