Tests for Hodgkin's Disease

Hodgkin's disease, also called Hodgkin's lymphoma, is a rare type of cancer that affects the lymphatic system, which includes the lymph nodes, the spleen, the liver and the bone marrow. The disease was named after Thomas Hodgkin, who first described it in 1832. Some of the symptoms of the disease include enlarged lymph nodes in the neck, arm and groin; fever and chills; itchy skin; a loss of appetite; and night sweats. This is the third most common type of cancer found in children ages 10 to 14, and those who have mononucleosis are more at risk.

Physical Exam

• During a physical examination, a doctor will test a patient to see if the lymph nodes are swollen. He will feel the lymph nodes in a part of a person's body, in areas such as the neck and underarms, as well as asking about the individual's symptoms and family history. He will look at the age of the patient and examine him for a large mass in the middle of his chest and the presence of the disease in four different regions of the body. Doctors may also look to see whether the spleen or liver are showing signs of being swollen.

Blood Tests

• Another basic test that may be done is a blood chemistry test, which tests the blood serum, or the part of the blood that does not have cells. During this test, a physician performs a number of tests, looking at levels of cholesterol and protein. This test shows how well certain organs in the body, such as the kidney and liver, are functioning, which can give clues as to whether cancer could be present. A doctor may also order a complete blood count, which is used to look at the number of different types of blood cells and the amount of hemoglobin in the red blood cells. Abnormalities in blood counts can be the first sign of Hodgkin's lymphoma.

CAT Scan

• During a CAT scan, x-rays are used to get pictures of a cross-section of the patient's body. This test can show whether there is cancer present is certain areas, such as the abdomen, chest, head and neck. If there is cancer present, the test can show that it has spread from the lymph nodes to other parts of the body. The procedure is similar to a chest x-ray, but instead of taking one picture, the CT scanner rotates around the patient's body and produces a number of images. During this procedure, patients are sometimes given an intravenous injection of a dye that can help outline their body's structures in the pictures that are taken, which will allow the doctor to tell the difference between bodily organs and tumors, if they are present.

Biopsy

• The most common type of test that is given to people with Hodgkin's lymphoma is a biopsy. During this type of test, a a full lymph node or a portion of one is removed from a patient's body. Usually, during a biopsy, cells or tissues are taken and looked at under a microscope, but a larger sample is needed to determine whether someone has Hodgkin's lymphoma. This type of biopsy is known as a needle biopsy because a needle is used to remove the lymph node that is potentially cancerous. If a part of the lymph node is taken out and examined by a pathologist under a microscope, it is considered to be an incisional biopsy; if the whole lymph node is removed, it is a excisional biopsy. A doctor may also perform a bone marrow aspiration and biopsy, to see if the cancer has spread to the bone marrow. During this procedure, bone marrow and a bone chip are removed and examined under a microscope.

PET and Gallium Scans

• A pet scan is different from a CAT scan because it is not used to show the structure of bodily organs, but instead to demonstrate how well organs and tissues are working. During these tests, a radioactive material, known as a tracer, is injected into one of the patient's veins; it then collects in the organs and tissues. About an hour later, after the substance is absorbed, the patient is put under a PET scanner, which takes pictures of organs where the radioactive substance has collected. These images can show how well organs are functioning, how they are shaped and where they are positioned, which can give doctors a sense of whether there are problems with these organs, such as the presence of cancer. A gallium test is another diagnostic tool that uses radioactive material. It works in a similar manner to the PET scan, as pictures are taken after the radioactive gallium is absorbed by organs. This test looks for inflammation in bodily organs.

Other Tests

• Other tests that doctors may perform to test their diagnoses are urine crytologies, Lumbar punctures, blood protein tests and tumor marker tests. These are used to diagnose many types of cancer. During a gallium scan, radioactive substances are injected into a patient to look for areas of the body where the cancer may have spread. In a urine crytology, doctors examine the patient's urine under a microscope to see whether there are cancer cells in areas of her body, such as her bladder and kidney. Another test that is sometimes performed for patients with symptoms of Hodgkin's Lymphoma is a Lumbar puncture, or a spinal test, during which cerebrospinal fluid is tested for the presence of cancerous cells. Blood protein tests look at whether there are proteins in the blood, such as immunoglobulin, that can be indicative of cancer. Tumor marker tests are used to find out if there are certain chemicals present in the body that could be made by cancerous cells. The problem is that these chemicals can also be present when people do not have cancer.