Loading icon
Press enter or spacebar to select a desired language.
Health Information Center

Diagnosis of Hodgkin Lymphoma

Authors:
  • Amy Scholten, MPH
Publication Type:

Condition InDepth

Diagnosis of Hodgkin Lymphoma

Diagnosis often starts when someone sees their doctor for symptoms and also has swollen lymph nodes. The swollen lymph nodes are painless. They may be found in the neck, collarbone, armpit, or groin. For some, swollen lymph nodes in the chest are found during a chest x-ray.

Lymph nodes can swell for reasons other than cancer. The doctor will ask about symptoms and family and past health. Lymph nodes throughout the body will be carefully checked. The doctor will check other areas of the body, such as the spleen and liver, for swelling. If there are no obvious reasons for these symptoms, a blood disorder may be suspected.

Diagnosis of Hodgkin Lymphoma

A lymph node biopsy is the only way to confirm a diagnosis. During the biopsy, all or part of a lymph node is removed. The tissue is examined under a microscope. The goal is to look for a specific cancer cells. The presence of these cells indicate Hodgkin lymphoma. Types of biopsies include:

  • Excisional—Most common. The entire lymph node is removed in an open procedure.
  • Incisional—A small part of the node is removed during an open procedure.
  • Fine needle aspiration—A thin needle is inserted into the lymph node. Lymph tissue and fluid removed with a syringe.
  • Core needle —A larger, hollow needle is inserted into the lymph node. Lymph tissue and fluid are removed with a syringe.

Diagnosis of Hodgkin Lymphoma

A lymph node biopsy is the only way to confirm a diagnosis. During the biopsy, all or part of a lymph node is removed. The tissue is examined under a microscope. The goal is to look for a specific cancer cells. The presence of these cells indicate Hodgkin lymphoma. Types of biopsies include:

  • Excisional—Most common. The entire lymph node is removed in an open procedure.
  • Incisional—A small part of the node is removed during an open procedure.
  • Fine needle aspiration—A thin needle is inserted into the lymph node. Lymph tissue and fluid removed with a syringe.
  • Core needle —A larger, hollow needle is inserted into the lymph node. Lymph tissue and fluid are removed with a syringe.

Staging of Hodgkin Lymphoma

If Hodgkin lymphoma is found, the biopsy results and new tests will help find the stage of the cancer. Staging is used to get information about the cancer. The outlook is based on staging and other information such as the person's age and health . It is also used to create treatment plan.

Staging Tests

A number of things determine staging. Tests will vary by person, but may include:

Stages of Hodgkin Lymphoma

Hodgkin lymphoma is staged from 0-4:

  • Stage 1—Cancer is INSIDE the lymphatic system in one the following places:
    • One lymph node or more than one in the same lymph node cluster
    • Lymphatic tissue in the throat (tonsils and/or adenoids)
    • Thymus
    • Spleen
  • Stage 1E —Cancer is OUTSIDE of the lymph system in ONE organ or area.
  • Stage 2 —Cancer is in 2 or more lymph node groups either above OR below the diaphragm (area between the chest and belly).
  • Stage 2E —Cancer is in one or more lymph node groups either:
    • Above OR below the diaphragm AND
    • In a nearby organ or area
  • Stage 3—Cancer is in lymph node groups above AND below the diaphragm.
  • Stage 3E—Cancer is in lymph node groups:
    • Above AND below the diaphragm AND
    • In a nearby organ or area
  • Stage 3S—Cancer is in lymph node groups:
    • Above AND below the diaphragm AND
    • In the spleen
  • Stage 3E, S—Cancer is in lymph node clusters:
  • Above AND below the diaphragm AND
    • In a nearby organ or area AND
    • In the spleen
  • Stage 4
    • Cancer is OUTSIDE of the lymph nodes. It is one or more organs AND lymph nodes near those organs OR
    • Cancer is OUTSIDE of the lymph nodes. It is in one organ AND has spread to areas far from the organ OR
    • Cancer is found in the lungs, liver, bone marrow, or fluid around the brain and spinal cord. The cancer is in these areas, but has not spread there from other nearby sites.

For treatment purposes Hodgkin lymphoma may also be grouped as:

  • Early favorable—stage 1 or 2 with no other factors
  • Early unfavorable—stage 1 or 2 with one or more factors, such as:
    • A tumor larger than 10 centimeters (cm)
    • Cancer in an organ
    • An ESR blood test that shows inflammation, or
    • Symptoms like night sweats or fever
  • Advanced favorable—stage 3 or 4 with 3 to 4 factors:
    • Male
    • Aged 45 years and older
    • Stage 4
    • Abnormal blood cell counts
  • Advanced unfavorable—stage 3 or 4—with 4 or more of any factors listed above

References

  • Adult Hodgkin lymphoma treatment (PDQ)—patient version. National Cancer Institute website. Available at: https://www.cancer.gov/types/lymphoma/patient/adult-hodgkin-treatment-pdq.
  • Diagnosis. Leukemia & Lymphoma Society website. Available at: http://www.lls.org/lymphoma/hodgkin-lymphoma/diagnosis.
  • Hodgkin lymphoma. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/hematology-and-oncology/lymphomas/hodgkin-lymphoma.
  • Hodgkin lymphoma (HL). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hodgkin-lymphoma-hl.
  • Tests for Hodgkin lymphoma. American Cancer Society website. Available at: https://www.cancer.org/cancer/hodgkin-lymphoma/detection-diagnosis-staging/how-diagnosed.html.

Contributors

  • Mohei Abouzied, MD, FACP
Last Updated:
2022-11-01

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.