The presence of swollen lymph nodes and other associated symptoms can suggest a diagnosis of non-Hodgkin lymphoma, but the only way to confirm the diagnosis is by carrying out a biopsy.
A biopsy involves removing some or all of an affected lymph node and lymphocytes, which is then studied in a laboratory. Biopsies can be carried out under a local anaesthetic (where the area is numbed), or at times a general anaesthetic may be required (you are put to sleep).
A pathologist (expert in the study of diseased tissue) will then check the tissue sample for the presence of cancerous cells. If they find cancerous cells, they can also identify exactly which type of lymphoma you have, which is an important factor in planning your treatment.
Confirming a diagnosis
There are two main types of lymphocytes:
- B-lymphocytes make antibodies that attack infecting bacteria and viruses.
- T-lymphocytes kill cells that have been infected with a virus and cause the immune response to respond faster to an infection the second time round.
In non-Hodgkin lymphoma, either the B-lymphocytes or the T-lymphocytes (or both) can be affected. B-cell lymphomas are more common.
Treatment depends on the subtype that you have. There are more than 20 types of non-Hodgkin lymphoma, including:
- diffuse large B-cell lymphoma
- follicular lymphoma
- extranodal marginal zone B-cell (MALT)
- mantle cell lymphoma
- Burkitt lymphoma
- mediastinal large B-cell lymphoma
- nodal marginal zone B-cell lymphoma
- small lymphocytic lymphoma
- lymphoplasmacytic lymphoma
- peripheral T-cell lymphoma
- skin (cutaneous) lymphomas
- anaplastic large-cell lymphoma
- lymphoblastic lymphoma (mainly T-cell but can be B-cell)
If the biopsy shows you have non-Hodgkin lymphoma, more tests may be carried out to see how far it has spread. These tests include:
- blood tests (there is no direct blood test for lymphoma)
- bone marrow biopsy
- imaging tests such as CT, PET and MRI scans and ultrasound
- lumbar puncture (sometimes called a spinal tap)
Sometimes it is helpful to talk to others about your experience. Cancer Council Australia offer support for you and your loved ones via their helpline on 13 11 20.
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Last reviewed: December 2017