What Is Hodgkin Lymphoma?

Doctor examining patient
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Lymphomas are cancers of the lymphocyte type of white blood cells, and these cancers usually start in the lymph nodes, though not always.

There are actually many different kinds of lymphoma, but for historical reasons lymphoma is essentially divided up into two categories: Hodgkin lymphoma (HL) – also called Hodgkin disease – and non-Hodgkin lymphoma (NHL), which essentially refers to all other lymphomas.

It is not an “even split” between the two groups – cases of NHL outnumber HL by far, but Hodgkin was the first lymphoma on the medical scene, and so as other lymphomas were discovered, they were often compared to and contrasted with HL, the historical standard.

In 2013, there were an estimated 193,545 people living with Hodgkin lymphoma in the United States.

Here are some more statistics based on estimates for 2016, along with comparisons with select other cancers:

Cancer Type                   New Cases 2016                         Deaths 2016

Hodgkin Lymphoma             8,500                                       1,120

Melanoma                            76,960                                     16,390

Non-Hodgkin Lymphoma     72,580                                     20,150

Leukemia                              60,140                                     24,400

Lung Cancer                         224,390                                  158,080


Why is it called Hodgkin Disease?

Hodgkin disease is named after Thomas Hodgkin, a doctor who worked at the Guys Hospital in London in the first part of the nineteenth century. He was largely responsible for bringing the stethoscope back to England from Paris, where he had been studying. At first, his seniors scoffed at the newfangled device from the continent, which was quite a bit larger than its modern counterpart, and they turned the large bell of the stethoscope upside-down, filled it with dirt, and used it as a flowerpot for all to see.

Thomas Hodgkin examined corpses for gross pathology for years. In particular, a series of cases captured his interest -- he noticed that some of the bodies had a different sort of lymph node and spleen disease that did not look like a common infection. He wrote a paper about the condition that now bears his name, but it took some time for skeptics to believe and for Hodgkin lymphoma to "sink in" as a clinical entity. A few decades later, other experts in the field recognized his contributions and gave the disease his name to honor his work.

Symptoms of Hodgkin Lymphoma

Adults and children can have Hodgkin disease and feel perfectly well, however HL can also present with various symptoms.

Lump Under the Skin – Swollen Lymph Nodes

Sometimes there are no symptoms at first, but when symptoms are present, the most common symptom of Hodgkin disease is an enlarged lymph node -- a lump in the neck, under the arm, or in the groin. Usually the lump is not painful, but sometimes it may become painful after drinking alcohol.

Cancers other than lymphoma can also cause swollen lymph nodes. And, it should be noted that most cases of enlarged lymph nodes are due to other things, such as infection, rather than cancer. This is especially true in children. Enlarged nodes due to infection generally return to their normal size a couple of weeks or months after the infection clears.  It is best, however, to see your doctor about enlarged lymph nodes so that a cause can be found and treatment begun, if needed.

General, Non-specific Symptoms

Some people with HL have what are termed B symptoms:

·       Fever (which can come and go over several days or weeks) without an infection

·       Drenching night sweats

·       Weight loss without trying (at least 10% of body weight over 6 months)

These symptoms are significant in that, in addition to helping to identify HL, their presence is also important in determining the stage of disease, which has implications on prognosis.

Other possible symptoms of HL include itching skin, feeling tired and loss of appetite. Cough, trouble breathing, and chest pain can also occur with Hodgkin disease within the thorax. If HL affects lymph nodes inside the chest, the swelling of these nodes effect structures such as the windpipe or trachea, prompting the cough reflex, or even resulting in trouble breathing.

How is Hodgkin Identified?

Hodgkin lymphoma is identified from a lymph node biopsy. What helps the pathologist looking at the node under the microscope to identify Hodgkin disease is the presence of the Reed-Sternberg cell. This is the cancer cell of Hodgkin disease and it looks rather like an owl under the microscope. When these cells are present, it helps the pathologist differentiate between HL, NHL, and other benign conditions.

There are 4 types of Hodgkin lymphoma, and they are often quite different in terms of prognosis and treatment options.

What Happens after Hodgkin Lymphoma Diagnosis?

After Hodgkin is diagnosed from the lymph node biopsy, a series of tests are performed for lymphoma staging and prognostic factors. Patients are then treated with chemotherapy, radiotherapy or both. See the article on Treatment Options for Hodgkin Lymphoma. Many of these individuals are diagnosed while their disease is in an early stage and are cured. Even with advanced disease, effective long-term control can often be possible.


American Cancer Society. Signs and symptoms of Hodgkin disease.

SEER Stat Fact Sheets: Hodgkin Lymphoma. http://seer.cancer.gov/statfacts/html/hodg.html. Accessed June 2016.

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