What is Hodgkin lymphoma?

Hodgkin lymphoma is a cancer of the lymphatic system.

Hodgkin lymphoma usually starts in the lymph nodes. But it can also affect other parts of the body, such as the spleen, bone marrow or liver. The most common area is the lymph nodes in the neck. Often several areas of lymph nodes around the body are affected.

About 1 in 5 (20%) of all diagnosed lymphomas are Hodgkin lymphoma. Around 1,700 people are diagnosed with Hodgkin lymphoma in the UK each year.

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

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. There are four sub-types:

  • Nodular sclerosing
  • Mixed cellularity
  • Lymphocyte-depleted
  • Lymphocyte-rich.

These sub-types are all treated in the same 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.

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 Hodgkin lymphoma is a lump where a lymph node is swollen. This is usually in the neck, armpit or groin. But other areas of lymph nodes can be affected and cause symptoms too.

We have more information about signs and symptoms of lymphoma.

Causes of Hodgkin lymphoma

Doctors do not know the exact causes of Hodgkin lymphoma. But there are risk factors that can increase your chance of developing it.

Having one or more risk factors does not mean you will get Hodgkin lymphoma. Also, having no risk factors does not mean you will not develop Hodgkin lymphoma.

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

Diagnosis of Hodgkin lymphoma

If you have symptoms, you usually begin 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, let your doctor know. Some tests and treatments can be harmful to a baby in the womb. Pregnant women can often still have tests for lymphoma. But, it is important to talk to your doctor so that can plan your care safely. We have more information about cancer and pregnancy.

Biopsy

The most important test for diagnosing lymphoma is a biopsy. A doctor or nurse will take a sample of tissue from the affected area. The most common place to take a biopsy from is an enlarged lymph node. This is called a lymph node biopsy. You may have all or a part of the lymph node removed. The tissue will be sent to a laboratory for testing.

Further tests for Hodgkin 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.

Information from these tests help your doctors plan your treatment safely and effectively.

You may have some of the following tests:

  • CT scan

    A CT scan takes a series of x-rays, which build up a three-dimensional picture of the inside of your body.

  • PET-CT scan

    PET-CT scan gives more detailed information about the part of the body being scanned.

  • MRI scan

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

  • Bone marrow sample

    A doctor or nurse takes a small sample of bone marrow 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

The results of your tests help your doctors find out how many areas of the body are affected by lymphoma and where these areas are. This is called staging.

Knowing the stage helps your doctors plan the best treatment for you.

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.

If you have HIV and lymphoma, your lymphoma doctors and HIV doctors will work together to plan your treatment. We have more information about what this might involve.

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 that you do not need to start treatment straight away. Instead, you have regular tests and appointments to monitor the lymphoma and check for signs that you need to start treatment.

  • Chemotherapy

    Chemotherapy is often used to treat lymphoma. It uses anti-cancer (cytotoxic) drugs to destroy lymphoma cells.

  • Steroids

    Steroids are drugs given with chemotherapy to help treat lymphoma.

  • Targeted therapies

    Targeted therapies are drugs that use unique features of the cancer to find and destroy cancer cells.

  • Radiotherapy

    Radiotherapy treats cancer by using high-energy rays that destroy cancer cells, while doing as little harm as possible to normal cells.

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

After Hodgkin lymphoma treatment

You have regular follow-up appointments after treatment. These appointments are a good opportunity for you to talk to your doctor or nurse about any concerns you have. Your doctor will want to know how you are feeling generally, and to check you are recovering from any side effects of treatment.

Late effects

Sometimes a side effect may continue or develop months or years after treatment. This is called a late effect.

We have more information about long-term and late effects of treatment for lymphoma.

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.

The organisations below also offer information and support:

  • Bloodwise
    Bloodwise offers support and information to people affected by blood cancers, including lymphoma.
  • Lymphoma Action 
    Lymphoma Action gives emotional support, advice and information on all aspects of Hodgkin lymphoma and non-Hodgkin lymphoma. It has a national network of people with lymphoma, and local groups.

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