• Diagnosis of Hodgkin’s Disease

    The doctor will ask about your symptoms and medical history. A physical exam will be done, paying careful attention to your lymph nodes. Most enlarged or swollen lymph nodes are caused by an infection, not lymphomas. If infection is suspected, you may be given an antibiotic medication and instructed to return for a follow up appointment. If swelling persists, your doctor may order a lymph node biopsy.

    Lymph Node Biopsy

    For a lymph node biopsy , your doctor will remove all or part of one of your lymph nodes. A pathologist will examine this tissue sample under a microscope. The biopsy can show whether or not there is cancer and the type and extent of cancer. A specific type of cell, called Reed-Sternberg cell, is associated with Hodgkin’s lymphoma .

    Staging of Hodgkin’s Disease

    If cancer is found, your prognosis and treatment depend on the location, size, and stage of the cancer, as well as your general health. Staging is an evaluation to determine whether the cancer has spread and, if it has, what body parts are affected.
    Your doctor considers the following factors to determine the stage of Hodgkin's disease:
    • The number and location of lymph nodes affected
    • Whether the affected lymph nodes are on one or both sides of the diaphragm (the thin muscular sheet that separates the chest from the abdomen)
    • Whether the disease has spread to other lymphatic tissues, such as the spleen
    • Whether the disease has spread to the bone marrow, liver, or other places outside the lymphatic system
    Additional tests to determine staging may include:
    Stages of Hodgkin’s Disease
    • Stage I—cancer is found only in a single lymph node area, in the area immediately surrounding that node, or in a single organ
    • Stage II—cancer involves more than one lymph node area on one side of the diaphragm
    • Stage III—cancer involves lymph node regions above and below the diaphragm
    • Stage IV—cancer involves one or more organs outside the lymph system or a single organ and a distant lymph node site
    Stages have an “A” and a “B” level. In Stage B, a person with Hodgkin's lymphoma experiences general symptoms from the disease—fever, night sweats, or significant weight loss. If these specific symptoms are not present, the classification is "A."
    Relapsed/refractory is the term used for a cancer that has persisted or returned following treatment.

    References

    Casciato D. Manual of Clinical Oncology. 6th ed. Lippincott Williams & Williams; 2009

    Hodgkin disease. EBSCO DynaMed website. Available at:http://www.ebscohost.com/dynamed. Updated July 17, 2012. Accessed October 25, 2012.

    Hodgkin lymphoma. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/types/hodgkin . Accessed October 25, 2012.

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