Hodgkin’s lymphoma is a type of cancer that affects the lymphatic system, including the lymph nodes. The cancer typically spreads from one lymph node to a neighboring one.

People with Hodgkin’s lymphoma have Reed-Sternberg cells. These are abnormally large B lymphocytes that often have more than one nucleus. Doctors can identify these cells in lymph fluid under a microscope.

With treatment, Hodgkin’s lymphoma has a high cure and survival rate.

This article looks at Hodgkin’s lymphoma, including its symptoms, causes, treatment options, and outlook.

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According to the National Health Service (NHS) in the United Kingdom, Hodgkin’s lymphoma is a type of cancer that develops in the lymphatic system, which is a part of the immune system.

Hodgkin’s lymphoma usually begins in B lymphocytes, a type of white blood cell that produces antibodies to help the immune system mount a response to infection.

Learn more about Hodgkin’s lymphoma.

Not everyone with Hodgkin’s lymphoma has symptoms. However, some people may experience signs that could point to this condition.

Swollen lymph nodes

The NHS states that the most common symptom of Hodgkin’s lymphoma is a swollen lymph node under the skin. This often appears as a lump in the neck, armpit, or groin.

The lump may not hurt all the time, but it might hurt more after a person has drunk alcohol. This is possibly due to increased blood flow, nerve sensitivity, chemical reactions, or immune responses, though the exact reason for this remains unclear.

However, a swollen lymph node does not necessarily mean a person has cancer since lymph nodes often swell when the body is tackling an infection.

If the swollen lymph node hurts when a person touches it, it could be due to an infection. If this is the reason for the swelling, it will go down when the infection has healed.

However, when a lymph node swells for no apparent reason, and the swelling remains, it could indicate cancer.

Additional symptoms

Sometimes, swollen lymph nodes occur with other symptoms, such as coughing or difficulty breathing. This is because a swollen lymph node puts pressure on the chest.

Other symptoms some people may experience include:

Anyone can develop Hodgkin’s lymphoma, which occurs when healthy cells divide and grow uncontrollably.

However, some factors can increase the risk of this condition, including:

  • Age: People ages 20 to 40 or over 75 years may be more vulnerable to Hodgkin’s lymphoma.
  • Sex: Hodgkin’s lymphoma is slightly more common in males than in females.
  • Immune system factors: People with diseases that weaken their immune systems, such as HIV, may be more likely to develop Hodgkin’s lymphoma.
  • Family history: People with a first-degree relative (parent, sibling, or child) who has had lymphoma are more at risk of developing this type of cancer. It’s unknown if this is because of an inherited genetic fault or lifestyle factors.
  • Epstein-Barr virus (EBV): People who have had EBV, which causes mononucleosis, may be more likely to develop Hodgkin’s lymphoma. About 1 in 4 people with classic Hodgkin’s lymphoma (CHL) have this virus in their Reed-Sternberg cells.

Learn more here about EBV testing.

There is no known effective strategy for preventing Hodgkin’s lymphoma or EBV, which increases the likelihood of developing this type of cancer.

Infection with HIV can increase a person’s risk of Hodgkin’s lymphoma. Ways to lower the risk of HIV include limiting intravenous drug use and avoiding sex without a condom or other barrier contraceptive.

Learn more here about the causes of HIV.

There are several factors doctors look at when staging Hodgkin’s lymphoma:

  • Stage 1: This is the most localized form of the cancer. This means that cancer is present only in one lymph node or lymph organ or that it is present in an organ after spreading there from a lymph node.
  • Stage 2: During this stage, the cancer has spread slightly, affecting two or more lymph nodes or lymph organs – either above or below the diaphragm. It may have also spread to a nearby organ.
  • Stage 3: Stage 3 Hodgkin’s lymphoma is present on both sides of the diaphragm or has spread to the spleen.
  • Stage 4: In this stage, the cancer has spread more widely to at least one organ outside of the lymphatic system. It does not just involve one organ near a cancerous lymph node.

Learn more about the four stages of lymphoma.

Bulky disease

People with bulky disease have stage 2 or higher cancer. They have tumors that are larger than 4 inches anywhere in the body or a tumor that is at least one-third as wide as the chest.

Doctors usually add an “X” to the stage to indicate bulky disease.

In lymphoma, bulky disease may mean a person requires more treatment.

A vs. B

In addition to a number, stages of cancer may also appear written with an “A” or “B.”

A person may have B stage cancer if they experience:

  • drenching night sweats
  • unexplained loss of more than 10% of body weight
  • a temperature consistently higher than 100.4°F (38°C)

If these symptoms are not present, the person has A-stage cancer.

Terminology

A person may hear a doctor use the following terms when discussing Hodgkin’s lymphoma:

  • Resistant or progressive: This means the lymphoma is not going away or is growing during treatment.
  • Recurrent or relapsed: This means that the lymphoma went away with treatment before but has now returned. It might have returned to the same place as before or be in another part of the body.

