Understanding Hodgkin Lymphoma -- Diagnosis and Treatment
How Do I Know If I Have Hodgkin Lymphoma?
The diagnosis of Hodgkin lymphoma can only be made by a tissue biopsy -- cutting a tissue sample for examination. If you have an enlarged, painless lymph node that your doctor suspects may be due to Hodgkin lymphoma, tissue will be taken for biopsy or the entire node will be removed. The diagnosis of Hodgkin lymphoma is sometimes confirmed by the presence of a type of cell called a Reed-Sternberg cell.
If a biopsy reveals that you do have Hodgkin lymphoma, you may need additional tests to determine the extent, or stage, of the disease. Tests include blood tests, chest X-ray, computed tomography (CT) scans of the chest, abdomen and pelvis, and possibly the neck, and a PET scans. Magnetic resonance imaging (MRI) scans, bone scans, spinal tap (lumbar puncture), and bone marrow studies are useful under special circumstances.
In general, the use of combined chemotherapy and low-dose involved-field radiation therapy (LD-IFRT) broadens the spectrum of potential toxicities, while reducing the severity of individual drug-related or radiation-related toxicities. Current approaches use chemotherapy with or without LD-IFRT. The volume of radiation and the intensity/duration of chemotherapy are determined by prognostic factors at presentation, including presence of constitutional symptoms, disease stage, and bulk.
These tests will reveal the stage of the Hodgkin lymphoma and determine the best type of therapy.
What Are the Stages of Hodgkin Lymphoma?
The prognosis and specific treatment used to treat Hodgkin depends on the stage of the disease or how widespread it is. Here are the stages of the disease:
Stage I. Hodgkin lymphoma is found in only one lymph node area or structure (such as the spleen).
Stage II. Hodgkin lymphoma is found in two or more lymph node areas on the same side of the diaphragm (the muscle beneath the lungs that moves up and down to help you breathe).
Stage III. Hodgkinlymphoma is in lymph nodes on both sides of the diaphragm, or the cancer may also have extended to an area or organ adjacent to the lymph node or to the spleen.
Stage IV. Hodgkin lymphoma has spread to one or more organs outside the lymphatic system such as the bone marrow or liver.
Refractory or recurrent Hodgkin lymphoma. Refractory disease is the term used when the disease does not respond to initial therapy. Recurrent disease means that Hodgkin lymphoma has come back after it has been treated. This may occur shortly after treatment or, less commonly, years later.