Hodgkin Lymphoma affects your lymphatic and immune systems. It can cause swollen lymph nodes, fever, night sweats and weight loss.
It most often develops in lymph nodes in your neck, chest or abdomen. But it can also affect your thymus, your bone marrow and Peyer’s patches in your intestines.
Hodgkin Lymphoma develops in the lymph system, a network of organs and nodes throughout your body. This system helps your immune system fight infections and gets rid of waste. It contains white blood cells called lymphocytes, which help protect you from germs and disease. Lymphoma starts in lymphocytes, which become abnormal and multiply uncontrollably. The change is caused by a fault (mutation) in the DNA of the cell. These cells grow out of control and collect in part of your lymphatic system, most often in lymph nodes in your neck or chest. The lymph nodes may become enlarged, leading to swelling in these areas and other parts of the body, such as your armpits, groin, or belly (abdomen).
Hodgkin lymphoma most commonly affects people from age 20 to 39 years. It’s more common in men than in women. It’s also more likely to affect people who have a past infection with the Epstein-Barr virus or human immunodeficiency virus (HIV). It’s rare for young children to get Hodgkin lymphoma.
The most common symptom of Hodgkin lymphoma is painless swelling of the lymph nodes, which are located in your neck, groin, arms, chest, or groin. It is often the first symptom that patients notice, which prompts them to visit their physician. Sometimes, the lymph nodes are swollen so much that they press on the airways in the chest, which causes symptoms such as difficulty breathing or a feeling of pressure in the chest.
Doctors can diagnose Hodgkin lymphoma by examining the tissue under a microscope for signs of abnormal cells. They may also use an imaging test to check if the cancer has spread to other organs in the body, such as the liver, bones, bone marrow, and spleen. This test is called a CT or PET scan.
Some types of Hodgkin lymphoma can cause general symptoms, such as unexplained fever, night sweats, and weight loss. These symptoms are called B symptoms and can be a good predictor of how the lymphoma will respond to treatment.
Some lymphomas spread more quickly than others, so the healthcare team may use more aggressive treatments to treat them. This can include radiation, chemotherapy, and possibly surgery.
Hodgkin lymphoma is one of the most curable cancers, especially when it’s diagnosed and treated in its early stages. You’ll need to go for regular exams after your treatment to check for signs that the cancer is coming back or has caused long-term problems.
Hodgkin Lymphoma starts when something changes the genetic code of a healthy white blood cell called a B-lymphocyte. These cells normally fight infections and are found in bean-sized lymph nodes throughout the body as well as in other lymphoid tissue, such as the spleen. The abnormal change in the cell causes it to grow and develop out of control, crowding out healthy cells. It also makes it harder for the body to fight infection.
The changes in the cells can be detected by specialized pathology tests, which look for specific types of abnormal lymphocytes called Reed-Sternberg (RS) cells. These cells look different from other lymphocytes and can be seen under a microscope. RS cells are a key indicator of Hodgkin lymphoma and help doctors determine the type of Hodgkin Lymphoma you have. This will determine your stage of disease and guide your treatment.
Other diagnostic tests may include ultrasound, which uses high-energy sound waves to create pictures of body tissues, and a biopsy. During a biopsy, a healthcare provider removes all or part of a lymph node to examine it under a microscope for RS cells. Healthcare providers may also take a sample of bone marrow, the spongy tissue inside bones where blood cells are produced, or a small piece of liver to look for cancerous cells.
Your doctor will consider many factors when deciding on a treatment plan, including your age, general health, whether or not you have ‘B symptoms’ and which parts of the lymphatic system are involved. Staging describes the extent of the disease and helps your doctor decide which treatments will be best for you.
Your care team may also use a special procedure that combines chemotherapy, radiation and surgery to kill tumor cells while sparing normal tissue. This is called a combination modality therapy. Other treatment options may include targeted therapies, which use drugs or other substances to identify and destroy cancer cells without harming the normal tissue around them.
During treatment, you may have different types of chemotherapy drugs taken by mouth or into the vein (IV). Some doctors combine these medications to improve their effectiveness. They also use radiation therapy to kill cancer cells and relieve symptoms such as pain and swelling. You may also receive other therapies that target specific proteins that help lymphoma grow and spread.
Lymphocytes are white blood cells that circulate throughout your body and help fight infections. These cells are most often found in the main part of your lymphatic drainage system called the lymph nodes, but they also are located in other parts of your body such as your spleen, liver, and bone marrow.
