Hodgkin Lymphoma: Diagnosis
How is Hodgkin lymphoma diagnosed?
If your healthcare provider thinks you may have Hodgkin lymphoma, you will need certain exams and tests to be sure. Diagnosing Hodgkin lymphoma starts with your healthcare provider asking you questions. You will be asked about your medical history, your symptoms, risk factors, and family history of disease. Your healthcare provider will also give you a physical exam.
What is a biopsy?
A biopsy is a small sample of tissue that’s removed and checked for cancer cells. A biopsy is the only way for your healthcare provider to know for sure if you have Hodgkin lymphoma. For a biopsy, the doctor removes a sample of tissue. The sample is sent to a lab. A doctor called a pathologist checks it under a microscope for cancer cells. A few types of biopsies can be done to look for Hodgkin lymphoma.
Types of biopsies
The different types of biopsies include:
Excisional or incisional biopsy. This is often the preferred type of biopsy for Hodgkin lymphoma. For an excisional biopsy, a surgeon takes out a whole lymph node. This type of biopsy almost always gives the pathologist enough tissue to make a full diagnosis. For an incisional biopsy, only part of the tumor is taken out. This type of biopsy can tell if there are more areas of disease. It can also tell if the disease has grown back.
Fine needle aspiration (FNA) or core needle biopsy. Your doctor may choose this type of biopsy if you have swollen lymph nodes in your neck or armpit. For FNA, the doctor uses a very thin, hollow needle. For a core needle biopsy, the doctor uses a slightly bigger needle. The needle is used to take a small sample of tissue from the lymph node. For tumors deeper in the body, ultrasound or CT scans may be used to help the doctor guide the needle into place. A needle biopsy may not remove enough tissue for the pathologist to see cancerous cells. Or the sample may also be too small to tell the type of lymphoma. Because of this, most doctors don’t use a needle biopsy to try to diagnose Hodgkin lymphoma. But there are times when a needle biopsy may be helpful. If you have been diagnosed with Hodgkin lymphoma, your doctor may use this to see if swelling in another part of your body is also lymphoma.
Bone marrow aspiration and biopsy. Bone marrow is the soft, inner part of certain bones. Hodgkin lymphoma can spread to the bone marrow. Because of this, some people who have been diagnosed will have a sample of bone marrow checked for cancer. For this method, the doctor uses a needle to take out small amounts of your liquid bone marrow. This is called aspiration. A small piece of the bone is also taken. This is the biopsy. In most cases the aspiration and biopsy are done in the bone in the back of your pelvis bone.
Getting your test results
Your healthcare provider will contact you with the results of your biopsy. Your provider will talk with you about other tests that may be needed if Hodgkin lymphoma is found. Make sure you understand the results and what follow-up is needed.
October 23, 2017
NCCN Clinical Practice Guidelines_Hodgkin Lymphoma 1.2017. National Comprehensive Cancer Network
LoCicero, Richard, MD,Watson, L Renee, MSN, RN