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To properly diagnose Hodgkin lymphoma, your doctor will start by taking your medical history and performing a physical examination, paying close attention to the lymph nodes and other parts of your body that might be affected, like the spleen and liver. Other diagnostic tests may follow, including:
This is the only way to be sure of the diagnosis. Your doctor will choose the best type of biopsy to do based on your situation:
Excisional or incisional biopsy. Your doctor cuts through the skin to remove the lymph node. If the whole lymph node is removed, it’s an excisional biopsy—if a small part of a larger tumor or node is removed, it’s an incisional biopsy.
Needle biopsy. A needle biopsy is less invasive than excisional or incisional biopsies. There are two main types:
Immunohistochemistry. This lab test looks for certain proteins on cells, such as CD15 and CD30. These are found on the surface of the Reed-Sternberg cells in classic Hodgkin lymphoma (cHL).
Imaging tests. X-rays, sound waves, magnetic fields, or radioactive particles make pictures of the inside of the body. The imaging tests most commonly used:
UCHealth follows the Lugano classification for staging Hodgkin lymphoma. It has 4 stages, labeled I, II, III, and IV.
For limited stage (I or II) HL that affects an organ outside of the lymph system, the letter E is added to the stage (for example, stage IE or IIE).
Stage I: Either of the following means that the HL is stage I:
Stage II: Either of the following means that the HL is stage II:
Stage III: Either of the following means that the HL is stage III:
Stage IV: HL has spread widely into at least one organ outside of the lymph system, such as the liver, bone marrow, or lungs.
Source: American Cancer Society