When you have Hodgkin lymphoma, the tumors grow in the cells of your lymph nodes and other parts of your body. These cells grow faster than normal and crowd out other healthy white blood cells. Over time, this can interfere with the body’s ability to fight infections.
Your doctor can diagnose Hodgkin lymphoma with a physical exam and by taking a sample of the affected lymph node for testing in a lab. The sample is examined under a microscope for Reed-Sternberg cells. Healthcare providers can also diagnose this condition by examining biopsy results from other areas of your body such as the thymus, liver, and bone marrow.
The most common treatments are chemotherapy, radiation therapy, and other targeted therapies that kill lymphoma cells or stop them from growing. Other treatments include stem cell or bone marrow transplantation and biologic therapies that target certain proteins involved in lymphoma growth.
If the first round of treatment doesn’t cure your Hodgkin lymphoma, or it returns after some time, your doctors will try a second round of more intensive chemotherapy. They may also suggest a combination of drugs such as bleomycin, doxorubicin, vinblastine, and dacarbazine. This type of chemotherapy can damage your bone marrow, which produces new blood cells, so you might need a bone marrow or stem cell transplant after your treatment is completed.
You might want to ask your doctor about clinical trials that test promising new treatments for Hodgkin lymphoma. These studies allow doctors to find out whether a new treatment is safe and effective. If it is, doctors can offer it to more patients.
If Hodgkin Lymphoma is diagnosed early and treatment begins soon after the diagnosis, the outlook is good. The longer the disease goes untreated, however, the more likely it is to spread and be fatal.
Hodgkin lymphoma is an uncommon cancer that develops in the lymphatic system, which is a network of vessels and glands spread throughout your body. Clear fluid called lymph flows through these lymphatic vessels and contains infection-fighting white blood cells, called lymphocytes. In Hodgkin lymphoma, a type of lymphocyte called B lymphocytes starts to multiply in an abnormal way and gathers in the lymphatic system. This causes the lymph nodes (glands) to become enlarged. These enlarged lymph nodes are often painless and are located in the neck, armpit or groin.
To diagnose Hodgkin lymphoma, your doctor will give you a physical examination and feel the lymph nodes in your neck, underarm or groin for enlargement. The doctor may also order an imaging test such as a chest X-ray, CT scan or an MRI. These tests help doctors see if the lymph nodes are enlarged and to look for other signs of the condition, such as swelling of the lymph node tissue itself or damage to nearby organs.
During a biopsy, the doctor removes part of a lymph node and looks at it under a microscope to see if it has the characteristic Reed-Sternberg cells. A biopsy can be done with a needle or surgically. It’s usually more accurate to do a surgical biopsy than to do a needle biopsy because it’s harder for the needle to miss the characteristic cell.
Sometimes, to make a diagnosis, the doctor may biopsy other tissue from the body such as the liver, spleen or bone marrow. Bone marrow is the soft spongy tissue inside certain bones, especially in the hip bone and breast bone. This is where white blood cells and platelets are made. In some cases, the doctor can also use a biopsy from the tonsils (the two masses of lymph tissue at the back of the throat) to make a diagnosis.
Hodgkin lymphoma is caused by a change in the DNA of a specific type of white blood cell. The exact cause isn’t known, but it’s thought that the cell DNA gives the cells basic instructions for how to grow and reproduce. The mutation changes these instructions, so the cells grow and multiply without control or order.
Hodgkin Lymphoma is one of the most curable cancers if caught early. Your treatment plan will depend on your staging.
Stage B symptoms include fever for no apparent reason, weight loss and drenching night sweats.
A health care provider can diagnose Hodgkin lymphoma by examining a sample of your blood, or by taking a small piece of tissue (biopsy) from a lymph node or other part of your body, such as your liver or spleen.
Swollen lymph nodes (also called enlarged glands) are one of the most common signs of Hodgkin Lymphoma. These bean-sized structures filter fluid that surrounds cells and store white blood cells that fight infections and disease. They are found in a network of lymph vessels throughout the body, including in the groin (axillary), armpits (axillary), and neck (cervical) regions. They are also found in the chest between the lungs (mediastinum) and in the belly area (abdomen) and in the liver and spleen.
Lymph nodes swell when they are fighting an infection, and often go back to their normal size after the infection is over. But if they remain swollen for an extended period of time, this may be a sign of Hodgkin Lymphoma.
