With Hodgkin disease malignant (cancer) cells form in the lymph system. The lymph system is part of the body’s immune system. The immune system protects the body from foreign substances, infection, and diseases. The following is all part of the lymph system:
Lymph: Colorless, watery fluid that carries lymphocytes (type of white blood cell) through the lymph system. Lymphocytes protect the body against infection.
Lymph nodes: Small bean-shaped structures that filter lymph and store white blood cells that help fight infection and disease. Lymph nodes are located along lymph vessels, found throughout body. Clusters of lymph nodes are found in neck, underarm, abdomen, pelvis and groin.
Spleen: An organ located on the left side of the abdomen near the stomach, that filters blood, makes lymphocytes, stores blood cells and destroys old blood cells.
Thymus: An organ in which lymphocytes grow and multiply. The thymus is in the chest behind the breastbone.
Tonsils: Two small masses of lymph tissue at the back of the throat. The tonsils make lymphocytes.
Bone marrow: The soft spongy tissue in the center of the large bones. Bone marrow makes white blood cells, red blood cells and platelets.
Tests to help diagnose Hodgkin Lymphoma
Physical exam and history: The health care provider checks general signs of health, assesses for any lumps or anything else that seems unusual. They will also get history of past illnesses, health habits and any family history of illness
CT scan: A computer assisted X-ray that shows detailed pictures inside the body, such as neck, chest, abdomen and pelvis. A dye may be injected into a vein or swallowed to help the organ and tissues show up more clearly.
PET scan (positron emission tomography): An X-ray that helps to show where the malignant tumor cells are in the body. A small amount of radioactive glucose (sugar) is injected into the vein. The scanner will then make pictures where the glucose is
being used in the body. Cancer cells show up brighter in the picture because they take up more glucose than normal cells. The PET scan has three steps:
Injection of radioactive glucose
A waiting period of 30-60 minutes
Scanning by the PET machine
Chest X-ray: An X-ray of the organs and bones inside the chest.
CBC (complete blood count) checks the number of red blood cells (oxygen carriers), platelets (cells that help the blood clot properly) and white blood cells (infection fighters)
Sedimentation rate can help measure how much inflammation is in the body
Blood chemistry studies measures amounts of certain substances released into the blood by organs and tissues in the body.
All these tests are usually done at time of diagnosis to rule out other diseases and are also done throughout treatment to monitor response and to monitor for possible side effects of treatment.
A pathologist will look at the tissue under the microscope to look for cancer cells. Reed - Sternberg cells are common in classical Hodgkin lymphoma.
Bone marrow aspiration and biopsy: Sometimes done to help determine if the Hodgkin lymphoma cells are in the bone marrow, the blood producing factory in the body. A special needle is inserted into one of the bones (typically the back of the hip bone)
and a small amount of marrow (liquid part) is aspirated into a syringe. The biopsy includes taking a small piece of bone and sending it to lab for review. Since the procedure is uncomfortable most patients are given pain medicine or sedated during