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Lymphoma (suspected) - investigations and initial management

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Investigations for suspected Lymphoma

Investigations and initial management depend on the type of lymphoma suspected:

T-cell NHL - as for suspected leukaemia but
Beware superior mediastinal syndrome. If present, delay CVL insertion 
Echocardiogram is required before starting treatment. 
B-cell NHL - as for  suspected leukaemia but
Be particularly aware of Tumour Lysis Syndrome
Avoid laparotomy if possible; diagnosis can often be established by tapping pleural effusion or ascites.
Toxicity evaluation for NHL chemotherapy
If protocol contains methotrexate, needs pre-chemo formal or calculated GFR (discuss with treating oncologist).
Toxicity evaluation for Hodgkin's Disease
Investigations as determined by intended protocol
Needs pre-chemo echo for fractional shortening
If protocol contains bleomycin, needs pre-chemo lung function tests (these are generally only reliable in children > 6 years).
Follow fertility guidelines pre-treatment

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Document Control

  • Date last published: 09 March 2016
  • Document type: Clinical Guideline
  • Services responsible: National Child Cancer Network
  • Author(s): Amanda Lyver, Tim Prestidge
  • Owner: Amanda Lyver
  • Review frequency: 2 years