Hodgkin lymphoma
Hodgkin lymphoma is a cancer of lymph tissue. Lymph tissue is found in the lymph nodes, spleen, liver, bone marrow, and other sites.
Hodgkin lymphoma - Animation
Did you ever touch your neck and feel a bump on one or both sides? Usually, it’s just a swollen gland or lymph node that’s caused by a cold or other infection. But occasionally, swollen lymph nodes can be a sign of cancer, perhaps a cancer called Hodgkin lymphoma. These are your lymph nodes. You’ll find them not only on your neck, but in your armpits and groin too. They’re a part of your body’s normal defense system, which protects you against invading viruses and bacteria. Hodgkin lymphoma is a type of cancer that starts inside the lymph nodes. What causes Hodgkin lymphoma isn’t known, but having the Epstein-Barr virus or HIV, may increase your risk. So, what are the signs of Hodgkin lymphoma? In addition to having swollen lymph nodes, you may feel tired and have no appetite. Some people wake up in the middle of the night soaked in sweat. That’s called night sweats. Remember, though, that these symptoms can occur with many different conditions. So if you have them, don’t panic. But do see your doctor, who can tell you for sure what’s causing your symptoms. If your doctor suspects that you have Hodgkin lymphoma, your doctor will probably cut and remove a small piece of tissue from your lymph node, called a biopsy, and the samples will be sent to a lab to look for cancer cells. If cancer is diagnosed, other tests are used to stage it, in other words, to see whether the disease has spread, and if so, how far it’s spread. That helps your doctor find the right treatment. If you have Hodgkin lymphoma, most often the treatment involves radiation therapy, chemotherapy, or a combination of both. People who don’t respond to these treatments sometimes need a bone marrow transplant. While you’re being treated for Hodgkin lymphoma, you may need other therapies to help you feel better. That might include antibiotics to fight an infection, or a blood transfusion to add red blood cells when they’re low. Getting diagnosed with any type of cancer can be difficult to hear. But, you should know that Hodgkin lymphoma is one of the most curable types of cancer. Even if the disease has spread, your chances of survival are very high. You can improve your odds by following the entire treatment plan. Once your lymphoma has been treated, you’ll need to see your doctor regularly for check-ups to make sure the cancer hasn’t returned, and to monitor for any side effects your treatment may have caused.
Causes
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
The first sign of Hodgkin lymphoma is often a painless 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.
Symptoms may include any of the following:
- Feeling very tired all the time
- 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)
Swollen glands
Lymph nodes are present throughout your body. They are an important part of your immune system. Lymph nodes help your body recognize and fight germ...
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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 health care provider about the meaning of your specific symptoms.
Exams and Tests
Your provider will perform a physical exam and check body areas with lymph nodes to feel if they are swollen.
Hodgkin's disease - liver involvement
Hodgkin's disease (lymphoma) is a malignant cancer that can affect many organs. A whitish, irregular tumor mass of lymphoma cells is seen on the left side of this cross-section of the liver.
The disease is diagnosed based on a biopsy of abnormal tissue, usually a lymph node.
Lymphoma, malignant - CT scan
This abdominal CT scan shows tumor masses (malignant lymphomas) in the area behind the peritoneal cavity (retroperitoneal space).
The following procedures will usually be done:
- Blood chemistry tests including liver function tests, kidney function tests, and lactate dehydrogenase (LDH)
Blood chemistry tests
A comprehensive metabolic panel is a group of blood tests. They provide an overall picture of your body's chemical balance and metabolism. Metaboli...
Read Article Now Book Mark Article - Erythrocyte sedimentation rate (ESR)
- Bone marrow biopsy
Bone marrow biopsy
A bone marrow biopsy is the removal of marrow from inside one of your bones. Bone marrow is the soft tissue inside bones that helps form blood cells...
Read Article Now Book Mark Article - CT scans of the chest, abdomen, and pelvis
CT scans
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
Read Article Now Book Mark Article - Complete blood count (CBC) to check for anemia and white blood count
Complete blood count
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
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PET scan
A positron emission tomography (PET) scan is a type of imaging test. It uses a radioactive substance called a tracer to look for disease in the body...
