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What tests should be done if lymphoma is suspected?

Nov 05, 2025 Source: Cainiu Health
Dr. Liu Feng
Introduction
Core tests typically required when lymphoma is suspected may include lymph node ultrasound, lymph node biopsy with pathological examination, routine blood and biochemical tests, whole-body CT or PET-CT scans, and bone marrow aspiration. Ultrasound allows evaluation of the size, shape, margins, internal echogenicity, and blood flow of lymph nodes, helping to determine whether abnormal proliferation or structural changes are present.

When lymphoma is suspected, core diagnostic tests generally include lymph node ultrasound, lymph node biopsy with pathological examination, routine blood and biochemical tests, whole-body CT or PET-CT scans, and bone marrow aspiration. Detailed explanations are as follows:

1. Lymph Node Ultrasound: This test uses ultrasound imaging to evaluate the size, shape, boundary, internal echogenicity, and blood flow of lymph nodes. It helps identify abnormal enlargement or structural changes, allowing preliminary differentiation between benign hyperplasia and malignant lesions. This non-invasive and convenient examination provides guidance for further testing.

2. Lymph Node Biopsy with Pathological Examination: This is the key test for confirming lymphoma. A tissue sample from the affected lymph node is obtained and analyzed pathologically to examine cellular morphology, tissue structure, and immunophenotype. This determines whether lymphoma is present and identifies the specific pathological type, providing essential information for developing a treatment plan. Biopsy methods include needle biopsy and excisional biopsy.

3. Routine Blood and Biochemical Tests: These assess the patient's general health status. A complete blood count (CBC) measures white blood cells, red blood cells, and platelets to detect infections, anemia, or platelet abnormalities. Biochemical tests evaluate liver and kidney function, lactate dehydrogenase (LDH) levels, and other markers to understand organ function and disease severity, helping assess the patient’s ability to tolerate treatment.

4. Whole-Body CT or PET-CT Scans: These are used to determine the extent of disease involvement. CT scans clearly show the distribution of lymph nodes and organ involvement throughout the body. PET-CT combines anatomical imaging with metabolic activity, enabling more precise identification of active lesions and detection of systemic metastases. These scans help stage the lymphoma and guide treatment decisions.

5. Bone Marrow Aspiration: This evaluates whether the bone marrow is involved. A sample is collected via needle aspiration to check for infiltration by lymphoma cells. Certain types of lymphoma commonly affect the bone marrow. Proper local disinfection is required before the procedure to prevent infection.

Individuals suspecting lymphoma should promptly visit the oncology or hematology department at a reputable hospital for evaluation and avoid self-diagnosis, which may delay timely testing and diagnosis.

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