Healthcare providers can find out if you have Hodgkin Lymphoma by examining your lymph nodes and other lymph tissues under a microscope. They can look for a type of white blood cell known as Reed-Sternberg cells that are characteristic of Hodgkin Lymphoma. They can also use a procedure that sends high-energy sound waves (ultrasound) into the body and checks for echoes from the lining of the lymph nodes and other organs. Healthcare providers can make this test by touching the surface of your skin with a small, soft tool, or using a thin needle to remove a tiny amount of tissue from a lymph node for testing.
Another way to check for Hodgkin Lymphoma is to see if the swollen nodes contain cancerous tissue by doing a biopsy of a lymph node or other lymph tissue, such as in the thymus, liver, bone marrow, or bowel. These tests can only be done under a general anaesthetic and are usually performed by a hematologist or oncologist.
Swollen lymph nodes that press against blood vessels can cause other symptoms, such as breathing difficulties. This is because swollen lymph nodes can prevent blood from flowing through them, and can lead to the formation of a clot.
A swollen lymph node that is surrounded by a red rash or is warm to the touch may be a sign of inflammation, such as psoriasis or eczema, rather than Hodgkin Lymphoma. However, these swollen nodes can be signs of other conditions, so it is important to have them checked by a doctor.
Lymphoma develops in lymphocytes, or white blood cells. These cells control a person’s immune system and help the body fight infection. Generally, lymph nodes don’t hurt, but when cancer is in them, the tumors grow and press against surrounding tissue and nerves. This can lead to pain, especially in areas where the swollen lymph nodes sit, such as in the neck, armpit or groin area.
Sometimes, the swollen lymph nodes in Hodgkin Lymphoma aren’t painful but feel enlarged rather than swollen. If the swollen nodes are painful, however, it can be a sign that the lymphoma is spreading to other parts of the body, such as the bone (bone-related Hodgkin Lymphoma).
Fatigue is another common early symptom of Hodgkin Lymphoma. This fatigue may be caused by changes in hormone levels or because the chemotherapy or radiation treatment is putting a strain on your body.
Night sweats are also associated with Hodgkin Lymphoma, though doctors aren’t sure why. They think that the sweating happens as a result of your body’s temperature rising above normal, which can cause you to overheat. Interestingly, this symptom can occur in any type of Hodgkin lymphoma, but it’s most likely to happen in people with the nodular sclerosing Hodgkin lymphoma subtype and mixed cellularity Hodgkin Lymphoma subtypes.
A person with Hodgkin Lymphoma can have an enlarged spleen (splenomegaly). This fist-sized organ is located on the left side of the abdomen and underneath the diaphragm, behind the stomach and ribcage. Sometimes, cancer in the spleen can make it work harder than it should, leading to enlargement.
Hodgkin Lymphoma is one of the most curable types of cancer when it’s diagnosed and treated in its early stages. However, even after successful treatment, you’ll need to see a specialist for regular exams so that your provider can check for signs of the cancer returning or long-term effects from your treatment. The specialist will recommend a treatment plan based on the type of Hodgkin Lymphoma you have and how far it has spread, as well as your overall health and age. The specialist may also ask you to participate in a clinical trial of new treatment options.
Fever is a common side effect of lymphoma. It happens because cancer cells grow faster than normal, which leads to high levels of chemicals that raise the body temperature. This can lead to a pattern of fever for several days alternating with low or normal temperatures for days or weeks. It may also cause night sweats and weight loss.
A fever in Hodgkin Lymphoma is usually accompanied by chills. It’s also possible to have heavy, soaking night sweats that leave your pajamas, sheets and blankets soaked. You can have these sweats with or without a fever, and they may happen during the day as well.
Lymphoma develops in the cells that form your lymph system, part of your immune system. This system protects the rest of your body from germs and diseases, including cancer.
Hodgkin lymphoma starts in infection-fighting white blood cells called lymphocytes. These cells become cancerous and spread from one part of the lymphatic system to another. They can also spread to other parts of the body, like the lungs and liver.
The most common signs of Hodgkin lymphoma are swollen glands, especially those in the neck above the collarbone, underarm or groin. These swollen glands are often tender and can feel lumpy or full of fluid. They can also hurt when they press against other tissues or nerves.
