Diagnosis

Your doctor will ask you about your personal and family medical history. He or she may then have you undergo tests and procedures used to diagnose Hodgkin's lymphoma, including:

• A 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. Your doctor may recommend imaging tests to look for signs of Hodgkin's lymphoma in other areas of your body. Tests may include X-ray, CT and positron emission tomography.
• Removing a lymph node for testing. Your doctor may recommend a lymph node biopsy procedure to remove a lymph node for laboratory testing. He or she will diagnose classical Hodgkin's lymphoma if abnormal cells called Reed-Sternberg cells are found within the lymph node.
• Removing a sample of bone marrow for testing. A bone marrow biopsy and aspiration procedure involves inserting a needle into your hipbone to remove a sample of bone marrow. The sample is analyzed to look for Hodgkin's lymphoma cells.

Other tests and procedures may be used depending on your situation.

Staging Hodgkin's lymphoma

After your doctor has determined the extent of your Hodgkin's lymphoma, your cancer will be assigned a stage. Knowing your cancer's stage helps your doctor determine your prognosis and 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 lymph node regions or the cancer has invaded one organ and the 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 the 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:

• 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.

Many types of Hodgkin's lymphoma exist, including rare forms that are difficult for inexperienced pathologists to identify. Accurate diagnosis and staging are key to developing a treatment plan. Research shows that review of biopsy tests by pathologists who aren't experienced with lymphoma results in a significant proportion of misdiagnoses. Get a second opinion from a specialist if needed.