Making the Diagnosis
To diagnose Hodgkin's disease, a doctor will need to perform a thorough
physical exam, checking the lymph nodes carefully for signs of swelling.
In some cases, an abnormal mass can be detected just by feeling the nodes. Some
nodes are deep in the body, so they can't be easily felt. Occasionally, the spleen enlarges (under the left rib cage) and can be felt by the doctor. The spleen, or other masses, may show up
on special tests like X-rays. A lymph node biopsy (the removal of some
lymph node tissue for analysis in the laboratory) is necessary to determine
the cause of enlarged lymph nodes and to confirm the diagnosis of cancer.
Other possible tests that may be needed include blood and urine tests,
as well as special scans like a computed tomography (CT) scan or a magnetic resonance
imaging (MRI) scan. These scans help doctors find out if the cancer has
spread to other areas of the body. All these tests are useful for the purpose
of "staging the cancer." This means determining the extent of the cancer
to see if it's in an early or advanced stage. Staging is important
for planning the course of treatment.
There are four stages of Hodgkin's disease. Stage I is the mildest and stage
IV is the most severe.
- Stage I: the cancer is still localized in the lymph node region,
which means that it has not spread
- Stage II: the cancer has spread to a small extent to nearby lymph
areas, on the same side of the diaphragm (the muscle that separates the areas
of the chest from the abdomen)
- Stage III: the cancer has spread to lymph node regions both below and above the
diaphragm
- Stage IV: the cancer has spread to organs outside of the lymph system. Common areas of spread are the liver and bone marrow