Tests and diagnosis
It’s really important to have the tests you need to investigate your condition and get a clear diagnosis before you start any treatment. At any time, you can ask your healthcare team to tell you why you’re having a certain test and what the results mean.
Tests to diagnose Hodgkin lymphoma
If your GP suspects you might have Hodgkin lymphoma, they’ll refer you to hospital for more tests.
If the lump is in your chest, you may need a different type of biopsy called a mediastinoscopy. Your doctor will pass a thin tube with a tiny camera on the end through a small cut at the base of your neck. This allows them to have a look inside your chest and take a biopsy at the same time. You’ll have a general anaesthetic so you’ll be asleep and won’t feel anything.
Staging describes how far a person’s disease has spread. Your healthcare team will use a system based on the Roman numbers I to IV to categorise this.
Staging for Hodgkin lymphoma is based on the symptoms you have and how many sites in your body are affected by lymphoma. The treatment you receive will depend on the stage of the Hodgkin lymphoma.
For any stage of Hodgkin lymphoma, a letter ‘A’ or a ‘B’ can be added to your diagnosis. These letters indicate whether you have certain symptoms or not. So your diagnosis might be IA or IIB, for example. Stages I and IIA are called early stage disease. Stages IIB, III(A or B) and IV(A or B) are called advanced disease.
||Only one group of lymph nodes is affected, in one place in your body
||More than one group of nodes is affected but all affected sites are on the same side of the diaphragm - either above or below. The diaphragm is a sheet of muscle separating your chest from your stomach and hip area (abdomen and pelvis).
||Lymph nodes on both sides of the diaphragm are affected, or the lymphoma has spread from the lymph nodes into organs close to the affected node, or nodes.
||The lymphoma has spread to other organs, such as the lungs, liver or bone marrow.
||No B symptoms (see below)
||B symptoms are present:
- fever (higher than 38ºC)
- drenching night sweats
- unexplained weight loss in the last six months (10% or more of your previous weight).
As well as putting an A or a B after the stage, sometimes an X is added. This describes bulky disease, which means that the lumps caused by the lymphoma are quite large. Whether or not you have bulky disease can be important in deciding which treatment you should have.
Further tests after diagnosis
After you’ve been diagnosed, you’ll have further tests so your healthcare team can find out which areas of your body are affected by Hodgkin lymphoma, and the stage of the disease. You may have the following tests:
- PET-CT scan to stage the lymphoma, support decisions about your treatment, and confirm that you have no active cancer (you’re in remission) when you’ve finished treatment
- MRI scan to look for affected lymph nodes in soft tissues (non-bony parts) around your body.
You may have a range of other tests, which will help your healthcare team check your general health and assess how well you might respond to certain treatments. These may include:
- a full blood count
- tests on your heart, lungs, kidneys, liver and thyroid (a gland that plays an important part in turning food into energy)
- tests for HIV and two types of liver disease: hepatitis B and hepatitis C.
Order or download our booklet, Hodgkin lymphoma.