How is Hodgkin lymphoma diagnosed?

If your healthcare provider thinks you might have Hodgkin lymphoma, certain exams and tests will be needed to be sure. The process starts with your healthcare provider 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 provider 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 healthcare provider to know for sure if you have Hodgkin lymphoma.

For a biopsy, the provider takes out a sample of tissue. The sample is sent to a lab. A healthcare 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 a 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 healthcare provider uses a very thin, hollow needle to do an FNA. For a core needle biopsy, the healthcare provider 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 provider 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 providers 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 healthcare provider has the results, they will contact you. Ask how long it will take and how you can expect to find out your biopsy results. Will it be a phone call or do you need to make an appointment?

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