The goals with testing are to diagnose and stage lymphoma, to distinguish it from other conditions, and to identify and monitor any associated complications. There are few blood tests that clearly indicate lymphoma.
The gold standard diagnostic test for both HL and NHL is the examination of lymph tissue by a pathologist (specialist). The sample is usually collected from an affected lymph node using a biopsy or fine needle aspiration procedure and is examined under the microscope. Other laboratory tests that may be useful include:
- Full blood count (FBC) - may be requested to rule out non-lymphoma conditions (such as leukaemia) and/or to see if anaemia or low platelet and/or white blood cells counts are present, which may indicate that lymphoma is present in the bone marrow.
- Bone marrow biopsy and examination – to evaluate the cells present in the bone marrow.
- Blood film to evaluate the quality of red and white blood cells and platelets
- Immunophenotyping (or “cell markers” can identify the cells involved by testing for the presence or absence of surface markers on the membrane of the cells. These markers are called clusters of differentiation (CD) and are listed numerically. By evaluating the patterns of CDs present on the cells, it is possible to classify the cells. This test can be done by several different methods, including flow cytometry and immunohistochemistry.
- Cytogenetics – an evaluation of the chromosomes in the nucleus of cancer cells to determine if pieces of the chromosomes have moved (translocation) or are otherwise abnormal.
- Molecular genetic analysis – evaluating the cancer cell’s DNA for genetic changes.
Primarily used to help stage and monitor lymphoma. They include:
- Physical examination
- Ultrasound scan
- Computed tomography (CT) scan
- Positron emission tomography (PET) scan
- Chest X-ray
- Exploratory surgery (occasionally necessary)
- Magnetic Resonance Imaging (MRI)