Your child will have a number of tests to investigate their symptoms and confirm a diagnosis of Hodgkin disease, including:
- medical history and physical examination
- blood tests
- medical imaging, which may include
- chest X-ray
- computed tomography (CT) scan
- magnetic resonance imaging (MRI)
- positron emission tomography (PET) scan
- lymph node biopsy – where a small sample of a lymph node is removed to be examined under a microscope
- bone marrow aspiration and biopsy – where a sample of bone marrow and a small piece of bone are taken to be examined under a microscope.
These tests are explained in more detail in How is cancer diagnosed?.
If your child is diagnosed with Hodgkin disease, some of the diagnostic tests will also help to stage the tumour. Staging determines where the tumour is, how big it is, which nearby organs are involved and whether it has spread to other parts of the body. This is important to determine the outlook (prognosis) for your child, and to decide on the best options for treatment.
There are different ways to assess the stage or extent of disease. One of the most common ways of describing stages for Hodgkin disease is as follows:
- Stage I – the cancer is found only in 1 lymph node area or lymphoid organ (such as the thymus), or only in 1 organ outside the lymphatic system.
- Stage II – the cancer is found in 2 or more lymph node areas on the same side of the body (either both above or both below the diaphragm, which separates the chest and the abdomen), or the cancer has spread from 1 lymph node area into 1 nearby organ.
- Stage III – either the cancer is found in more than 1 lymph node area on both sides of the diaphragm (both above and below), or it is found in lymph node areas both above and below the diaphragm and has spread to a nearby organ and/or the spleen.
- Stage IV – the cancer has spread to 1 or more organs outside the lymphatic system; or it is found in 2 organs in distant parts of the body (but not in the nearby lymph nodes); or it is in the liver, bone marrow, lungs or cerebrospinal fluid.