If the biopsy shows that Hodgkin lymphoma is present, your specialist will want you to have some further tests to see if the lymphoma has spread to other parts of the body. This shows the stage of the lymphoma.

Once your doctor knows where the Hodgkin lymphoma is in your body, and whether or not you have symptoms, they can plan the most effective treatment for you.

The tests to find out the stage may include any of the following:

Blood samples will be taken throughout your treatment to check your general health, the levels of red and white cells and platelets in your blood, and your liver and kidney functions.

A sample of bone marrow is taken, usually from the pelvis, and examined to see if it contains any lymphoma cells. The test doesn't take very long and can be done on the ward or in the outpatient department. If you are very anxious about the test a mild sedative may be helpful. You can ask your doctor about this beforehand.

Before the sample is taken, a local anaesthetic is used to numb the area. A needle is passed through the skin into the bone marrow. A tiny piece of the bone and bone marrow are taken into the syringe to be examined under the microscope. A small dressing is applied to the area after the procedure. The test can be painful and you will need to take painkillers afterwards. The discomfort may last for a few days, and painkillers may be necessary during this time.

This is taken to check for any sign that the lymphoma has spread to the lymph nodes in the chest.

A CT scan takes a series of x-rays which builds up a three-dimensional picture of the inside of the body. The scan is painless but takes from 10—30 minutes. CT scans use a small amount of radiation. The radiation is very unlikely to harm you and will not harm anyone you come into contact with. You will be asked not to eat or drink for at least four hours before the scan.

You may be given a drink or injection of a dye which allows particular areas to be seen more clearly.  For a few minutes, this may make you feel hot all over. If you are allergic to iodine or have asthma, you could have a more serious reaction to the injection, so it is important to let your doctor know beforehand. You will probably be able to go home once the scan is over.

This test is similar to a CT scan but uses magnetism instead of x-rays to build up a detailed picture of areas of your body.

During the test you will be asked to lie very still on a couch inside a long tube for about 30 minutes. The scan is painless, but can be slightly uncomfortable. Some people feel a bit claustrophobic during the scan. It is also noisy, but you will be given ear plugs or headphones to wear. You may be able to take someone into the room with you to keep you company.

Some people are given an injection of dye into a vein in the arm, but this is not usually uncomfortable.

PET scans are a new type of scan and you may have to travel to a specialist centre to have one. They are not always needed but you can discuss with your doctor whether one would be useful in your case. PET scans can be used to find whether a lymphoma has spread beyond the original area of the body. They may also be used to examine any lumps that remain after treatment to see whether they are scar tissue or whether cancer cells are still present.

A PET scan uses low-dose radioactive sugar to measure the activity of cells in different parts of the body. A very small amount of a mildly radioactive substance is injected into a vein, usually in the arm. A scan is then taken a couple of hours later. Areas of cancer are usually more active than surrounding tissue and show up on the scan.
It will probably take several days for the results of your tests to be ready and a follow-up appointment will be arranged for you before you go home. Obviously this waiting period is an anxious time and it may help you to talk things over with a close relative or friend. You can also contact Cancerbackup or one of the organisations listed.