Some common tests used to identify NHL include:
Biopsy: The removal of a piece of tissue from an area of suspected cancer for examination under a microscope. Non-Hodgkin’s Lymphoma is diagnosed by looking at cancer cells and determining how they are growing in the lymph nodes or other tissues. The information provided by this tissue sample is crucial to the diagnosis and treatment of NHL.
X-Ray: This procedure uses radiation to take pictures of an area inside the body.
Computerized Axial Tomography (CT) scan: A CT scan takes X-rays from different angles around the body. The images are then combined using a computer to give a detailed image. CT scans are most commonly performed on the neck, chest, abdomen and/or pelvis.
Positron Emission Tomography (PET) scan: PET is a technology that combines the fields of medicine, computer science, chemistry, physics and physiology to study the function of organs such as the heart, brain and bone. Rather than providing an image of the tissue such as X-rays, CTs, ultrasounds or MRIs, PET scans provide information about how tissue functions.
Magnetic Resonance Imaging (MRI): MRI is similar to a CT scan but uses magnets and radio frequency waves instead of X-rays. MRI can provide important information about tissues and organs that is not available from other imaging techniques. It is less used in NHL than are CT scans, but it can be useful in evaluation of the bones and brain.
Lymphangiogram: A special X-ray of the lymphatic system. A dye (contrast medium) is injected into the lymphatic vessels in both feet. When the body is X-rayed, lymph nodes and lymphatic vessels containing the dye are more clearly seen on the film.
Gallium (radioisotope) Scan: Radioactive gallium is a chemical that collects in some tumors. A small amount of gallium is injected into a blood vessel, and it circulates throughout the body. The body is then scanned from several angles to see if the gallium has collected in a tumor. This test can be very useful in managing NHL.
Blood Tests: These are performed to determine if the different types of blood cells are normal in numbers and appearance and if blood chemistry is normal.
Bone Marrow Aspiration and Biopsy: Bone marrow contains immature cells called stem cells, which go on to develop into three types of cells: red blood cells, which deliver oxygen and take away carbon dioxide; white blood cells, which protect the body from infection; and platelets, which help blood to clot. Bone marrow is obtained by numbing the skin, tissue and surface of the bone with a local anesthetic. A thin needle is inserted into the hip or another large bone to collect a small sample.
Echocardiogram: This diagnostic test evaluates the size and function of the heart.
Pulmonary Function Test: This test will determine how well the lungs function. It is an important test since some drugs used to treat NHL may affect lung function.
Staging
Staging is a standardized method to determine if the cancer has spread, and to determine the best possible treatment. Accurate staging also helps to predict patient’s prognosis and how the disease might progress.
Stage I (early stage): One lymph node region is involved. If the cancer is found in one organ outside the lymph node such as the skin, lung, brain, etc., this is called "extension," or "E" disease.
Stage II (locally advanced disease): The cancer is found in two or more lymph regions on one side of the diaphragm. If the cancer is found in one lymph node region plus a nearby area or organ, the situation is considered "E" disease.
Stage III (advanced disease): The disease involves lymph nodes both above and below the diaphragm or one node area and one organ on opposite sides of the diaphragm.
Stage IV (widespread disease): The Lymphoma is outside the lymph nodes and spleen and has spread to one or more organs such as bone, bone marrow, skin and other organs.
In addition, each stage is classified as "A" or "B". An "A" means asymptomatic, which is used for patients who do not complain of fever, drenching sweat or unexplained weight loss. When patients have any of these symptoms, "B" is assigned to their stage.