If the swollen glands are in the chest, they may be causing pressure on the airways and can lead to coughing or trouble breathing. It’s also possible for the swollen glands to cause swelling in other areas of the body, such as the belly, face or feet.
It’s important to tell your doctor about any new symptoms you have, including a fever or swollen lymph nodes. Your doctor will then determine if the symptoms are from lymphoma and what stage they’re in. This will help them plan your treatment.
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Lymphoma is a group of cancers that start in the lymphatic system, which is a network of organs, nodes, and vessels throughout your body. The lymphatic system helps your immune system get rid of waste and fight infections. It also transports white blood cells to fight germs. Hodgkin Lymphoma starts in the lymphocytes, which are the white blood cells that fight infection and disease.
One of the most common symptoms of Hodgkin Lymphoma is fatigue. This can happen because of your treatment or it can be a side effect of the cancer itself. Fatigue can also be a sign of anemia, which is a lack of red blood cells in your body.
Anemia makes you feel tired and breathless because your body has to work harder to get enough oxygen. You can treat anemia with a blood transfusion, iron tablets or injections. You can also get help to cope with depression and anxiety, which may make fatigue worse.
You can get relief from fatigue by doing regular exercise, eating a healthy diet and getting plenty of rest. You can also ask your doctor for medicines to help with fatigue, such as antidepressants or other cancer drugs. These are often given as part of a clinical trial, but your doctor can explore other medications that have been proven to help with fatigue.
Some types of Hodgkin Lymphoma and other lymphomas cause swollen glands in your chest (mediastinum). When these swell, they may press on your airways or lungs and create a feeling of pressure in the chest. You might also have other symptoms in the chest, such as a cough or trouble breathing; weight loss; itchy skin; itching; or pain when you wee.
Fatigue is common after chemotherapy and other treatments for Hodgkin lymphoma. You might also have other symptoms depending on where the lymphoma has spread in your body.
You might find that your fatigue gets better as you get older or after treatment ends. Some people who had Hodgkin lymphoma and got treatment early found that their fatigue level stayed the same or went down over time. Other survivors found that their fatigue level stayed the same but then got worse later on.
Hodgkin Lymphomatreatment is generally very successful. The type of treatment you get depends on the stage of your Hodgkin lymphoma. You may have doctors from several specialties, including a hematologist (blood specialist) and medical oncologists who use chemotherapy.
If your Hodgkin lymphoma doesn’t respond to front-line therapy or comes back after it has responded (relapse), you may have higher doses of chemotherapy and a blood stem cell or bone marrow transplant.
Hodgkin lymphoma (also known as Hodgkin disease) develops in the lymph system, part of your body’s germ-fighting immune system. With advances in diagnosis and treatment, this cancer is now often curable. It tends to affect people in two age groups: those in their early adulthood (20 to 39 years) and those age 65 and older. It most commonly starts in the lymph nodes in your neck, chest (mediastinum), underarms, belly (abdomen), groin, and pelvis. Lymph nodes are small, bean-shaped structures that filter lymph and store white blood cells that fight infection and disease. In Hodgkin lymphoma, these cells grow out of control and form swollen lymph nodes or other growths throughout the body.
You can be diagnosed with Hodgkin lymphoma by having a healthcare professional examine a sample of enlarged lymph tissue under a microscope. Your provider may also use a test to find out how far the cancer has spread. This test is called a biopsy. During this test, your healthcare professional removes tissue from one or more of the lymph nodes and checks it for signs of Hodgkin lymphoma, such as Reed-Sternberg cells.
Sometimes, healthcare providers can diagnose Hodgkin lymphoma by examining a biopsy of other tissues in your body, such as your bone marrow, liver, or spleen. These results help them decide what treatment plan is best for you.
The stage of your Hodgkin lymphoma determines the type and how aggressively your treatment will be. It also helps determine your chances for a cure. Symptoms and staging information are used to make these decisions.
Getting diagnosed with any type of cancer can be scary. But it’s important to know that Hodgkin lymphoma is one of the most curable types of cancer, especially when it is caught in its early stages.
While Hodgkin lymphoma can be treated with chemotherapy and radiation, it’s likely that you will need other treatments, too. These might include antibiotics to treat infections, a blood transfusion to add red blood cells when you’re low, or surgery to remove swollen lymph nodes or other abnormalities. After your treatment, you’ll need regular follow-up visits to watch for signs of the cancer returning or for long-term effects from your treatment.
