Most people begin by visiting their doctor. If your doctor has concerns about you, he or she will refer you to a hospital for further tests. At the hospital the doctor will ask you questions about your health before doing a physical examination. A blood test and a chest X-ray may be taken to check your general health.

The doctor may have to remove a lymph node and examine it under a microscope. This can be carried out under a local anaesthetic, but in a lot of cases, a general anaesthetic is required to complete the test.

Lymph node biopsy:

Before the test you may be given a mild sedative to help you relax while the test is being carried out. A local anaesthetic is used on the skin to numb the area. A small cut is made through the skin and the lymph node is removed for examination under a microscope.

A couple of stitches are generally required at the biopsy site. This test can be uncomfortable but only takes 5-10 minutes to do. As soon as the sedation has worn off you will be able to go home. You will have to arrange for someone to take you home, as you will be feeling sleepy. You will not be able to drive for 24 hours after the test.

A general anaesthetic may be required if the lymph node is not easy to locate. You will not be allowed to eat or drink for a few hours before the test. You may also be given a sedative. This will help you feel more relaxed when going to theatre. The procedure takes about 15-20 minutes to complete. You will not be allowed to eat or drink anything for at least four hours after the test. You should be allowed to go home the next day.

If the enlarged lymph nodes are in the chest you may need to have a mediastinoscopy.

Mediastinoscopy:

This test allows the doctor to examine the area at the centre of the chest (mediastinum) and the lymph nodes that are found there. This test is done under a general anaesthetic and will mean a short stay in hospital. Before the test you will not be able to eat or drink for a few hours. Just before the test you may be given a sedative. This will help you to feel more relaxed going to theatre.

A small cut is made through the skin at the base of the neck above your breastbone. A tube, like a small telescope, is passed into the chest. The doctor can then view the tissues and organs in the mediastinum. He or she will take samples of lymph nodes and other tissues for examination under a microscope. This examination takes 20-30 minutes to complete. You will not be able to eat or drink anything for at least four hours after the test.

If there are lymph nodes in the abdomen these will have to be biopsied under a general anaesthetic. However, this is not common. Your doctor will discuss this with you if it is needed.

Where the biopsy test shows that you have lymphoma it will also indicate the type of lymphoma it is.

Non-Hodgkin Lymphoma

Where the biopsy test shows that you have lymphoma it will also indicate the type of lymphoma it is.

Lymphomas are divided into three main groups:

Low-grade or slow growing

Intermediate grade (between fast and slow growing)

High-grade or faster growing

Non-Hodgkin lymphomas are also classified according to their cell type, either B-cell or T-cell; most people have a B-cell lymphoma, with T-cell lymphomas occurring more often in older children and young adults.