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.
While non-Hodgkin lymphomas (NHL) frequently spread in an unpredictable pattern, Hodgkin lymphoma spreads first to contiguous lymphoid tissues.
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.
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.
Drenching diaphoresis, particularly at night, is a common constitutional B symptom of Hodgkin lymphoma.
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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