Hodgkin’s Lymphoma Detection & Diagnosis

As with most other cancers, early detection is the main key to the successful treatment of Hodgkin’s lymphoma (HL). However, because there are currently no recommended screening tests, it’s important to pay attention to possible signs and symptoms associated with the disease. 

Signs & Symptoms of Hodgkin Lymphoma

The most common symptom of HL is the swelling of one or more lymph nodes. In most cases, these lumps are painless and can be found in areas such as on the side of the neck, in the armpit, or in the groin. Other symptoms can include: 

  • Fatigue
  • Fever
  • Chills 
  • Night sweats
  • Weight loss
  • Severe itching

Many times, these symptoms can be attributed to something other than lymphoma. Still, it’s a good idea to have them checked by a doctor, especially if they don’t go away or worsen. 

If you have swollen lymph nodes or another symptom that suggests Hodgkin lymphoma, your doctor will try to find out what’s causing the problem. Your doctor will first ask about your personal and family medical history. He or she will also perform a physical examination to check for signs of the disease or anything else that seems unusual. 

Tests Used to Diagnose Hodgkin Lymphoma

Tests that may be used to diagnose HL can include:

  • Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. In this case, to check the tissue for lymphoma cells. Your doctor may remove an entire lymph node (excisional biopsy) or only part of a lymph node (incisional biopsy). A thin needle (fine needle aspiration) usually cannot remove a large enough sample for the pathologist to diagnose lymphoma. Removing an entire lymph node is best. A biopsy is the only sure way to diagnose lymphoma.
  • Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the: 
    • Number of red blood cells, white blood cells, and platelets
    • Amount of hemoglobin (the protein that carries oxygen) in the red blood cells
    • Portion of the sample made up of red blood cells
  • Computed tomography (CT or CAT) scan. A procedure that makes a series of detailed pictures of areas inside the body, such as the neck, chest, abdomen, pelvis, and lymph nodes, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • Magnetic resonance imaging (MRI). A test that uses magnetic fields, not x-rays, to produce detailed images of the body. It can be used to measure the size of the tumor. A special dye called contrast medium is given intravenously before the scan to create a clearer picture. A radiologist interprets the scan.
  • PET scan (positron emission tomography scan): A procedure to find malignant (cancerous) tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
  • Bone marrow aspiration and biopsy: The removal of bone marrow and a small piece of bone by inserting a needle into the hipbone or breastbone. A pathologist views the bone marrow and bone under a microscope to look for signs of cancer.
  • Erythrocyte sedimentation rate (ESR): A procedure that measures how much inflammation is in the body. A higher than normal sedimentation rate may be a sign of lymphoma or another condition. 

If diagnosed with HL, and chemotherapy is part of the treatment plan, your doctor may recommend additional tests since chemo can affect the heart and lungs. These tests might include: 

  • An echocardiogram (an ultrasound of the heart) or a MUGA scan
  • Lung (pulmonary) function tests (PFTs) 

After diagnostic tests are done, your doctor will take the time to go over the results with you. If the diagnosis is Hodgkin lymphoma, these results will also help your doctor determine your specific subtype of HL as well as the stage.

If you’ve recently been diagnosed with Hodgkin’s lymphoma, visit our guide for newly diagnosed lymphoma patients.