Hodgkin Lymphoma: Diagnosis

Common signs and symptoms of Hodgkin lymphoma include swelling of the lymph nodes, fever, night sweats, unexplained weight loss and lack of energy. While most people who experience these symptoms will not have lymphoma, anyone with persistent symptoms should be seen by their doctor to make certain that lymphoma is not present. Only a physician will be able to conduct an accurate assessment for Hodgkin lymphoma, which requires a number of diagnostic tests (detailed below).

First, a pathologist (a doctor who studies tissues and cells to identify diseases) specializing in hematologic malignancies will examine the tumor tissue under the microscope for the characteristic features of Reed-Sternberg (R-S) cells in the surrounding tissue and then confirm the diagnosis by analyzing the antigens or markers on the surface of the cells. In classical Hodgkin lymphoma, the cell markers (antigens) are CD30 positive and CD15 positive. In nodular lymphocyte predominate Hodgkin lymphoma, the immunophenotype, or diagnostic proteins, are CD30 negative, CD15 negative and CD20 positive.

Further examinations will then be performed to determine how far the disease has spread (staging) and how well the patient’s body is functioning. The physician may use some or all of the following tests as well as the patient’s medical history to assess the course of treatment that has the best chance of rendering either a remission or cure:

  • Lymph node biopsy
  • Blood tests
  • Bone marrow examination
  • Imaging tests (chest x-ray, computerized tomography scan, positron emission tomography scan, etc.)
  • Cardiac function test
  • Pulmonary function test

All of the information gained from these tests will help the patient’s healthcare team determine the best course of treatment. To learn more about specific diagnostic tests as well as interpreting the results, read the Lymphoma Research Foundation’s comprehensive booklet, Understanding Hodgkin Lymphoma