Hodgkin Lymphoma
A treatable cancer of the lymphatic system
Quick Facts
- Type: Cancer of the lymphatic system
- Hallmark: Reed-Sternberg cells
- Common early sign: Painless swollen lymph node
- Outlook: Often highly treatable
Overview
Hodgkin lymphoma is a cancer that begins in the lymphatic system, the network of vessels, nodes, and organs that helps fight infection as part of the immune system. It develops when certain white blood cells called lymphocytes grow abnormally and form tumors, most often in the lymph nodes. Hodgkin lymphoma is defined by the presence of a distinctive abnormal cell called a Reed-Sternberg cell, which distinguishes it from the other main group, non-Hodgkin lymphoma.
Hodgkin lymphoma can occur at any age but is most common in young adults and in people over 55. It often starts in the lymph nodes of the neck, chest, or under the arms and tends to spread in an orderly way from one group of nodes to the next. Importantly, Hodgkin lymphoma is one of the most treatable cancers, and many people are cured.
Symptoms
The most common first sign is a painless swelling of a lymph node. Symptoms may include:
- A painless lump, usually in the neck, armpit, or groin
- Fever without an obvious infection
- Drenching night sweats
- Unexplained weight loss
- Persistent fatigue
- Itching of the skin
- Occasionally, discomfort in swollen lymph nodes after drinking alcohol
Fever, night sweats, and weight loss are sometimes called B symptoms and can affect treatment planning. Many of these symptoms have harmless causes, but a swollen lymph node that does not go away should always be evaluated.
Causes
The exact cause of Hodgkin lymphoma is not known. It begins when a lymphocyte develops genetic changes that cause it to grow out of control and form abnormal Reed-Sternberg cells. These cells crowd out healthy cells and cause lymph nodes to enlarge.
Certain factors are linked to a higher risk, including past infection with the Epstein-Barr virus (which causes mononucleosis) and a weakened immune system. However, most people with these factors never develop the disease, and Hodgkin lymphoma is not contagious.
Risk Factors
- Being a young adult or being over 55
- Past infection with the Epstein-Barr virus (mononucleosis)
- A weakened immune system, such as from HIV or immune-suppressing medication
- A family history of Hodgkin lymphoma
- Male sex, which carries a slightly higher risk
Diagnosis
Diagnosing Hodgkin lymphoma requires examining affected tissue and determining how far it has spread:
- Lymph node biopsy: Removing all or part of an enlarged lymph node to look for Reed-Sternberg cells under the microscope, which confirms the diagnosis.
- Blood tests: To assess overall health and blood counts.
- Imaging: CT and PET scans to find affected nodes and check for spread.
- Bone marrow test: Sometimes done to see whether the marrow is involved.
These tests determine the stage, which guides treatment.
Treatment
Hodgkin lymphoma responds well to treatment, and the plan depends on the stage and type. A team of cancer specialists tailors care to each person.
- Chemotherapy: Medications that kill cancer cells throughout the body, often the main treatment.
- Radiation therapy: Targeted radiation to affected lymph node areas, sometimes combined with chemotherapy.
- Targeted therapy and immunotherapy: Newer medicines that attack specific features of the cancer or help the immune system fight it, used in some situations.
- Stem cell transplant: Considered for lymphoma that returns or does not respond to initial treatment.
Many people with Hodgkin lymphoma are cured. After treatment, long-term follow-up monitors for any return and for late effects of therapy.
Prevention
There is no known way to prevent Hodgkin lymphoma, because its cause is not understood and most risk factors cannot be changed. General health measures that support the immune system may help, and people with risk factors can stay alert to symptoms:
- Manage conditions that weaken the immune system, such as HIV, with proper treatment
- See a doctor about any lymph node that stays swollen, so any problem is found early
- Maintain general good health
When to See a Doctor
See a doctor if you have a painless swollen lymph node in the neck, armpit, or groin that lasts more than a couple of weeks, or if you have unexplained fever, drenching night sweats, weight loss, or persistent itching. While these symptoms often have harmless causes, they should be checked, especially if they persist.
Early diagnosis is important because Hodgkin lymphoma is highly treatable, and prompt evaluation allows treatment to begin if needed.
Frequently Asked Questions
What is the difference between Hodgkin and non-Hodgkin lymphoma?
Both are cancers of the lymphatic system, but Hodgkin lymphoma is defined by a particular abnormal cell called the Reed-Sternberg cell. Non-Hodgkin lymphoma is a larger and more varied group that lacks these cells. The distinction affects treatment and outlook.
What is usually the first sign of Hodgkin lymphoma?
The most common first sign is a painless swollen lymph node, often in the neck, armpit, or groin. Some people also have fever, drenching night sweats, unexplained weight loss, fatigue, or itching. A node that stays swollen should be evaluated.
Is Hodgkin lymphoma curable?
Hodgkin lymphoma is one of the most treatable cancers, and many people are cured, especially when it is found early. Treatment usually involves chemotherapy, sometimes with radiation, and most people respond well, though long-term follow-up is important.
What causes Hodgkin lymphoma?
The exact cause is unknown. It begins when a lymphocyte develops genetic changes and grows uncontrollably. Past Epstein-Barr virus infection (mononucleosis) and a weakened immune system raise the risk, but most people with these factors never develop the disease.
How is Hodgkin lymphoma diagnosed?
Diagnosis requires a biopsy of an affected lymph node to look for Reed-Sternberg cells. Blood tests, CT and PET scans, and sometimes a bone marrow test are used to determine the stage, which shows how far the cancer has spread and guides treatment.
References
- National Cancer Institute (NCI). Hodgkin Lymphoma Treatment.
- American Cancer Society. Hodgkin Lymphoma.
- Mayo Clinic. Hodgkin's lymphoma — Symptoms and causes.
- MedlinePlus, U.S. National Library of Medicine. Hodgkin lymphoma.