Hodgkin's lymphoma diagnostic study of choice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [3]
Overview
The diagnostic study of choice for Hodgkin's lymphoma is excisional lymph node biopsy. A bone marrow biopsy is an alternative to a lymph node biopsy.
Diagnostic study of choice
- The diagnostic study of choice for Hodgkin's lymphoma is excisional lymph node biopsy. In addition to light microscopy evaluation of the biopsy samples, the immunophenotypic analysis with immunohistochemistry helps to determine Hodgkin's lymphoma subtypes and distinguish Hodgkin's lymphoma from T cell rich large B cell lymphoma and anaplastic large cell lymphoma. The presence of Reed-Sternberg cell is diagnostic for classic Hodgkin's lymphoma. The Reed-Sternberg cells of classic Hodgkin's lymphoma particularly express CD15 and CD30 and do not present CD3 or CD45. Flow cytometry is an effective method in differentiating between classic Hodgkin's lymphoma, nodular lymphocyte predominant Hodgkin's lymphoma, and T cell rich large B cell lymphoma based upon the presence of specific T cell populations.
<ref>R. von Wasielewski, M. Mengel, R. Fischer, M. L. Hansmann, K. Hubner, J. Franklin, H. Tesch, U. Paulus, M. Werner, V. Diehl & A. Georgii (1997). "Classical Hodgkin's disease. Clinical impact of the immunophenotype". The American journal of pathology. 151 (4): 1123–1130. PMID 9327746. Unknown parameter |month= ignored (help)
- A bone marrow biopsy can also be done to diagnose Hodgkin lymphoma if there is sufficient evidence of marrow involvement (i.e. presence of cytopenias). Hodgkin lymphoma cells originate in the bone marrow, which is the site of B cell production and maturation. A bone marrow is not the diagnostic study of choice if a lymph node can be biopsied.