Hodgkin lymphoma
Lymphoma - Hodgkin; Hodgkin disease; Cancer - 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.
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.
EBV
Epstein-Barr virus antibody test is a blood test to detect antibodies to the Epstein-Barr virus (EBV).
Symptoms
The first sign of Hodgkin lymphoma is often a 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:
-
Fatigue
Fatigue
Fatigue is a feeling of weariness, tiredness, or lack of energy.
- 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...
- Weight loss that cannot be explained
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 doctor about the meaning of your specific symptoms.
Exams and Tests
The doctor will perform a physical exam and check body areas with lymph nodes to feel if they are swollen.
The disease is often diagnosed after a biopsy of suspected tissue, usually a lymph node.
The following procedures will usually be done:
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Blood chemistry tests
including protein levels, liver function tests, kidney function tests, and uric acid level
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...
-
Bone marrow biopsy
Bone marrow biopsy
A bone marrow biopsy is the removal of marrow from inside bone. Bone marrow is the soft tissue inside bones that helps form blood cells. It is foun...
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CT scans of the chest
, abdomen, and pelvis
CT scans of the chest
An abdominal CT scan is an imaging method. This test uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomog...
-
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 red blood cells (RBC count)The number of white blood cells (WBC count)The tota...
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PET (positron emission tomography) scan
PET (positron emission tomography) scan
A positron emission tomography scan is a type of imaging test. It uses a radioactive substance called a tracer to look for disease in the body. A po...
If tests show that you have Hodgkin lymphoma, more tests will 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 (there are different forms of Hodgkin lymphoma)
- The stage (where the disease has spread)
- Whether the tumor is more than 4 inches (10 cm) wide
- Your age and other medical issues
- Other factors, including weight loss, night sweats, and fever
You may receive chemotherapy , radiation therapy , or both. Your doctor 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 ...
Radiation therapy
Radiation therapy uses high-powered x-rays, particles, or radioactive seeds to kill cancer cells.
High-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 destroyed bone marrow with healthy bone marrow stem cells. Bone marrow is the soft, fat...
You and your health care provider may need to manage other concerns during your leukemia treatment, including:
-
Having chemotherapy at home
Having chemotherapy at home
Home intravenous antibiotic therapy; Central venous catheter - home; Peripheral venous catheter - home; Port - home; PICC line - home; Infusion thera...
-
Managing your pets
during chemotherapy
Managing your pets
People with weakened immune systems may be advised to give up their pets to avoid getting diseases from the animals. People in this category include...
-
Bleeding problems
Bleeding problems
Cancer treatment - bleeding; Chemotherapy - bleeding; Radiation - bleeding; Bone marrow transplant - bleeding; Thrombocytopenia - cancer treatment...
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Dry mouth
Dry mouth
Chemotherapy - dry mouth; Radiation therapy - dry mouth; Transplant - dry mouth; Transplantation - dry mouth
-
Eating enough calories
Eating enough calories
Getting more calories - adults; Chemotherapy - calories; Transplant - calories; Cancer treatment - calories
-
Safe eating
during cancer treatment
Safe eating
Cancer treatment - eating safely; Chemotherapy - eating safely; Immunosuppression - eating safely; Low white blood cell count - eating safely; Neutro...
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 -- www. cancer. orgCancerCare -- www. cancercare. or...
Outlook (Prognosis)
Hodgkin lymphoma is one of the most curable cancers. Cure is even more likely if it is diagnosed and treated early. Unlike other cancers, Hodgkin lymphoma is also very curable in its late stages.
You will need to have regular exams and imaging tests for years after your treatment. This helps your doctor 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 doctor who knows about monitoring and preventing these complications.
When to Contact a Medical Professional
Call your provider if:
- You have symptoms of Hodgkin lymphoma
- You have Hodgkin lymphoma and you have side effects from the treatment
References
Bartlett NL, Foyli KV. Hodgkin lymphoma. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology . 5th ed. Philadelphia, PA: Elsevier; 2014:chap 105.
National Cancer Institute: PDQ adult Hodgkin lymphoma treatment. Bethesda, MD: National Cancer Institute. Updated February 12, 2016. cancer.gov/cancertopics/pdq/treatment/adulthodgkins/HealthProfessional . Accessed March 17, 2016.
National Cancer Institute: PDQ childhood Hodgkin lymphoma treatment. Bethesda, MD: National Cancer Institute. Updated February 3, 2016. cancer.gov/cancertopics/pdq/treatment/childhodgkins/HealthProfessional . Accessed March 17, 2016.
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: Hodgkin lymphoma. Version 2.2015. www.nccn.org/professionals/physician_gls/pdf/hodgkins.pdf . Accessed March 17, 2016.
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Hodgkin lymphoma
Animation
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Lymphatic system - illustration
The lymphatic system filters fluid from around cells. It is an important part of the immune system. When people refer to swollen glands in the neck, they are usually referring to swollen lymph nodes. Common areas where lymph nodes can be easily felt, especially if they are enlarged, are: the groin, armpits (axilla), above the clavicle (supraclavicular), in the neck (cervical), and the back of the head just above hairline (occipital).
Lymphatic system
illustration
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Hodgkin's disease, liver involvement - illustration
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.
Hodgkin's disease, liver involvement
illustration
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Lymphoma, malignant - CT scan - illustration
This abdominal CT scan shows tumor masses (malignant lymphomas) in the area behind the peritoneal cavity (retroperitoneal space).
Lymphoma, malignant - CT scan
illustration
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Immune system structures - illustration
The immune system protects the body from potentially harmful substances. The inflammatory response (inflammation) is part of innate immunity. It occurs when tissues are injured by bacteria, trauma, toxins, heat or any other cause.
Immune system structures
illustration
-
Lymphatic system - illustration
The lymphatic system filters fluid from around cells. It is an important part of the immune system. When people refer to swollen glands in the neck, they are usually referring to swollen lymph nodes. Common areas where lymph nodes can be easily felt, especially if they are enlarged, are: the groin, armpits (axilla), above the clavicle (supraclavicular), in the neck (cervical), and the back of the head just above hairline (occipital).
Lymphatic system
illustration
-
Hodgkin's disease, liver involvement - illustration
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.
Hodgkin's disease, liver involvement
illustration
-
Lymphoma, malignant - CT scan - illustration
This abdominal CT scan shows tumor masses (malignant lymphomas) in the area behind the peritoneal cavity (retroperitoneal space).
Lymphoma, malignant - CT scan
illustration
-
Immune system structures - illustration
The immune system protects the body from potentially harmful substances. The inflammatory response (inflammation) is part of innate immunity. It occurs when tissues are injured by bacteria, trauma, toxins, heat or any other cause.
Immune system structures
illustration
Review Date: 2/1/2016
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.