Hodgkin's Disease - Diagnosis

Laparotomy. Laparotomy is abdominal surgery used to examine the internal organs, particularly the liver, spleen, and any nodes not detectable using noninvasive imaging techniques. During this procedure, the spleen is removed (splenectomy) and tissue samples in the abdominal area are taken for biopsy. Because removal of the spleen affects the body's resistance to infection, after laparotomy some patients are susceptible to infection, which can be life-threatening. This risk has been greatly minimized with use of preoperative vaccinations and chemotherapy treatments that have less of a negative effect on the immune system. Children are at higher risk for infection than adults. It is advisable to be vaccinated against Hemophilus influenzae type b, meningococcal, and pneumococcal organisms at least one week before splenectomy. Some investigators recommend re-immunization with all three vaccines2 years after completion of treatment and pneumococcal vaccine every 6 years thereafter.

Laparoscopy. A less-invasive technique called laparoscopy is sometimes considered to avoid the invasive laparotomy. This procedure uses small abdominal incisions and the insertion of fiberoptic tubes and tiny cameras for viewing the internal areas. The laparoscopy has a high incidence of missing cancers, but if cancer is observed and confirmed with a biopsy, then the patient does not need a laparotomy.

Click the icon to see an image of laparoscopy.

Biologic Markers

Biologic markers, called biomarkers for short, are high levels of substances that are released by tumors and indicate the level of cancer activity. Biomarkers can be found in sputum, blood, and tissue samples. Biomarkers can be enzymes, hormones, amino-acid compounds, antigens (identified by antibodies that specifically target them), growth factors, and other chemicals. Some under investigation include the following:

CD44 is a molecule that binds to the surface of cells and may be involved in metastasis. High levels of this molecule may suggest a more aggressive disease.
Interleukin (IL) 10 is another immune factor that may indicate a poor outlook when it occurs in high levels.