Hodgkin lymphoma
Meaning of Hodgkin lymphoma: Painless swelling of a node in the neck is the usual opening, sometimes with drenching night sweats and a fever that comes and goes.
Definition of Hodgkin lymphoma
Hodgkin lymphoma is a cancer that begins in lymphocytes and grows within the lymph nodes and other lymphatic tissue. It is separated from all other lymphomas by what an affected node looks like under the microscope: a small number of large abnormal cells surrounded by a heavy population of normal immune cells drawn in around them. It usually appears first in the neck or chest.
What forms does it take?
| Form | What distinguishes it |
|---|---|
| Classical Hodgkin lymphoma | The great majority of cases, defined by large Reed-Sternberg cells and divided further by the tissue pattern around them |
| Nodular sclerosis | The most common classical pattern, with bands of fibrous tissue dividing the node, and a tendency to involve the chest |
| Mixed cellularity | A classical pattern with a varied mixture of surrounding cells |
| Lymphocyte rich and lymphocyte depleted | Less common classical patterns at opposite ends of the range |
| Nodular lymphocyte predominant | A separate form with a different abnormal cell, slower behavior and a distinct treatment approach |
What does it look like in a person?
A painless, rubbery swelling of one or more lymph nodes is the usual first sign, most often in the neck, above the collarbone or in the armpit. A mass in the chest may be found on imaging before it causes anything at all, or may produce a cough, breathlessness or a feeling of pressure. One group of general symptoms is asked about specifically, because it affects how the disease is staged: unexplained fever, drenching sweats at night, and weight loss with no other explanation. Itching without a rash is a recognized feature, as is the unusual observation of pain in affected nodes shortly after drinking alcohol. The disease has two peaks in age, one in young adulthood and another later in life, which is unusual among cancers.
How does it differ from non-Hodgkin lymphoma?
The distinction is not a technicality. Non-Hodgkin lymphoma is not one disease but a large collection of separate ones, ranging from indolent conditions watched for years to aggressive types treated urgently, and its cells fill the node they occupy. Hodgkin lymphoma is a small, related group in which the cancer cells are outnumbered by the immune cells they attract, and it typically travels from one node group to the next in orderly fashion instead of appearing at scattered sites. That predictability, together with a strong response to treatment, is why it ranks among the more curable cancers even when found widely spread. Older sources call it Hodgkin disease, which is the same condition under its former name.
Also known as
Used in a sentence
The oncologist reviewed staging results after confirming a diagnosis of Hodgkin lymphoma.
Good to know
The Reed-Sternberg cell separates classical Hodgkin lymphoma from the many lymphatic cancers grouped as non-Hodgkin lymphoma, although the nodular lymphocyte predominant form contains a different abnormal cell and is classified apart from classical disease.