Hodgkin Lymphoma Surgery
Hodgkin lymphoma is a cancer of the lymphatic system, a large network of organs, tissues and vessels that protects the body against infection and maintains a healthy fluid balance. The cancer can be distinguished from non-Hodgkin lymphoma by the presence of certain abnormal cells known as Reed-Sternberg cells, which can be seen when a tissue sample is viewed under a microscope.
Although Hodgkin lymphoma can occur at any age, it is most frequently diagnosed in adults between ages 20 and 40 and those older than 75. The symptoms can include painless lymph node swelling, fatigue, fever, night sweats and weight loss.
Hodgkin lymphoma is usually highly treatable, especially when detected early. Treatment options can include chemotherapy, radiation therapy and sometimes bone marrow transplantation.
Unlike many other types of cancer, Hodgkin lymphoma does not produce solid tumors that can be surgically removed. Therefore, surgical treatment is generally considered only in rare cases of extranodal lymphoma, in which the cancer develops in an area outside the lymph nodes, such as in the thyroid or stomach.
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Schedule an AppointmentWhat does Hodgkin lymphoma surgery involve?
In addition to removing solid tumors in rare cases of extranodal lymphoma, Hodgkin lymphoma surgery may be performed to confirm the diagnosis, stage the cancer or alleviate the symptoms.
Surgery to diagnose Hodgkin lymphoma
To obtain tissue samples for diagnosing and classifying Hodgkin lymphoma, a surgeon may perform an excisional biopsy to remove one or more lymph nodes for microscopic examination by a pathologist, who can identify cancerous cells.
Surgery to alleviate Hodgkin lymphoma symptoms
If Hodgkin lymphoma is causing disruptive symptoms, such as pain, weakness and loss of appetite, surgical removal of the spleen (splenectomy) may be considered to improve red blood cell or platelet counts. Also, if the spleen is enlarged and pressing on nearby structures, this surgical procedure can help alleviate the associated pain and other symptoms.
Surgery to stage the cancer
After a Hodgkin lymphoma diagnosis is confirmed, a surgeon may perform a staging (exploratory) laparotomy to determine if the cancer is confined to one specific area or has spread throughout the body.
What happens during Hodgkin lymphoma surgery?
The specifics of Hodgkin lymphoma surgery can vary based on the type of procedure performed:
Excisional biopsy
An excisional biopsy for Hodgkin lymphoma is a minor surgical procedure that is usually performed on an outpatient basis. The surgeon may use imaging guidance to confirm the exact location of the targeted lymph node. After the biopsy site is thoroughly cleaned and numbed, the surgeon will make an incision and remove the lymph node. The removed tissue will then be sent to a laboratory for pathological evaluation.
Splenectomy
A splenectomy can be performed using a traditional open or minimally invasive laparoscopic approach. When performing an open splenectomy, the surgeon will make a long incision in the abdomen; when performing a laparoscopic splenectomy, the surgeon will make a few small incisions in the abdomen and insert a miniature camera, light source and specialized surgical instruments. Either way, the surgeon will then separate the spleen from the surrounding tissues, tie off the blood supply, place the spleen in a special bag and remove it from the body.
Exploratory laparotomy
When performing an exploratory laparotomy for Hodgkin lymphoma, a surgeon will make an incision in the abdomen. Next, the surgeon may:
- Evaluate various structures in the abdominal cavity
- Perform multiple lymph node biopsies
- Perform a wedge or needle biopsy of the liver
- Perform a bone marrow biopsy
- Perform a splenectomy
Usually, this invasive diagnostic procedure is not performed unless the potential value of obtaining better staging information outweighs the risk of surgery.
What are the risks and possible complications of Hodgkin lymphoma surgery?
As with any surgical procedure, Hodgkin lymphoma surgery has some risks and possible complications, including:
- Infection at the incision site
- Excessive bleeding during or after the procedure
- Post-operative pain and discomfort
- Allergic reaction to anesthesia
- Scarring at the incision site.
- Damage to nearby organs, blood vessels or nerves
- Disruption of normal lymphatic drainage, leading to swelling and fluid retention (lymphedema)
The risk level can vary depending on the patient’s health, the surgical site and the extent of the procedure. To help the patient make fully informed treatment decisions, the surgeon will explain the risks and possible complications of Hodgkin lymphoma surgery and answer any questions the patient may have.
What to expect during recovery from Hodgkin lymphoma surgery
During recovery from any type of Hodgkin lymphoma surgery, the patient can expect:
- Post-operative care – The patient will be monitored in a recovery room until the effects of the anesthesia wear off.
- Pain management – If needed, medication may be provided to manage pain and discomfort at the incision site.
- Wound care – The surgeon will provide post-operative instructions on how to care for the incision to prevent infection and promote healing.
- Limited activity – The patient will be instructed to rest after surgery and gradually resume their daily activities to allow for proper healing.
- Follow-up appointments – The patient will have regular medical check-ups to monitor their recovery and discuss further treatment if necessary.
- Side effects – Possible side effects of Hodgkin lymphoma surgery include swelling, bruising and numbness around the incision site.
How effective is Hodgkin lymphoma surgery?
Hodgkin lymphoma surgery is generally highly effective for obtaining biopsy samples, which are essential for an accurate diagnosis and staging. Both are important considerations when planning treatment.
Although Hodgkin lymphoma surgery is not intended to be a primary treatment for symptom management, it can be effective for this purpose in certain cases. For instance, if an enlarged lymph node is causing painful pressure or obstructing an organ, its surgical removal can provide symptom relief.
Benefit from world-class care at Moffitt Cancer Center
If you have questions about Hodgkin lymphoma surgery, you can request an appointment with a specialist in Moffitt’s renowned Malignant Hematology Program by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.