Childen's Hospital Boston 300 Longwood Avenue
Boston, MA 02115
(617) 355-6000
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Clinical Services (Hodgkin's Lymphoma Program):
Diagnostic Evaluation
To outline the best treatment possible, it is very important to identify the exact type of Hodgkin's lymphoma and its presence throughout the body. To collect this information, our physicians will schedule several diagnostic tests and procedures.
Determining the tissue type
A tissue sample of the cancerous cells is required to establish the exact type of Hodgkin's lymphoma. Tissue samples are collected during a procedure called a biopsy. There are three types of biopsies we use to collect tissue samples. Our physicians will determine the type of biopsy required.

The three types of biopsies are:

  • Needle - a method that collects a sample of the suspicious tissue by inserting a needle through the skin
  • Minimally invasive surgery - a method that collects a sample of the suspicious tissue through a small incision
  • Open surgery - a method that removes a sample of the suspicious tissue by surgical incision
For some patients we may also recommend a bone marrow biopsy and aspiration. This surgical procedure collects a sample of the bone marrow, the substance that produces white blood cells, red blood cells and platelets.

After the tissue sample is collected, our pediatric hematopathologists will examine it under the microscope to determine if it is Hodgkin's lymphoma and the exact type. In addition to examining the tissue under the microscope, additional tests (often called stains or "immpox") are done to be certain about the diagnosis. Sometimes, molecular tests may also be required. Pathologists will usually assign a specific type of Hodgkin's: nodular sclerosing, mixed cellularity, lymphocyte depleted, or lymphocyte predominant. The first three types are sometimes called "classical" Hodgkin's.

Determining the location
Patients will also receive a series of imaging scans to measure the cancer's presence throughout their body. These scans include a Computerized Axial Tomography (CT) scan from the neck through the pelvis, a Positron Emission Tomography (PET) scan and gallium scan. Depending on the results, other imaging scans, such as an MRI or bone scan, may be required.

These studies are non-invasive. However, because they require patients to lie very still, children may receive procedural sedation or general anesthesia.

Interpreting all the information
After all the tests are complete, your physicians will review all the information as a group. Sometimes information from one test will influence the interpretation of another test. Thus, this is a critical step in determining the location of tumor cells and assigning the "stage."
Dana-Farber/Children's Hospital Cancer Care
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