How Hodgkin Lymphoma Is Diagnosed

Some of the early symptoms of Hodgkin lymphoma include high fevers, night sweats, unexplained weight loss, fatigue, persistent cough, abdominal pain, swelling, or the enlargement of lymph nodes.

If you experience one or more of these symptoms, your healthcare provider will likely run a series of tests to diagnose whether or not your condition is Hodgkin lymphoma. This will include a physical exam, blood tests, imaging tests like an X-ray or computerized tomography (CT) scan, and a biopsy.

Self-Checks/At-Home Testing

There are no at-home tests available when it comes to Hodgkin lymphoma. But being aware of what’s going on with your body with frequent self-checks is often the first line of defense.

If you find painless swelling in the areas where your lymph nodes are located (the neck, armpits, and groin area) it’s important to bring it to the attention of your healthcare provider, whether you exhibit any of the other symptoms of Hodgkin lymphoma or not.

A clinical diagnosis is crucial when it comes to treating Hodgkin lymphoma as effectively and quickly as possible for the best possible outcome.

Physical Examination

Most often your general practitioner is the best place to start. Similar to any possible disease or condition, you’ll be asked to go over your medical history (make sure to bring your past medical records if you’re seeing a new healthcare provider), risk factors, and family health history.

Your healthcare provider will start with a physical exam when it comes to diagnosing Hodgkin lymphoma. They’ll examine your lymph nodes, looking for any possible swelling or enlargement in the neck, groin, armpits, as well as the spleen and liver.

From there, they will determine the next tests to run and will be able to refer you to a specialist down the road should you need one.

Labs and Tests

After a physical exam, your healthcare provider will likely order a blood test in order to detect if there are signs of Hodgkin lymphoma in your body. This will show the levels of red and white blood cells in the body, platelets, as well as take a look at your liver and kidney function.

Some common blood tests run during a Hodgkin lymphoma diagnosis include:

• Complete blood count (CBC): This count includes red blood cells (RBC), white blood cells (WBC), platelets, RBC indices, and types of WBC.
• Erythrocyte sedimentation rate (ESR): This test looks at how quickly red blood cells settle to the bottom of a test tube. If they do so at a fast rate it could be a sign of inflammation and disease in the body.
• Lactate dehydrogenase (LDH): High amounts of lactate dehydrogenase could be a sign of diseased tissue in the body.
• HIV and hepatitis B testing: These conditions may affect treatment should you be diagnosed with Hodgkin lymphoma.

If certain lymph nodes look suspect and don’t shrink after a certain amount of time or with prescription medication like an antibiotic, a biopsy will be done to diagnose Hodgkin lymphoma as well as determine which type of Hodgkin lymphoma is affecting the cells.

The biopsy will take either a piece or the entire lymph node out. Once the diagnosis is confirmed (or often done at the same time as the biopsy) a bone marrow biopsy may follow to see if the cancer has spread to the bone marrow.

Imaging

Imaging tests are a way to help your healthcare provider take a look inside the body to see what lymph nodes may be affected by Hodgkin lymphoma, and/or if the cancer has spread and is affecting organs outside of the lymph nodes.

Depending on your symptoms and the results from your physical exam and blood work it may be advised you get one or more of the following imaging tests done:

• Chest X-ray
• CT scan
• Positron emission tomography-computerized tomography (PET-CT) scan
• Magnetic resonance imaging (MRI)

A bone scan may also be recommended, but only if previous lab tests indicate Hodgkin lymphoma may have spread to the bones or if one of your symptoms is bone pain.

Differential Diagnoses

There are many conditions that have similar symptoms to Hodgkin lymphoma, which is why it’s so important to seek counsel from a healthcare professional if you happen to spot a swollen lymph node or have symptoms that align with a Hodgkin lymphoma diagnosis. These include other types of cancer such as:

• Non-Hodgkins lymphoma
• Leukemia
• A tumor located in the glands
• Testicular cancer

But a swollen lymph node isn’t an automatic red flag for cancer. Some other diseases that may have similar signs to Hodgkins lymphoma include:

• A neck cyst
• Infection (such as mononucleosis)
• Sarcoidosis
• Cytomegalovirus
• HIV
• A parasite (like toxoplasmosis)
• Autoimmune diseases

Infections that cause swollen lymph nodes can include viral, bacterial, fungal, or parasitic infections.

A Word From Verywell

It can be extremely unsettling to discover what you think may be a swollen lymph node, but it’s important to remember that there are many benign causes that may result in swelling. However, this doesn’t mean you should ignore it, especially if you begin to exhibit other concerning symptoms that fall in line with Hodgkin lymphoma.

Bring it to the attention of a healthcare provider immediately so that they can begin to run the proper tests and diagnose what’s happening. If it is Hodgkin lymphoma, early detection can make more treatment options available to you.