Hodgkin lymphoma is a cancer of lymph tissue. Lymph tissue is found in the lymph nodes, spleen, liver, bone marrow, and other sites.
Lymphoma - Hodgkin; Hodgkin disease; Cancer - Hodgkin lymphoma
The cause of Hodgkin lymphoma is not known. Hodgkin lymphoma is most common among people 15 to 35 years old and 50 to 70 years old. Past infection with the Epstein-Barr virus (EBV) is thought to contribute to some cases. People with HIV infection are at increased risk compared to the general population.
Symptoms may include any of the following:
- Fever and chills that come and go
- Itching all over the body that cannot be explained
- Loss of appetite
- Drenching night sweats
- Painless swelling of the lymph nodes in the neck, armpits, or groin (swollen glands)
- Weight loss that cannot be explained
Other symptoms that may occur with this disease:
- Coughing, chest pains, or breathing problems if there are swollen lymph nodes in the chest
- Excessive sweating
- Pain or feeling of fullness below the ribs due to swollen spleen or liver
- Pain in lymph nodes after drinking alcohol
- Skin blushing or flushing
Symptoms caused by Hodgkin lymphoma may occur with other conditions. Talk to your doctor about the meaning of your specific symptoms.
Exams and Tests
The first sign of Hodgkin lymphoma is often a swollen lymph node that appears without a known cause. The disease can spread to nearby lymph nodes. Later it may spread to the spleen, liver, bone marrow, or other organs.
The disease is usually diagnosed after a biopsy of suspected tissue, usually a lymph node.
If the biopsy and other tests show that you have Hodgkin lymphoma, more tests will be done to see how far the cancer has spread. This is called staging. Staging helps guide treatment and follow-up.
The following procedures will usually be done:
- Blood chemistry tests including protein levels, liver function tests, kidney function tests, and uric acid level
- Bone marrow biopsy
- CT scans of the chest, abdomen, and pelvis
- Complete blood count (CBC) to check for anemia and white blood count
- PET scan
In rare cases, abdominal surgery is needed to take out a piece of the liver and remove the spleen.
Treatment depends on the following:
- The type of Hodgkin lymphoma (there are different forms of Hodgkin lymphoma)
- The stage (where the disease has spread)
- Whether the tumor is more than 4 inches (10 cm) wide
- Your age and other medical issues
- Other factors, including weight loss, night sweats, and fever
High-dose chemotherapy may be given when Hodgkin lymphoma returns after treatment or does not respond to the first treatment. This is followed by an autologous stem cell transplant (using your own stem cells).
You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences can help you not feel alone.
Hodgkin lymphoma is one of the most curable cancers. Cure is even more likely if it is diagnosed and treated early. Unlike other cancers, Hodgkin lymphoma is also very curable in its late stages.
You will need to have regular exams and imaging tests for years after your treatment. This helps your doctor check for signs of the cancer returning and for any long-term treatment effects.
Treatments for Hodgkin lymphoma can have complications. Long-term complications of chemotherapy or radiation therapy include:
- Bone marrow diseases (such as leukemia)
- Heart disease
- Inability to have children (infertility)
- Lung problems
- Other cancers
- Thyroid problems
Keep following up with a doctor who knows about monitoring and preventing these complications.
When to Contact a Medical Professional
Call your health care provider if:
- You have symptoms of Hodgkin lymphoma
- You have Hodgkin lymphoma and you have side effects from the treatment
Bartlett NL, Foyli KV. Hodgkin lymphoma. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:chap 105.
National Cancer Institute: PDQ Adult Hodgkin Lymphoma Treatment. Bethesda, MD: National Cancer Institute. Date last modified: February 25, 2015. Available at: cancer.gov/cancertopics/pdq/treatment/adulthodgkins/HealthProfessional. Accessed March 2, 2015.
National Cancer Institute: PDQ Childhood Hodgkin Lymphoma Treatment. Bethesda, MD: National Cancer Institute. Date last modified: January 28, 2015. Available at: cancer.gov/cancertopics/pdq/treatment/childhodgkins/HealthProfessional. Accessed March 2, 2015.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Hodgkin Lymphoma. Version 2.2014. Available at: www.nccn.org/professionals/physician_gls/pdf/hodgkins.pdf. Accessed March 2, 2015.
Reviewed By: Rita Nanda, MD, Assistant Professor of Medicine, Section of Hematology/Oncology, University of Chicago Medicine, Chicago, IL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.