American Board of Internal Medicine (ABIM) Certification Practice Exam

The staging evaluation of Hodgkin lymphoma generally includes which procedures?

1. CT scan and lumbar puncture

2. Bone marrow biopsy and PET scan

3. MRI and chest X-ray

4. Ultrasound and biopsy of the liver

The correct answer is: Bone marrow biopsy and PET scan

The staging evaluation of Hodgkin lymphoma primarily aims to assess the extent of the disease and its spread throughout the body. A PET scan is particularly important in this context, as it provides valuable information about metabolic activity in lymph nodes and other tissues, helping to determine the stage and response to therapy. This imaging modality is highly sensitive for detecting active disease and has become a standard part of the staging process for various lymphomas, including Hodgkin lymphoma. Additionally, a bone marrow biopsy is considered to be an important procedure in the evaluation of Hodgkin lymphoma. This is done to check for involvement of the bone marrow, which is crucial, as involvement can change the staging and management of the disease. The presence of lymphoma in the bone marrow signifies a more advanced stage that may require different treatment strategies. In contrast, other combinations mentioned in the options do not align with the standard staging protocols for Hodgkin lymphoma. For instance, lumbar punctures are typically reserved for evaluating central nervous system involvement, which is rare in Hodgkin lymphoma, and while MRIs and chest X-rays may be useful, they are not the primary modalities recommended for staging this type of cancer. Similarly, ultrasound and liver biopsy are not standard procedures in the staging evaluation of Hodgkin lymphoma. Thus,