by Debra Wood, RN
En Espaol (Spanish Version) The doctor will ask about your symptoms and medical history and perform a physical exam, paying carefully 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 re-examination. If swelling persists, your doctor may order a lymph node biopsy.
For a lymph node biopsy, your doctor will remove all or part of one of your lymph nodes. A pathologist will examine this tissue sample under a microscope. The biopsy can show whether or not there is cancer and the type and extent of cancer. A specific type of cell, called Reed-Sternberg cell, is associated with Hodgkins lymphoma.
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.
Your doctor considers the following factors to determine the stage of Hodgkin's disease:
The number and location of lymph nodes affectedWhether the affected lymph nodes are on one or both sides of the diaphragm (the thin muscular sheet that separates the chest from the abdomen)Whether the disease has spread to other lymphatic tissues, such as the spleenWhether the disease has spread to the bone marrow, liver, or other places outside the lymphatic system Additional tests to determine staging may include: Blood testssuch as complete blood count, sedimentation rate, blood chemistries, and liver and kidney function testsImaging studiessuch as chest x-ray; CT scan of the chest, abdomen, and pelvis; ultrasound of the abdomen; and gallium (radionuclide) scanAdditional biopsies of lymph nodesBiopsies of the liver, bone marrow, or other tissuesLaparotomy (rarely done)An incision is made through the wall of the abdomen; samples of tissue are removed and examined under a microscope to check for cancer cells. Stages of Hodgkins DiseaseStage Icancer is found only in a single lymph node area, in the area immediately surrounding that node, or in a single organ Stage IIcancer involves more than one lymph node area on one side of the diaphragm Stage IIIcancer involves lymph node regions above and below the diaphragm
Stage IVcancer 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 Hodgkin's lymphoma experiences general symptoms from the diseasefever, night sweats, or significant weight loss. If these specific symptoms are not present, the classification is "A."Relapsed/RefractoryThis is the term used for a cancer that has persisted or returned following treatment. References: The Leukemia & Lymphoma Societywebsite. Available at: http://www.leukemia-lymphoma.org/hm_lls. National Cancer Institute website. Available at: http://www.cancer.gov/. Last reviewed May 2007 by Igor Puzanov, MDPlease 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.