Hodgkin lymphoma is cancer of lymphocytes, which are white blood cells that circulate throughout the body’s “drainage” system called lymph nodes and other tissues. Lymphocytes are important for controlling a person’s immune response and defending against infection. The characteristic feature of a Hodgkin lymphoma is the presence of oversized B-cells, called Reed-Sternberg cells, within a lymph node biopsy. Reed-Sternberg cells are different from other B-cells and are more likely to be found in liquid lymphomas, such as Hodgkin lymphoma, than in solid tumors like lung cancer or mesothelioma.
A physical exam and lab tests are the first steps in diagnosing Hodgkin lymphoma. Your doctor will look for swollen lymph nodes in the neck, underarm and groin. He or she will also check the spleen and liver. X-rays, computed tomography (CT) and positron emission tomography (PET) scans are also used to help find the location of lymph nodes in other parts of the body and to determine whether they are enlarged.
If a biopsy is done, the lymph node tissue may be examined under a microscope to see if Hodgkin lymphoma is present. The diagnosis can also be made with a test that measures the activity of certain genes in lymphocytes. The test can be used to identify the type of Hodgkin lymphoma and tell how quickly it is growing.
Often, doctors will use combination chemotherapy with radiation therapy as the treatment of choice for patients in stage I or II Hodgkin lymphoma. This is because new types of chemotherapy and better techniques for delivering radiation allow patients to receive higher doses of these treatments with less risk of long-term side effects.
For a smaller number of people, Hodgkin lymphoma will not respond to treatment or will come back after treatment (relapse). If this happens, your doctor may recommend a stem cell transplant. This procedure uses high-dose chemotherapy to kill any remaining malignant cells and replace them with healthy bone marrow. The transplant can then be followed by radiation and other chemotherapy to kill any remaining cancer cells. These treatment options are called salvage therapies.
Hodgkin lymphoma, also called Hodgkin disease, starts in your lymph system — the network of tissues and organs that help fight infection and other diseases. Some treatments for Hodgkin Lymphomacan cure the condition and prevent it from returning, while others slow its progression and relieve symptoms.
Your healthcare team will talk to you about the goals of your treatment and what side effects might happen. This is called shared decision-making and is an important part of your care.
For most cases of early-stage Hodgkin lymphoma, your healthcare provider will recommend radiation therapy and chemotherapy. Radiation therapy uses high-energy X-rays or other waves to kill cancer cells and shrink tumours. Chemotherapy uses drugs to stop the growth of cancer cells. You may also have other cancer treatments, such as surgery or stem cell transplants.
If you have Hodgkin lymphoma that doesn’t respond to the first treatment (refractory) or comes back after it goes away (relapse), your healthcare provider will use different medicines, such as brentuximab vedotin and nivolumab, instead of the usual treatment for refractory Hodgkin lymphoma (high doses of chemotherapy followed by a stem cell transplant). These medications are less likely to cause serious side effects, like neutropenia.
In rare cases, Hodgkin lymphoma doesn’t respond to any of these treatments. If this happens, your healthcare provider may suggest a more intensive treatment with higher doses of chemotherapy and a stem cell transplant or other therapy to treat the lymphoma.
If you have Hodgkin lymphoma, you must tell any doctors who care for you that you have this condition. You should carry a card that says so and give it to any medical professional who doesn’t know your health history. This helps to avoid misdiagnosis and unnecessary treatment. You also should carry this card if you need a blood transfusion or other procedure that uses non-irradiated blood. You can order a free card from your healthcare team or from the Leukemia and Lymphoma Society. You can also ask your healthcare provider about clinical trials that are testing new ways to treat Hodgkin lymphoma.
Hodgkin lymphoma is usually curable, but it can come back (relapse). Most people who have Hodgkin lymphoma are cured because their treatment wipes out all of the cancer cells. But this cancer can return, and it’s important to have follow-up care to watch for signs of the disease and prevent relapse.
Your follow-up plan will vary based on your needs and the type of treatment you receive. But your doctor will check your symptoms and health, do a physical examination, and order tests to find out how well you’re responding to treatment. These tests may include blood and urine exams, a chest x-ray, and a bone scan.
A blood test called a complete blood cell count (CBC) can help detect problems such as anemia and low white blood cell counts. The CBC also measures how much oxygen your red blood cells are carrying. If your red blood cells aren’t carrying enough oxygen, they can die, which can lead to a condition called anemia. The CBC can also help identify other health conditions such as infection and liver or kidney problems.
