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What tests should be done initially for lymphoma?

Sep 23, 2025 Source: Cainiu Health
Dr. Yang Ziqi
Introduction
In general, the initial evaluation of lymphoma involves ultrasound examination of lymph nodes, pathological biopsy, complete blood count, bone marrow aspiration, and CT scans. Additionally, depending on individual circumstances, patients with lymphoma may also undergo PET-CT or immunohistochemical testing. Patients should actively cooperate with their physicians during the diagnostic process, especially if any test results are abnormal.

Under normal circumstances, the initial evaluation of lymphoma includes lymph node ultrasound, pathological biopsy, complete blood count (CBC), bone marrow aspiration, and CT scans. The details are as follows:

1. Lymph Node Ultrasound

Lymph node ultrasound can clearly display the size, shape, boundaries, internal echoes, and blood flow of lymph nodes. Lymphoma often causes abnormal enlargement of lymph nodes, which may appear with unclear borders, irregular shapes, and heterogeneous internal echoes. This examination helps to preliminarily determine whether there are abnormalities in the lymph nodes and provides guidance for further diagnostic tests.

2. Pathological Biopsy

Pathological biopsy is a key test for diagnosing lymphoma. A sample of the affected lymph node or other suspicious tissue is taken and examined under a microscope to observe cellular morphology and structure. Lymphoma cells have distinct morphological features, and through pathological analysis, it can be determined whether malignant changes are present and the specific type of lymphoma can be identified—providing essential information for developing an appropriate treatment plan.

3. Complete Blood Count (CBC)

A CBC measures indicators such as red blood cells, white blood cells, and platelets. Some lymphoma patients may show abnormally high or low white blood cell counts, reduced platelet levels, or signs of anemia. This test helps assess the patient’s overall blood condition and assists in evaluating disease severity and possible complications such as infection.

4. Bone Marrow Aspiration

Bone marrow aspiration involves extracting a small amount of bone marrow fluid to examine the morphology and proportions of cells within the marrow. Certain types of lymphoma tend to infiltrate the bone marrow, leading to impaired hematopoietic function. This test determines whether the bone marrow is involved, which is critical for accurate staging of lymphoma.

5. CT Scan

CT scanning can image multiple areas of the body, including the neck, chest, abdomen, and pelvis, providing clear visualization of lymph nodes and the structure of organs in these regions. A CT scan helps determine the extent and distribution of lymphoma lesions, as well as whether surrounding organs are affected. This enables physicians to accurately stage the disease and formulate a comprehensive treatment strategy.

In addition, depending on individual cases, patients with lymphoma may also undergo PET-CT or immunohistochemical testing. It is important to actively cooperate with doctors during the diagnostic process. If test results are abnormal, timely communication with the physician is essential to clarify the next steps in diagnosis and treatment. Maintaining a positive mindset and avoiding excessive anxiety are also crucial.

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