How Your Doctor Uses a Biopsy to Diagnose Hodgkin’s Disease
A biopsy is the only way for your doctors to know for sure if you have cancer. For a biopsy, the doctor removes a sample of the tumor. The sample is sent to a lab, where a pathologist checks it under a microscope for cancer cells. Several types of biopsies can be done to look for Hodgkin’s disease.
Fine needle aspiration (FNA) biopsy. Your doctor may choose this type of biopsy if the swollen lymph nodes can be felt in your neck or the armpit. You may need a general anesthetic to put you to sleep. Then, the doctor uses a very thin needle to take a small sample of tissue from the tumor. In some cases, this thin needle doesn’t remove enough tissue for the pathologist to see cancerous cells. Or the sample may also be too small to tell the type of lymphoma. That means you may need a repeat biopsy. Or your doctor may have to use another type of biopsy.
Excisional or incisional biopsy. In an excisional biopsy, a surgeon takes out a whole lymph node. Before the procedure, you’d take an anesthetic so you would be asleep. This type of biopsy almost always gives the pathologist enough tissue to make a complete diagnosis. In an incisional biopsy, only part of the tumor is taken out. This form of biopsy can be useful to tell whether additional sites or recurrence (a return of the disease) are present. Here are some examples of specific types of these biopsies. If the lymph node is in your chest, your doctor may use a mediastinoscopy. This is a biopsy that is done using x-rays for guidance. Another less common way for a doctor to get a sample from your chest is a thoractomy. This method involves cutting your chest cavity so the lymph node may be taken out.
Bone marrow aspiration and biopsy. Because Hodgkin’s disease can spread to the bone marrow, most people with the condition should have a sample of the bone marrow analyzed for any signs of the disease. For this procedure, the doctor uses a needle to take out small amounts of your liquid bone marrow, called the aspirate, as well as a small piece of the bone, called the biopsy. The tissue is usually taken from the bone in the back of your hips.
Liver Biopsy. In certain circumstances, your doctor may take a tissue sample from your liver. For this, the doctor uses a fine needle while you are under local anesthetic so you aren’t aware of what’s happening.
Results from biopsies and bone marrow aspirations are usually available in 48 to 72 hours. Special staining techniques may then be required to help make a firm diagnosis, so if it takes a few days, have patience: the delay is not due to incompetence of your medical team.
After the biopsy, you may also need other tests to help your doctor choose the right treatment for you.