Many of the other serious illnesses involving diseased lymph nodes, however, develop simultaneously at multiple sites, while Hodgkin's nearly always starts at one location before spreading to nearby nodes. The physician will take a medical history and perform a physical examination. If these simple procedures point to Hodgkin's disease, a number of additional tests may be needed to either rule out other diseases or to confirm HD and determine the extent of the cancer. Blood Tests Blood tests are performed to measure white and red blood cells, blood protein levels, the uric acid level, blood proteins, and the liver's function. A CT scan also is important in detecting cancer below the diaphragm in the abdomen and pelvic areas.
Lymphangiography is an x-ray of the lymph glands and vessels after an injection of a dye.
It provides additional information on lower parts of the body and is a good complement to CT scans. The test is often important after a diagnosis of Stage I or II Hodgkin's disease to pinpoint the location of lymph nodes that are scheduled to be treated. There is a small risk that the dye will affect the lungs, so this test should not be used in patients with severe lung disease. Biopsy A biopsy of the suspicious lymph node is performed only when less invasive tests have ruled out other diseases and the physician still suspects Hodgkin's disease. Sometimes a physician may choose to wait and observe the involved lymph nodes, which will usually regress on their own if HD or other serious conditions are not present.