Some adults with relapsed or refractory Hodgkin lymphoma benefit from treatment with drugs that boost the immune system. This treatment is called immunotherapy. It can be used on its own or with other treatments such as chemotherapy.
Drugs that target specific molecules on cancer cells are another treatment option. Some of these drugs are monoclonal antibodies that attach to a protein on the surface of cancer cells, stopping them from growing or spreading. Examples of monoclonal antibodies used to treat Hodgkin lymphoma include rituximab and brentuximab vedotin.
For most people, the main treatments for Hodgkin lymphoma are radiation therapy and chemotherapy. Radiation therapy uses high-energy rays to kill cancer cells and can cause damage to normal cells. Chemotherapy is a combination of drugs that can kill cancer cells and stop them from growing or spreading.
Stem cell transplant is a treatment that replaces your own stem cells to rebuild your immune system after receiving chemotherapy or radiation. This can be an option for people with relapsed or refractory HL who are candidates for transplant.
Hodgkin lymphoma develops in certain types of white blood cells (lymphocytes) in your lymphatic system, a vast network of nodes, vessels and organs that eliminates waste and fights infection throughout the body. HL can be divided into four subtypes based on the type of tumor cells found in affected lymph nodes: nodular sclerosis, mixed cellularity, lymphocyte-rich and lymphocyte-depleted.
Hodgkin lymphoma is an abnormal cancer that develops in the lymphatic system, a network of vessels and glands throughout the body. Clear fluid called lymph flows through these vessels, carrying infection-fighting white blood cells known as B-lymphocytes. In Hodgkin lymphoma, B-lymphocytes start to multiply in an uncontrolled way and collect in certain parts of the lymphatic system, such as the lymph nodes. These abnormal cells can crowd out healthy lymphocytes and interfere with the immune system’s ability to guard against infections. The most common sign of this disease is a painless swelling in a lymph node, usually in the neck, armpit or groin. Other signs and symptoms may include fever, weight loss, fatigue and night sweats.
In nodular sclerosing Hodgkin lymphoma, or NLP-HL, the earliest stage of this disease, B-lymphocytes in the lymph nodes develop a pattern of nodules with fibrous bands in the tissue surrounding them. This is the most common of the four cHL subtypes, making up about 70 percent of all cHL cases.
This type of cHL is more common in men than in women. It most often affects people in their 20s or younger, and it tends to occur in the lymph nodes in the center of the chest. In this subtype, B-lymphocytes can also develop a form of aplastic anemia, which is when the bone marrow stops producing new blood cells.
Other signs and symptoms of this subtype include a fatigue, nausea and weight loss. In some patients, this lymphoma can spread to other organs, such as the lungs and liver.
Doctors use a system of staging and risk factors to characterize the prognosis of Hodgkin lymphoma and help plan treatment. Having certain risk factors can increase the likelihood that the lymphoma will come back after treatment. It’s important to talk to your healthcare provider about any questions or concerns you have about staging and risk factors.
Hodgkin lymphoma develops when cancerous white blood cells, called B cells and T cells, grow out of control and crowd out healthy white blood cells that fight infections. Lymph is the fluid that drains from your cells and blood vessels into larger lymphatic vessels, where it collects fats, proteins, damaged cells, minerals, viruses, bacteria and germs. It then flows to lymph nodes, where it is filtered and cleaned by lymphocytes (b cells and t cells). The lymph then returns to the blood stream to be recirculated around the body. In Hodgkin lymphoma, the abnormal lymphocytes accumulate in one or more lymph nodes and spread to other lymph nodes, blood vessels, organs and tissue, causing disease.
A health care provider may suspect that you have Hodgkin lymphoma if you have painless, swollen lymph nodes and fevers. Your doctor will ask about your symptoms and perform a physical exam and imaging tests. Your healthcare team may also order a lymph node biopsy, in which they remove all or part of a lymph node and examine it under a microscope for signs of Hodgkin lymphoma. A biopsy can also be done for other types of lymphoma, and may be used to diagnose other diseases that affect the lymphatic system.
Classical Hodgkin lymphoma, or cHL, is divided into four histologic subtypes: nodular sclerosis cHL, mixed cellularity cHL, lymphocyte depleted cHL and lymphocyte-rich cHL. Most cases of cHL are classified as either nodular sclerosis or mixed cellularity.
