Tests and procedures used to diagnose Hodgkin's lymphoma include:
- Physical exam. Your doctor checks for swollen lymph nodes, including in your neck, underarm and groin, as well as a swollen spleen or liver.
- Blood tests. A sample of your blood is examined in a lab to see if anything in your blood indicates the possibility of cancer.
- Imaging tests. Imaging tests used to diagnose Hodgkin's lymphoma include X-rays, computerized tomography (CT) scan, magnetic resonance imaging (MRI) and positron emission tomography (PET).
- Surgery to remove a swollen lymph node. Minor surgery may be done to remove all or part of an enlarged lymph node for testing. The lymph node is sent to a laboratory for testing. A diagnosis of Hodgkin's lymphoma is made if the abnormal Reed-Sternberg cells are found within the lymph node.
- A procedure to collect bone marrow for testing. A bone marrow biopsy may be used to look for signs of cancer in the bone marrow. During this procedure, a small amount of bone marrow, blood and bone are removed through a needle.
Staging Hodgkin's lymphoma
After your doctor has determined the extent of your Hodgkin's lymphoma, your cancer will be assigned a stage. Your cancer's stage helps determine your prognosis and your treatment options. Stages of Hodgkin's lymphoma include:
- Stage I. The cancer is limited to one lymph node region or a single organ.
- Stage II. In this stage, the cancer is in two different lymph nodes or the cancer is in a portion of tissue or an organ and nearby lymph nodes. But the cancer is still limited to a section of the body either above or below the diaphragm.
- Stage III. When the cancer moves to lymph nodes both above and below the diaphragm, it's considered stage III. Cancer may also be in one portion of tissue or an organ near the lymph node groups or in the spleen.
- Stage IV. This is the most advanced stage of Hodgkin's lymphoma. Cancer cells are in several portions of one or more organs and tissues. Stage IV Hodgkin's lymphoma affects not only the lymph nodes but also other parts of your body, such as the liver, lungs or bones.
Additionally, your doctor uses the letters A and B to indicate whether you're experiencing symptoms of Hodgkin's lymphoma:
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- A means that you don't have any significant symptoms as a result of the cancer.
- B indicates that you may have significant signs and symptoms, such as a persistent fever, unintended weight loss or severe night sweats.
- Diehl V, et al. Hodgkin lymphoma: Clinical manifestations, staging and therapy. In: Hoffman R, et al. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2009. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-443-06715-0..X5001-8--TOP&isbn=978-0-443-06715-0&uniqId=230100505-56. Accessed May 23, 2011.
- Hodgkin lymphoma. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed May 23, 2011.
- What you need to know about Hodgkin lymphoma. National Cancer Institute. http://www.cancer.gov/cancertopics/wyntk/hodgkin/AllPages. Accessed May 23, 2011.
- Integrative medicine & complementary and alternative therapies as part of blood cancer care. The Leukemia & Lymphoma Society. http://www.lls.org/resourcecenter/freeeducationmaterials/treatment/integrativemedandcam. Accessed May 23, 2011.