Medical Conditions

Hodgkin lymphoma — also called Hodgkin disease — is a cancer of the immune system, more specifically the lymphatic system. In a patient with Hodgkin lymphoma cells in the lymphatic system grow abnormally and eventually progress enough that your body's ability to fight infections are compromised. Lymphatic tissue is located in many parts of the body so Hodgkin lymphoma can begin in different locations. The most common location is in the diaphragm but Hodgkin lymphoma can also begin in a group of lymph nodes or other parts of the lymphatic system.

Hodgkin Lymphoma (HL) Facts

• The disease is more common in men than women.
• Hodgkin's lymphoma occurs most commonly in people 15-40 years old; then again after 60 years.
• Hodgkin's lymphoma is rare in children under 10.
• HL is much less common than non-Hodgkin lymphoma.
• Unlike non-Hodgkin's lymphoma, the incidence of Hodgkin lymphoma is on the decline.

Risk Factors for Hodgkin's Lymphoma
Exposure to carcinogens such as herbicides, viruses and bacteria may be linked to an increased risk for Hodgkin lymphoma. Other risk factors may include infection with Epstein-Barr, HIV, weakened immune system (inherited or caused by immune suppressants), and family history of Hodgkin lymphoma.

Symptoms of HL

Very often Hodgkin lymphoma causes no classic symptoms. The most likely symptoms are very similar to flu or other common illnesses. Therefore, it is important to pursue a cancer diagnosis if symptoms persist longer than two weeks or are recurring.

Symptoms may include excessive weight loss, swelling of lymph nodes (painless), decreased appetite, fever and chills, chest pain and cough, fatigue, itching, infections, bleeding problems, jaundice (yellowing of skin and eyes) and heightened sensitivity to alcohol ingestion.

Diagnosing HL

In establishing a diagnosis of Hodgkin lymphoma first a physical exam will be performed which includes checking for swollen lymph nodes in the neck, underarm and groin as well as swelling in the spleen and liver. Blood tests and chest x-rays will be taken but a biopsy of enlarged lymph node tissue is the most definitive way to identify HL.

Imaging tests (CT/PET scans) and bone marrow tests are used to determine staging of the disease once a diagnosis has been confirmed. A spinal tap (lumbar puncture) is a procedure in which fluid is drawn from the spinal cord and analyzed for the presence of lymphoma cells which would indicate the spread of the disease to the central nervous system.

Further testing will determine which main type of Hodgkin lymphoma is present, either “classic Hodgkin disease” (cHD) or “lymphocyte-predominant Hodgkin’s disease” (LPHD). These can be further broken down into sub-types which will help doctors give an accurate prognosis and determine the most effective treatment.

Staging for Hodgkin Lymphoma

After Hodgkin lymphoma is diagnosed the disease will be staged. Staging is a careful way of determining how widespread the disease is. Proper staging is crucial to determining the best treatment option for a patient. Hodgkin lymphoma and non-Hodgkin lymphoma is staged the same way in stages I-IV.

• Stage I: In stage I, the cells are located in one lymph node group. If they are not in the lymph nodes they are located in only one part of your body's tissue or an organ.
• Stage II: The lymphoma cells are in at least two lymph node groups on the same side of the diaphragm. Or, the lymphoma cells are in one part of a tissue or an organ and the lymph nodes near that organ.
• Stage III: In stage III of Hodgkin lymphoma lymphoma cells are on both sides of the diaphragm (above and below). Lymphoma cells may also be found in one part of a tissue or an organ near these lymph node groups or in the spleen.
• Stage IV: Lymphoma cells are found in several parts of one or more organs or tissues. Or, the lymphoma is in an organ (such as the liver, lung, or bone) and in distant lymph nodes

Treatment of HL

More than 80% of HL patients experience a full remission from initial treatment. Chemotherapy, radiation, stem cell therapy and bone marrow transplants may be employed to fight the disease. Innovative treatments and clinical trials are constantly emerging and are especially worth inquiring about for patients who are unresponsive to the standard treatment protocols.

Alternate Names for Hodgkin lymphoma
Hodgkin lymphoma is also commonly referred to as Hodgkin’s lymphoma or Hodgkin’s disease.