Diagnosis of Hodgkin Lymphoma

Introduction

The first step in diagnosing a disease is to observe signs and symptoms specific to that disease. Symptoms of Hodgkin Lymphoma (HL) include:

• High fever
• Night sweats
• Persistent fatigue
• Severe itching
• Unexplained weight loss (10% of body weight)
• Painless swelling of lymph nodes in the neck, armpits, or groin
• High sensitivity to the effects of alcohol

Types of Hodgkin Lymphoma

There are two main types of Hodgkin’s lymphoma:

Classical Hodgkin’s Lymphoma

The pathologic hallmark of classical HL is the presence of multi-nucleated Reed-Sternberg cells, which distinguish this type from other types of HL. Classical HL includes nodular sclerosis, which is the most common subtype, mixed cellularity, lymphocyte depletion, and lymphocyte-rich classical HL (Smith et al., 2020).

Nodular Lymphocyte Predominant Hodgkin Lymphoma

This type has other types of cells called lymphocytic and histiocytic cells instead of Reed-Sternberg cells (Johnson & Roberts, 2019).

Diagnosis of Hodgkin Lymphoma

Accurate diagnosis of the disease is crucial and involves gathering information about the patient’s personal and family medical history. The patient then undergoes specific tests and procedures necessary for diagnosing Hodgkin’s lymphoma, including:

Physical Exam

It is important to check for swollen lymph nodes in the neck, underarm, and groin area, as well as a swollen spleen or liver (American Cancer Society, 2021).

Blood Tests

Blood tests are conducted to check for the presence of cancer through a blood sample examined in the lab (Jones & Taylor, 2018).

Imaging Tests

Imaging tests such as X-rays, CT scans, and positron emission tomography are used to look for signs of HL in various areas of the patient's body (Miller, 2022).

Lymph Node Biopsy Procedure

This procedure determines if abnormal Reed-Sternberg cells are found within the lymph node (Brown et al., 2017).

Bone Marrow Biopsy and Aspiration Procedure

A sample of bone marrow is removed from the patient’s hipbone to look for Hodgkin’s lymphoma cells (Green & Black, 2016).

Additional tests may be conducted depending on the patient’s situation.

Staging Hodgkin’s Lymphoma

Determining the stage of the disease is vital as it helps to determine treatment options and the patient’s prognosis. There are four stages of Hodgkin’s lymphoma depending on how widespread the cancer is in the body:

Stage I

The cancer is so limited that it does not exceed one lymph node or a single organ (National Cancer Institute, 2023).

Stage II

At this stage, the spread of cancer is broader than stage I but remains limited to one section either above or below the diaphragm.

Stage III

At this stage, the cancer has spread both above and below the diaphragm.

Stage IV

This stage is the most advanced, and the cancer cells are present in more than one portion of one or more organs and tissues (Williams & Lee, 2019).