Your doctor will do a physical exam to search for signs of Hodgkin’s lymphoma in your body. He can also ask you questions about your medical history and the symptoms you experience to help him have a better idea of your condition. During the physical examination, your oncologist will look for signs of swollen lymph nodes. Depending on the volume of lymph nodes, a simple touch may reveal a mass, a vivid indication of Hodgkin’s lymphoma. In addition, if you have Hodgkin’s lymphoma, the size of your spleen tends to increase under the left rib cage.
However, these procedures are not sufficient to confirm the diagnosis; other medical techniques must be performed, which may include:
- Biopsy – to confirm a Hodgkin’s lymphoma diagnosis, a biopsy is always necessary. Your specialist can perform a needle biopsy to remove a small sample. He can choose to perform a surgical biopsy to remove the entire gland in order to obtain enough tissue for laboratory analysis. This procedure helps your physician to detect the presence of Reed-Sternberg cells, the main indicator of Hodgkin’s lymphoma.
- Blood analysis – a blood test will be done to determine the quantity and quality of your white and red blood cells. The blood test may also include an analysis of blood chemistry and the search for an abnormal erythrocyte sedimentation rate (ESR); high ESR levels are always seen in certain cancer of white blood cells and rheumatoid disease.
- Chest X-ray – this imaging technique is performed to detect swollen lymph nodes in your body that were not palpable during the physical examination
- CT scan/MRI of the thorax – a CT scan or magnetic resonance imaging (MRI) of the thorax, pelvis and abdomen is important to determine if you have a metastatic Hodgkin’s lymphoma.
- Positron emission tomography (PET) scan – this imaging technique aims to discover areas where cellular activity is increased, which often indicates the position of the cancer;
- Bone marrow aspiration and biopsy– under local anesthesia, your physician removes a tiny sample of your bone marrow and bone to be examined under microscope. This procedure allows your doctor to determine if bone marrow has been affected by the cancer.