What is Hodgkin lymphoma?

Hodgkin lymphoma is a cancer of the lymphatic system. The lymphatic system is part of the body's immune system. Lymphoma develops from white blood cells called lymphocytes

Hodgkin lymphoma can begin in almost any part of the body. But it usually starts in the lymph nodes. The most common area is the lymph nodes in the neck. Different areas of lymph nodes around the body may be  affected.

We have more information about how lymphoma develops

Around 2,100 people are diagnosed with Hodgkin lymphoma in the UK each year. Hodgkin lymphoma can happen at any age. It is one of the most common cancers to affect people in their teens and early 20s. 

We have separate information about another lymphoma called non-Hodgkin lymphoma (NHL).

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Types of Hodgkin lymphoma

There are two main types of Hodgkin lymphoma. Doctors can find out which type you have by examining some lymphoma cells under a microscope.

Classical Hodgkin lymphoma

This is the most common type of Hodgkin lymphoma. About 9 in 10 (90%) of all Hodgkin lymphomas are this type. There are four sub-types of classical Hodgkin lymphoma, depending on how the cells look under a microscope:

  • nodular sclerosing
  • mixed cellularity
  • lymphocyte-depleted
  • lymphocyte-rich.

These sub-types are all treated in a similar way.

Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL)

This is a rarer type of Hodgkin lymphoma. NLPHL develops and is treated differently to classical Hodgkin lymphoma. It tends to be slower growing than classic HL.

Rarely, NLPHL can change into a type of non-Hodgkin lymphoma (NHL). If that happens, it is treated as NHL instead of Hodgkin lymphoma.

Symptoms of Hodgkin lymphoma

The most common symptom of lymphoma is a painless swelling in the lymph nodes in the neck, armpit or groin.

We have more information about signs and symptoms of lymphoma.

Causes of Hodgkin lymphoma

The causes of Hodgkin lymphoma are mostly unknown. But some things may increase your risk of developing it. These are called risk factors.

We have more information about the causes and risk factors for Hodgkin lymphoma.

Diagnosis of Hodgkin lymphoma

If you have symptoms, you usually start by seeing your GP. If they think your symptoms could be caused by cancer, they may arrange for you to have blood tests or scans. Your doctor will refer you to hospital for tests and for specialist advice and treatment.

If you think you may be pregnant, tell your doctor. Some tests and treatments for lymphoma can be harmful to a baby in the womb. If you are pregnant, you can usually still have tests and treatment for lymphoma. But it is important to talk to your doctor so they can plan your care safely..

Biopsy for lymphoma

The most important test for diagnosing lymphoma is a biopsy. A biopsy is the removal of a small piece of tissue or a sample of cells, to be looked at under a microscope.

The tissue is examined under a microscope by a doctor called a pathologist. They look for lymphoma cells and do different tests on the cells.

Further tests for lymphoma

You will have more tests before you start treatment for lymphoma. Some tests help to show the stage of the lymphoma.

You may have other tests, such as blood tests or x-rays to check your general health and how well your heart, lungs, liver and kidneys are working. 

For example, your doctor will do blood tests to check the levels of different blood cells in your blood. They may also talk to you about having blood tests to check for certain viruses, such as HIV and hepatitis.

You may have some of the following tests:

  • CT scan

    A CT scan makes a three-dimensional (3D) picture of the inside of the body using x-rays taken by the CT scanner.

  • Ultrasound

    An ultrasound uses sound waves to build up a picture of internal organs. It can be used to guide a biopsy. The scan helps to guide them to the exact area.

  • PET-CT scan

    A PET-CT scan uses low-dose radiation to check the activity of cells in different parts of the body. It is sometimes given together with a CT scan. This is called a PET-CT scan.

  • MRI scan

    An MRI scan uses magnetism to build up a detailed picture of areas of your body.

  • Bone marrow sample

    A small sample of bone marrow is taken from the back of the hip bone (pelvis). The sample is sent to a laboratory to be checked for abnormal cells. 

Waiting for test results can be a difficult time, we have more information that can help.

Stages of Hodgkin lymphoma

Knowing the extent of the lymphoma helps your doctor plan the right treatment. This is called staging.

We have more information on the stages of Hodgkin lymphoma.

Treatment for Hodgkin lymphoma

A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).

Your doctor or cancer specialist or nurse will explain the different treatments and their side effects. They will also talk to you about things to consider when making treatment decisions

Treatment for Hodgkin lymphoma will depend on the stage and type of Hodgkin lymphoma you have. These may include one or more of the following treatments:

  • Watch and wait

    If you have nodular lymphocyte predominant Hodgkin lymphoma (NLPHL), your doctor may suggest you delay having treatment. This is called watch and wait.

  • Chemotherapy

    Chemotherapy is often used to treat lymphoma. It uses anti-cancer (cytotoxic) drugs to destroy lymphoma cells. You can have chemotherapy with steroids and sometimes with targeted therapy drugs.

  • Steroids

    Steroids are drugs given with chemotherapy to help treat lymphoma.

  • Radiotherapy

    Radiotherapy treats cancer by using high-energy rays that destroy cancer cells, while doing as little harm as possible to normal cells. It is given to groups of lymph nodes affected by the lymphoma.

  • Targeted therapies

    Targeted therapies find and attack cancer cells. Certain drugs called immunotherapies also use the immune system to destroy cancer cells. You may have these drugs alone or with chemotherapy.

  • Stem cell transplant

    Some people may have a stem cell transplant. A stem cell transplant is an intensive treatment, so it is not suitable for everyone. You may have a transplant using:

We have more information about treating Hodgkin lymphoma.

You may have some treatments as part of a clinical trial.

After Hodgkin lymphoma treatment

You will have regular follow-up appointments after your treatment. You can talk to your doctor or nurse about any concerns you may have at these appointments. Your doctor will want to know how you are feeling, and to check you are recovering from any side effects of treatment.

Late effects

Sometimes side effects may continue or develop months or years after treatment. These are called late effects. We have more information about long-term and late effects of treatment for lymphoma.

Sex life and fertility

Cancer and its treatment can sometimes affect your sex life. There are ways to improve your sexual well-being and to manage any problems.

Treatment for lymphoma may affect your fertility. If you are worried about your fertility it is important to talk with your doctor before you start treatment. We have more information about:

Well-being and recovery

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes after treatment.

Making small changes such as eating well and keeping active can improve your health and wellbeing and help your body recover.

Getting support

Everyone has their own way of dealing with illness and the different emotions they experience. You may find it helpful to talk things over with family and friends or your doctor or nurse.

Macmillan can offer emotional, practical and financial help and support. If you would like to talk, you can:

The organisations below also offer information and support:

  • Blood Cancer UK

    Blood Cancer UK offers support and information to people affected by blood cancers, including lymphoma.

  • Lymphoma Action

    Lymphoma Action gives emotional support, advice and information for people with Hodgkin lymphoma or non-Hodgkin lymphoma and those close to them. It has a national network of people with lymphoma, as well as local groups. Their website has a section called trialslink where you can see information about lymphoma clinical trials.

About our information

  • References

    Below is a sample of the sources used in our Hodgkin lymphoma (HL) information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

    Hodgkin lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up; European Society for Medical Oncology (2018).

    National Institute of Health and Care Excellence (NICE). Blood and bone marrow cancers. NICE Pathways. Last accessed 3 December 2020.

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editors, Dr Anne Parker, Consultant Haematologist; and Professor Rajnish Gupta, Macmillan Consultant Medical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

Reviewed: 01 March 2021
Reviewed: 01/03/2021
Next review: 01 March 2024
Next review: 01/03/2024