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| Overview: Hodgkin Disease |
How Is Hodgkin Disease Found? |
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There are no tests to find Hodgkin disease early, and some people with
the disease have no symptoms at all. Most people with Hodgkin disease
see their doctor because they have felt a lump that hasn’t gone away or
they just don’t feel well and go in for a check-up. They may have a
swollen lymph node in the neck, arm pit, or groin area. Sometimes it
will go away only to come back. Eventually, it doesn’t go away, and
though it doesn’t hurt, it will get larger and cause the person to go
to the doctor.
But in most people, especially children, enlarged lymph nodes are
caused by an infection or other illness and not cancer. If you (or your
child) have lymph nodes over an inch in size and no recent infection,
it is best to have them checked by the doctor.
Signs and Symptoms of Hodgkin Disease
You or your child can have Hodgkin disease and feel perfectly well.
However, there are some symptoms that this disease may cause.
Lumps Under the Skin
You may notice a lump in the neck, under the arm, or in the groin.
Sometimes this may go away, only to come back. Although it doesn't
hurt, it may finally not go away, and lead you to see a doctor.
General Symptoms
Some patients with Hodgkin disease have fever, drenching night sweats,
or weight loss. The fever can come and go over many days or weeks.
Itching, tiredness, and poor appetite are other symptoms that may
occur. Sometimes the only symptom may be feeling tired all the time.
However, infections, other types of cancer, or other conditions can
also cause these symptoms.
Cough or Trouble Breathing
When Hodgkin disease affects lymph nodes inside the chest, the swelling
of these nodes may press on the windpipe. This can make you cough or
even have trouble breathing, especially when lying down.
If you or your child has any of these symptoms, discuss them with your
doctor right away. The sooner a correct diagnosis is made, the sooner
treatment can be started and the better the treatment will work.
Medical History and Physical Exam
If symptoms suggest that you might have Hodgkin disease, the doctor
will want to get a complete medical history, including how long you
have had the symptoms. The doctor will ask questions about your health
now and in the past and to do a physical exam to see whether there is
an infection. During the exam, the doctor will pay special attention to
the lymph nodes. Because it is common for people, especially children,
to have swollen lymph nodes, the doctor will look for infection first.
If the doctor thinks that Hodgkin disease might be causing the
symptoms, he or she will want to do a biopsy.
Biopsy
A biopsy involves removing a sample of the lymph node and looking at it
under a microscope. This is the only way to know for sure if the
swelling is caused by cancer. There are many different kinds of
biopsies, and the doctor will choose the one best suited for you or
your child. The goal is to get enough tissue to be sure of the
diagnosis.
Some biopsies involve cutting through the skin to remove an entire node
or a small part of a larger tumor. If the node is near the surface of
the skin, the skin can be numbed and the sample taken. But if the node
is deeper inside the body, the patient may need to be asleep first.
In a less common type of biopsy, the doctor uses a thin needle to
remove a small amount of fluid and tiny bits of tissue from the tumor.
Lab Tests
A doctor with special training in blood and lymph tissue disease
(called a pathologist) looks at all biopsy samples under a microscope.
The doctor looks at the appearance, as well as the size and shape of
the cells to find out whether any of them are Reed-Sternberg cells.
Sometimes the first biopsy does not provide a definite answer and more
biopsies are needed.
Looking at the tissue under the microscope can often tell whether you
have Hodgkin disease and what type it is, but sometimes special stains
are used on the sample to provide more information.
Last Medical Review: 10/16/2007
Last Revised: 05/06/2009
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