How is Hodgkin lymphoma diagnosed?

If your doctor thinks you might have Hodgkin lymphoma, certain exams and tests will be needed to be sure. The process starts with your doctor asking you questions. You will be asked about your health history, your symptoms, risk factors, and family history of disease. A physical exam will be done. It will focus on checking for swollen lymph nodes in your body. Blood tests will also be done.

Based on the findings, your doctor may decide you need a biopsy to check for cancer.

What is a biopsy?

A biopsy is a tiny piece of tissue (called a sample) that’s removed and checked for cancer cells. A biopsy is the only way for your doctor to know for sure if you have Hodgkin lymphoma.

For a biopsy, the doctor takes out a sample of tissue. The sample is sent to a lab. A health care provider called a pathologist tests it for cancer cells. A few types of biopsies can be done to look for Hodgkin lymphoma.

Types of biopsies

The types of biopsies used to diagnose Hodgkin lymphoma include:

• Excisional or incisional biopsy. This type of biopsy is most often used for Hodgkin lymphoma. For an excisional biopsy, the surgeon takes out the whole lymph node. This type of biopsy almost always gives the pathologist enough tissue to make an accurate diagnosis. For an incisional biopsy, only part of a large tumor or lymph node is taken out.

• Fine needle aspiration (FNA) or core needle biopsy. The doctor uses a very thin, hollow needle to do an FNA. For a core needle biopsy, the doctor uses a slightly bigger needle. The tip of the needle is put into the lymph node or tumor. Then a syringe is used to pull a small sample of tissue into the needle. For tumors deeper in the body, the doctor may use an ultrasound or CT scan to help guide the needle into the right place. A needle biopsy may not take out enough tissue for the pathologist to find cancer cells. Or the sample may be too small to tell the exact type of lymphoma. Because of this, most doctors don’t use a needle biopsy to diagnose Hodgkin lymphoma.

Getting your test results

It usually takes several days for the results of your biopsy to come back. When your doctor has the results, they will contact you. Ask how long it will take and how you can expect to find out your biopsy results. Can you contact them for the results, or will you need to make an appointment?

If Hodgkin lymphoma is found, your doctor will talk with you about other tests that might be needed. Make sure you understand the results and what your next steps should be.