Diagnosis
Imaging Tests
Your doctor may order imaging tests if your medical history and physical exam suggest a possible diagnosis of Hodgkin lymphoma. Your doctor looks for:
- enlarged lymph nodes in the chest or abdomen or both
- tumor masses outside the lymph nodes in lung, bone or other body tissue
Imaging tests can include:
- a chest X-ray
- a computed tomography (CT) scan of the chest, pelvis and abdomen (stomach area)
- a magnetic resonance imaging (MRI) scan
- a positron emission tomography (PET) scan
- a fluorodeoxyglucose PET (FDG-PET) scan of the entire body with a radioactive tracer
Lymph Node Biopsy
Diagnosing Hodgkin lymphoma usually involves performing a lymph node biopsy. If the biopsy confirms that you have the disease, your doctor performs additional tests to stage the lymphoma.
The lymph node biopsy's purpose is to confirm a diagnosis and:
- identify your Hodgkin lymphoma subtype
- develop a treatment plan
Understanding lymph node biopsy
Lab Tests to Confirm a Diagnosis
A hematopathologist examines the sample of your lymph node under a microscope to look for the identifying characteristics of Hodgkin lymphoma. A hematopathologist is a specialist who studies blood cell diseases by looking at samples of blood and marrow cells and other tissues.
The hematopathologist may use a lab test called immunophenotyping to look for the presence of Reed-Sternberg cells and Hodgkin cells to distinguish Hodgkin lymphoma from other types of lymphoma and other noncancerous conditions.
Hodgkin lymphoma can be a difficult disease to diagnose. You may want to get a second medical opinion by an experienced hematopathologist before you begin treatment. Hodgkin lymphoma can be confused with some types of non-Hodgkin lymphoma. The appropriate treatment depends on having the correct diagnosis.
Understanding lab and imaging tests
Staging Tests
Once your hematologist oncologist confirms a Hodgkin lymphoma diagnosis, he or she orders more tests to stage your disease. Staging identifies the extent of your disease and where it's located in your body.
Staging tests include:
- blood tests
- bone marrow tests
- imaging tests
Blood Tests
After your blood is taken, it's sent to a lab for a complete blood count (CBC) and more blood work. Your blood is measured for:
- levels of red cells, white cells and platelets
- blood protein levels
- uric acid levels
- erythrocyte sedimentation rate (the speed that red cells settle at the bottom of a test tube?an increased rate can indicate cancer)
- liver function
Understanding blood tests and blood counts
Bone Marrow Tests
Your doctor may decide to examine your bone marrow to see whether the disease has spread. If your disease is in an early stage and some signs and symptoms haven't appeared, you may not need the test.
Bone marrow testing involves two steps usually done at the same time in a doctor's office or a hospital:
- a bone marrow aspiration to remove a liquid marrow sample
- a bone marrow biopsy to remove a small amount of bone filled with marrow
Understanding bone marrow tests
Imaging Tests
Your doctor conducts one or more imaging tests, along with a physical exam, to look for:
- the location and distribution of enlarged lymph nodes
- the disease's effect, if any, on other organs such as the lungs and liver
- large tumor masses
Imaging tests may include:
- a chest X-ray
- a computed tomography (CT) scan of the chest, pelvis and abdomen (stomach area)
- a magnetic resonance imaging (MRI) scan
- a positron emission tomography (PET) scan
- a fluorodeoxyglucose PET (FDG-PET) scan of the entire body with a radioactive tracer (F-18)