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If tests show that you have Hodgkin lymphoma, more tests may be done to see how far the cancer has spread. This is called staging. Staging helps guide treatment and follow-up.
Treatment
Treatment depends on the following:
- The type of Hodgkin lymphoma
- The stage (where the disease has spread)
Stage
Cancer staging is a way to describe how much cancer is in your body and where it is located. Staging helps determine where the original tumor is, ho...
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- Other factors, including whether you have weight loss, night sweats, and fever
You may receive chemotherapy, radiation therapy, or both, or immunotherapy. Your provider can tell you more about your specific treatment.
Chemotherapy
The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to:Cure the cancerShrink the cancerPrevent the cancer from ...
Read Article Now Book Mark ArticleRadiation therapy
Radiation therapy uses high-powered radiation (such as x-rays or gamma rays), particles, or radioactive seeds to kill cancer cells.
Read Article Now Book Mark ArticleImmunotherapy
Immunotherapy is a type of cancer treatment that relies on the body's infection-fighting system (immune system). It uses substances made by the body...
Read Article Now Book Mark ArticleHigh-dose chemotherapy may be given when Hodgkin lymphoma returns after treatment or does not respond to the first treatment. This is followed by a stem cell transplant that uses your own stem cells.
Stem cell transplant
A bone marrow transplant is a procedure to replace damaged or diseased bone marrow with healthy bone marrow stem cells. Bone marrow is the soft, fatt...
Read Article Now Book Mark ArticleBlood transfusions or platelet transfusions may be required if blood counts are low.
You and your provider may need to manage other concerns during your lymphoma treatment, including:
- Having chemotherapy at home
Having chemotherapy at home
You or your child will be going home from the hospital soon. Your health care provider has prescribed medicines or other treatments that you or your...
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Managing your pets during chemotherapy
If you have a weak immune system, having a pet can put you at risk for serious illness from diseases that can spread from animals to humans. Learn w...
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Bleeding problems
Your bone marrow makes cells called platelets. These cells keep you from bleeding too much by helping your blood clot. Chemotherapy, radiation, and...
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Dry mouth
Some cancer treatments and medicines can cause dry mouth. Take good care of your mouth during your cancer treatment. Follow the measures outlined b...
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Eating enough calories
If you are sick or undergoing cancer treatment, you may not feel like eating. But it is important to get enough protein and calories so you do not l...
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Support Groups
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.
Cancer support group
The following organizations are good resources for information on cancer:American Cancer Society. Support and online communities. www. cancer. org/...
Read Article Now Book Mark ArticleOutlook (Prognosis)
Hodgkin lymphoma is one of the most curable cancers. A cure is even more likely if it is diagnosed and treated early. Unlike many other cancers, Hodgkin lymphoma is also very curable in its late stages.
You will need to have regular exams for years after your treatment. This helps your provider check for signs of the cancer returning and for any long-term treatment effects.
Possible Complications
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 provider who knows about monitoring and preventing these complications.
When to Contact a Medical Professional
Contact your provider if:
- You have symptoms of Hodgkin lymphoma
- You have Hodgkin lymphoma and you have side effects from the treatment
Reviewed By
Mark Levin, MD, Hematologist and Oncologist, Monsey, NY. Review provided by VeriMed Healthcare Network. Internal review and update on 02/20/2024 by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Bartlett N, Triska G. Hodgkin lymphoma. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 102.
National Cancer Institute website. Hodgkin lymphoma treatment (PDQ) - health professional version. www.cancer.gov/types/lymphoma/hp/adult-hodgkin-treatment-pdq. Updated April 18, 2024. Accessed August 2, 2024.
National Cancer Institute website. Childhood Hodgkin lymphoma treatment (PDQ) - health professional version. www.cancer.gov/types/lymphoma/hp/child-hodgkin-treatment-pdq. Updated April 30, 2024. Accessed August 2, 2024.
National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology: Hodgkin lymphoma. Version 2.2024. www.nccn.org/professionals/physician_gls/pdf/hodgkins.pdf. Updated February 12, 2024. Accessed February 19, 2024.