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Hodgkin Lymphoma Signs & Symptoms

Hog-king with Lime-foam
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Lymphoma is a term used to describe lymphoid neoplasms that arise as discrete tissue masses, as opposed to widespread involvement of the bone marrow as in leukemias. Within the large group of lymphomas, Hodgkin lymphoma is distinguished from all other forms due to distinctive pathologic features. This cancer is one of the most common cancers of adolescents and young adults, but also has a bimodal age distribution, as disease incidence again increases with age. While non-Hodgkin lymphomas (NHL) frequently occur at extranodal sites and spread in an unpredictable pattern, Hodgkin lymphoma is typically localized to a single lymph node or a chain of nodes, and spreads first to contiguous lymphoid tissues. Hodgkin lymphoma also has distinctive morphologic features, particularly characterized by the presence of neoplastic giant cells called Reed-Sternberg cells. Reed-Sternberg cells release factors that induce the accumulation of reactive lymphocytes, macrophages and granulocytes. These cells have a characteristic appearance with two nuclear lobes, large inclusion like nucleoli and abundant cytoplasm. These cells have an owl’s eye appearance and have a characteristic immunophenotype, including CD15 and CD30, while negative for other B cell markers. In the majority of Hodgkin lymphomas, the neoplastic Reed-Sternberg cells are derived from germinal center B cells. Hodgkin lymphoma commonly presents as painless lymphadenopathy, often in the mediastinum. Patients with disseminated disease are more likely to have constitutional B symptoms, such as fever, night sweats and weight loss.
6 KEY FACTS
SIGNS AND SYMPTOMS
Localized Single Group of Lymph Nodes
Single pile of lymph-limes

An important differentiating feature characteristic of Hodgkin lymphoma is progression along a single group of lymph nodes, with rare extranodal involvement. This is unlike the peripheral spread to multiple groups of lymph nodes and common extranodal involvement of non-Hodgkin lymphoma.

Contiguous Spread
Contiguous Trail

While non-Hodgkin lymphomas (NHL) frequently spread in an unpredictable pattern, Hodgkin lymphoma spreads first to contiguous lymphoid tissues.

Constitutional B Symptoms
Constitution Bee

Patients with disseminated Hodgkin disease are more likely to have constitutional B symptoms, which classically include fever, night sweats and weight loss. They are called “B” symptoms because of the Ann Arbor staging system of lymphomas. “A” indicates an absence of systemic symptoms while “B” indicates the presence of these symptoms.

Low-Grade Fever
Fever-beaver

A fever greater than 38 degrees Celsius is a component of constitutional B symptoms. The fever of Hodgkin lymphoma is typically an intermittent fever that occurs at variable intervals of days to weeks, and lasts for several weeks before resolving.

Night Sweats
Moon Sweats

Drenching diaphoresis, particularly at night, is a common constitutional B symptom of Hodgkin lymphoma.

Weight Loss
Scale showing Weight Loss

Unintentional weight loss, or weight loss of greater than 10% of normal body weight in a period of six months or less, is considered a constitutional B symptom in Hodgkin lymphoma.

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