After you learn that you have Hodgkin lymphoma, you may need other tests to help with making decisions about treatment. Staging tests can show the stage (extent) of disease, such as whether lymphoma cells are found in more than one group of lymph nodes.
Lymphoma cells usually spread from one group of lymph nodes to the next. For example, Hodgkin lymphoma that starts in lymph nodes in the neck may spread first to lymph nodes above the collarbones, and then to lymph nodes under the arms and within the chest.
In time, lymphoma cells can invade blood vessels and spread to almost any other part of the body. For example, they can spread to the liver, lungs, bone, and bone marrow.
Staging tests may include:
- CT scan: Your doctor may order a CT scan of your neck, chest, abdomen, and pelvis. An x-ray machine linked to a computer will take a series of detailed pictures of these areas. You’ll receive contrast material by mouth and by injection into a blood vessel in your arm or hand. The contrast material makes swollen lymph nodes and other abnormal areas easier to see. The pictures can show whether Hodgkin lymphoma has spread.
- PET scan: Your doctor may use a PET scan to find Hodgkin lymphoma that has spread. You’ll receive an injection of a small amount of radioactive sugar. A machine makes computerized pictures of cells in your body that have taken up the radioactive sugar. Because lymphoma cells take up sugar faster than do normal cells, areas with lymphoma cells look brighter on the pictures.
- Bone marrow biopsy: To check for lymphoma cells in the bone marrow, your doctor will use a thick needle to remove a small sample of bone and bone marrow from your hipbone or another large bone. Local anesthesia can help control pain.
Other staging tests may include biopsies of lymph nodes or other tissue.
Questions you may want to ask your doctor about testing
- What type of Hodgkin lymphoma do I have?
- How do I get a copy of the report from the pathologist?
- Has the lymphoma spread? Was it found on both sides of the diaphragm?