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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, a lymph node biopsy may be ordered.

Lymph Node Biopsy

For a lymph node biopsy, all or part of one of your lymph nodes will be removed. The tissue sample will be examined under a microscope. The biopsy can show whether there is cancer and the type and extent of cancer. A specific type of cell, called Reed-Sternberg cell, is associated with Hodgkins lymphoma.

Staging of Hodgkins 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.

The following factors are used to determine the stage of Hodgkins disease:

  • The number and location of lymph nodes affected
  • Whether the affected lymph nodes are on one or both sides of the diaphragm. The diaphragm is 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 Hodgkins 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 Hodgkins 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 is the term used for a cancer that has persisted. Refractory is the term used for a cancer that has returned following treatment.

References:

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

Hodgkin disease. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated March 8, 2013. Accessed April 30, 2013.

Hodgkin lymphoma. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/types/hodgkin. Accessed April 30, 2013.



Last reviewed April 2013 by Mohei Abouzied, MD; Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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