context: The diagnosis of Hodgkin lymphoma can only be made by a tissue biopsy -- cutting a tissue sample for examination. If you have an enlarged, painless lymph node that your doctor suspects may be due to Hodgkin lymphoma, tissue will be taken for biopsy or the entire node will be removed. The diagnosis of Hodgkin lymphoma is sometimes confirmed by the presence of a type of cell called a Reed- Sternberg cell. If a biopsy reveals that you do have Hodgkin lymphoma, you may need additional tests to determine the extent, or stage, of the disease. Tests include blood tests, chest X-ray, computed tomography ( CT) scans of the chest, abdomen and pelvis, and possibly the neck, and PET scans. Magnetic resonance imaging ( MRI) scans, bone scans, spinal tap (lumbar puncture), and bone marrow studies are useful under special circumstances. These tests will reveal the stage of the Hodgkin lymphoma and determine the best type of therapy. The prognosis and specific treatment used to treat Hodgkin depends on the stage of the disease or how widespread it is. Here are the stages of the disease: Stage I. Hodgkin lymphoma is found in only one lymph node area or structure (such as the spleen). Stage II. Hodgkin lymphomais found in two or more lymph node areas on the same side of the diaphragm (the muscle beneath the lungs that moves up and down to help you breathe). Stage III. Hodgkinlymphoma is in lymph nodes on both sides of the diaphragm, or the cancer may also have extended to an area or organ adjacent to the lymph node or to the spleen. Stage IV. Hodgkin lymphoma has spread to one or more organs outside the lymphatic system such as the bone marrow or liver. Refractory or recurrent Hodgkin lymphoma. Refractory disease is the term used when the disease does not respond to initial therapy. Recurrent disease means that Hodgkin lymphoma has come back after it has been treated. This may occur shortly after treatment or, less commonly, years later. The goal of treatment for Hodgkin lymphoma is to eradicate the lymphoma cells without damaging normal cells in order to minimize treatment side effects. Talk with your doctor about any treatment-related side effects you experience. The most common treatment for Hodgkin lymphoma is chemotherapy (drugs). Immunotherapy is sometimes used, while the use of radiation therapy has diminished over the years. Patients with Hodgkin lymphoma that is resistant to treatment or returns after initial treatment may need autologous stem cell transplantation. In this procedure, higher doses of chemotherapy or total body irradiation are applied in an effort to destroy Hodgkin lymphoma cells that have survived standard therapy. As a side effect, the higher doses of therapy are likely to destroy normal blood and bone marrow cells. Therefore, normal bone marrow stem cells are taken from the patient's bloodstream before he or she undergoes chemotherapy or radiation. The stem cells are then frozen and saved and returned to the body intravenously after the treatment in order to repopulate the bone marrow. A new drug, brentuximab vedotin ( Adcetris), is designed to treat patients whose lymphoma has progressed after treatment with bone marrow stem cell transplantation or those who have had two chemotherapy treatments and are not eligible for transplant. It's the first new drug approved to treat Hodgkin lymphoma in over 35 years. The five-year survival rate refers to the percentage of patients, according to the stage of their disease at diagnosis, who live at least five years after treatment for Hodgkin lymphoma. Many of these patients live longer than five years. Stage I: 90%-95% Stage II: 90%-95% Stage III: 85%-90% Stage IV: about 65% Long-term health problems may occur after being treated for Hodgkin lymphoma, including leukemia, myelodysplastic syndrome, breast cancer, heart disease, thyroid disease, lung disease, lung cancer, and infertility. Therefore, it is essential that patients who have been treated for Hodgkin lymphoma receive annual physical exams, as they may need to be screened for other diseases. Seek medical attention for any new, serious, or unexplained symptoms that don't go away.