blood disorders
Hodgkin Lymphoma
Diagnosis of Hodgkin Lymphoma
Lymph node biopsy Doctors suspect Hodgkin lymphoma when a person with no apparent infection develops persistent and painless enlargement of lymph nodes that lasts for several weeks. The suspicion is stronger when lymph node enlargement is accompanied by fever, night sweats, and weight loss. Rapid and painful enlargement of lymph nodes—which may occur when a person has a cold or infection—is not typical of Hodgkin lymphoma. Sometimes enlarged lymph nodes deep within the chest or abdomen are found unexpectedly when a chest x-ray or computed tomography (CT) scan is done for another reason. Abnormalities in blood cell counts and other blood tests may provide supportive evidence. However, to make the diagnosis, doctors must do a biopsy of an affected lymph node to see if it is abnormal and if Reed-Sternberg cells are present. Reed-Sternberg cells are large cancerous cells that have more than one nucleus (a structure inside a cell that holds the cell's genetic material). Their distinctive appearance can be seen when a biopsy specimen of lymph node tissue is examined under a microscope. The type of biopsy depends on which node is enlarged and how much tissue is needed. Doctors must remove enough tissue to be able to distinguish Hodgkin lymphoma from other disorders that can cause lymph node enlargement, including Non-Hodgkin Lymphomas , infections, inflammation, or other types of cancer. The best way to obtain enough tissue is with an excisional biopsy (a small incision made to remove a piece of the lymph node). Occasionally, when an enlarged lymph node is close to the body's surface, a sufficient amount of tissue can be obtained by inserting a hollow needle (under ultrasound or CT guidance) through the skin and into the lymph node (core needle biopsy). When an enlarged lymph node is deep inside the abdomen or chest, surgery may be needed to obtain a piece of tissue. 