Learn more about recurrent lymphoma.

There are two major types of Hodgkin’s lymphoma:

CHL

At least 90% of Hodgkin’s lymphoma cases are CHL. This type of cancer occurs when B lymphocytes develop into a type of cancer called Reed-Sternberg cells.

There are four subtypes of CHL:

  • Nodular sclerosis Hodgkin’s lymphoma (NSHL): This is the most common type of this cancer. It usually appears in young adults and teenagers. In NSHL, symptoms typically begin in the lymph nodes of the chest or neck.
  • Lymphocyte-rich Hodgkin’s lymphoma (LRHL): This is an uncommon form of lymphoma. LRHL affects lymph nodes in the upper portion of the body.
  • Lymphocyte-depleted Hodgkin’s lymphoma (LDHL): This a rare form of CHL and is more common among people with weakened immune systems, such as older adults and those with HIV. LDHL is a more aggressive form of cancer with a higher fatality rate. It tends to affect lymph nodes in the stomach, liver, or spleen.
  • Mixed cellularity Hodgkin’s lymphoma (MCHL): This form of lymphoma, which affects about 40% of people with CHL, is more common among older adults, children, and people with HIV. MCHL usually begins in lymph nodes near the top of the body, such as in the armpits.

Nodular lymphocyte predominant Hodgkin’s lymphoma

About 5% of Hodgkin’s lymphoma cases are nodular lymphocyte predominant Hodgkin’s lymphoma (NLPHL). This type of the condition causes a form of Reed-Sternberg cells called “popcorn” cells.

This slow-growing cancer often begins in the armpit and neck.

People of all ages can develop NLPHL. However, it is more common in males than in females.

Both Hodgkin’s and non-Hodgkin’s lymphoma affect the lymphatic system.

The main difference between these two types of cancer is that people with non-Hodgkin’s lymphoma do not have Reed-Sternberg cells.

Non-Hodgkin’s lymphoma is also more common than Hodgkin’s lymphoma.

The 5-year survival rate for all stages of Hodgkin’s lymphoma is 89%.

Survival rate refers to the number of people still alive for a specific after a particular diagnosis.

For example, a 5-year survival rate of 50% of people means that half of the people are still alive at least 5 years after diagnosis.

It is important to remember that these figures are estimates and are based on previous medical studies. Talk with your doctor about the outlook for your specific condition.

According to the NHS, most people who have survived 5 years with Hodgkin’s lymphoma will recover.

However, many factors can affect a person’s outlook and the intensity of the treatment they need, including:

Access to quality, evidence-based treatment could also affect a person’s outlook.

Moreover, some people relapse after going into remission or do not respond to initial treatment. Data suggest about 30% of people with this type of cancer experience a relapse.

A doctor may suspect lymphoma when a person has unexplained swollen lymph nodes.

A biopsy of the lymph node can test for cancer cells.

Typically, a doctor will cut out the entire lymph node for testing. They may also insert a needle into the lymph node and remove some fluid.

If a doctor diagnoses someone with a lymphoma, they may recommend a bone marrow biopsy. This procedure involves inserting a needle into the bone to see whether the cancer has spread to the bone marrow.

Learn more here about bone marrow cancer.

Hodgkin’s lymphoma can spread quickly throughout the body. However, it is one of the most treatable types of cancer.

Treatment will depend on disease staging and other risk factors. For example, people with bulky advanced stage CHL do not respond well to radiation, so a doctor may advise against it.

In general, treatment options include:

  • Chemotherapy and radiation: The first treatment option for most people, especially those with early stage and low risk cancers, is chemotherapy and radiation therapy.
  • Stem cell transplant: This procedure can help people who do not respond to chemotherapy or radiation or whose cancer returns.
  • Immunotherapy: This type of treatment involves using drugs that help the immune system fight the cancer.

What is the survival rate of Hodgkin’s lymphoma?

The 5-year survival rate for all stages of Hodgkin’s lymphoma is 89%.

What are the first signs of Hodgkin’s lymphoma?

Typically, the first sign of Hodgkin’s lymphoma is a swelling in the neck, armpit, or groin. Other symptoms include night sweats, fever, and a persistent cough.

How curable is Hodgkin’s lymphoma?

Hodgkin’s lymphoma is one of the most easily treated types of cancer. Most people who have survived 5 years with Hodgkin’s lymphoma will likely be cured.

Is Hodgkin’s lymphoma a serious cancer?

Hodgkin’s lymphoma is a relatively aggressive cancer and can spread quickly through the body. It is a serious cancer but is also one of the most easily treated types of cancer.

Hodgkin’s lymphoma is a type of cancer that affects the lymphatic system. It has a high remission rate, and most people with this condition survive.

Survival rates are best in people who receive an early diagnosis. Therefore, it is important to contact a doctor as soon as possible for any unexplained changes in a lymph node or other symptoms of infection or illness.