The histologic characteristics of cHL have been associated with a variety of underlying causes. Past Epstein-Barr virus infection (mononucleosis) increases the risk of cHL, as does HIV infection. MC cHL, which is characterized by diagnostic HRS cells in a mixed inflammatory background without sclerosis, has a different genetic profile than nodular sclerosis and lymphocyte-depleted cHL.
Symptoms and signs of cHL include painless, swollen lymph nodes in the neck or under the armpit, an enlarged spleen and a general feeling of being unwell. If the disease spreads to other parts of the body, it can cause infections and lead to serious complications.
Hodgkin lymphoma starts when an abnormal change in the DNA of a normal white blood cell leads it to grow and divide faster than it should. These cancerous cells crowd out normal white blood cells and prevent them from effectively guarding against infection. Over time, the body develops masses of these cancerous cells, usually in lymph nodes located throughout the lymphatic system, which connect to the rest of the body’s blood vessels. Depending on the subtype of Hodgkin lymphoma, symptoms and signs of the disease vary.
Reed-Sternberg cells are the hallmark of classic Hodgkin lymphoma, but they’re found in different ways in each histological subtype. Nodular sclerosis and mixed cellularity histological subtypes of classic Hodgkin Lymphoma are the most common types, with nodular sclerosis being more prevalent than mixed cellularity. Lymphocyte-depleted and lymphocyte-rich subtypes are less common, but these can occur in the same person.
When the disease is diagnosed, healthcare providers determine what stage it’s in by examining the number and location of lymph nodes involved, as well as evaluating whether the tissue has any special features that indicate the type of cHL. They may also test for certain genetic markers that might identify the type of cHL more precisely.
For people diagnosed with nodular sclerosis classic Hodgkin lymphoma (cHL), the most common subtype, treatment is often successful. The outlook is also favorable for people diagnosed with mixed cellularity cHL, which tends to occur in lymph nodes in the neck and armpits and is more common in young adults.
However, a type of cHL called lymphocyte-rich classical Hodgkin lymphoma (LRHL) is more common in older adults and in people with HIV, which can cause this type to be diagnosed at a later stage than other cHLs. LRHL grows more slowly than other types of cHL, and it rarely causes B symptoms.
Healthcare providers can diagnose Hodgkin lymphoma with a physical exam and other diagnostic tests, such as blood work and imaging scans. A lymph node biopsy is another important test. This involves removing all or part of the affected lymph node and examining the tissue under a microscope for signs of Reed-Sternberg cells. Occasionally, healthcare providers may perform a specialized imaging test known as an ultrasound-guided lymph node biopsy to help remove the lymph node and avoid damaging the surrounding structures.
Hodgkin lymphoma forms when white blood cells called B-cells mutate and grow out of control. They crowd out the normal cells and swell up your lymph nodes. They can also spread to other parts of the body. If it is caught early, this cancer has a very good outlook.
Healthcare providers group Hodgkin lymphoma into different categories as they plan treatment. These groups are based on your cancer stage and how the lymphoma looks under a microscope. They also look at your risk factors. These are things that increase the chance your lymphoma will come back after treatment.
Your risk of lymphoma increases with age. You are also more likely to get lymphoma if you have a blood relative with the disease or are male. Having certain viruses like HIV or Epstein-Barr virus makes you more likely to develop lymphoma. Having an organ transplant raises your risk of getting lymphoma, too. You may need to take antirejection drugs after the transplant to keep your immune system weak.
There are two main types of Hodgkin Lymphoma: Classical and nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). You may have one or both. Both of these types have unique neoplastic cells that are diagnostic for the disease. The cells are called Reed-Sternberg cells and have mirror-image nuclei (called owl eyes) in a reactive cellular background. They are the most common diagnosis for classical HL. The other neoplastic cell in classic HL is lacunar cell, which has a diffuse growth pattern with fine interstitial fibrosis without RS cells and a more general inflammatory background.
NLPHL has neoplastic cells similar to those in classic HL but with a more widespread, less aggressive inflammatory background and less dense fibrosis. These cells are often harder to biopsy than those in CLASSIC HL. This subtype tends to occur in younger adults and is more likely in men.
Healthcare providers treat Hodgkin lymphoma by using radiation, chemotherapy and sometimes stem cell transplantation. You will work with a team of doctors including a GP, haematologist, surgeon and radiation oncologist. Your GP will refer you to specialists if needed.