Hodgkin Lymphoma: Diagnosis

How is Hodgkin lymphoma diagnosed?

If your healthcare provider thinks you may have Hodgkin lymphoma, you'll need certain exams and tests to be sure. Diagnosing Hodgkin lymphoma starts with your healthcare provider asking you questions. You'll be asked about your medical history, your symptoms, risk factors, and family history of disease. A physical exam will be done focusing on swollen lymph nodes in your body. Blood tests will also be done.

What is a biopsy?

A biopsy is a tiny piece (called a 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 takes out a sample of tissue. The sample is sent to a lab. A doctor called a pathologist tests it 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 type of biopsy is most often used for Hodgkin lymphoma. For an excisional biopsy, the 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 or lymph node is taken out.

• Fine needle aspiration (FNA) or core needle biopsy. The doctor uses a very thin, hollow needle to do an FNA. For a core needle biopsy, the doctor uses a slightly bigger needle. The tip of the needle is put into the lymph node or tumor. Then a syringe is used to pull a small sample of tissue into the needle. For tumors deeper in the body, the doctor may use an ultrasound or CT scan to help guide the needle into the right place. A needle biopsy may not take out enough tissue for the pathologist to see cancer cells. Or the sample may be too small to tell the exact type of lymphoma. Because of this, most doctors don’t use a needle biopsy to diagnose Hodgkin lymphoma.

Getting your test results

Your healthcare provider will contact you with the results of your biopsy. Ask how long it will take and how you'll get the results.

If Hodgkin lymphoma is found, your provider will talk with you about other tests that might be needed. Make sure you understand the results and what happens next.