Hodgkin’s Disease (Hodgkin’s Lymphoma) - Types | Symptoms | Causes | Stages | Treatment
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Hodgkin’s Disease (Hodgkin’s Lymphoma) - Types, Symptoms, Causes, Stages, and Treatment

Published on Feb 20, 2020 and last reviewed on Jul 06, 2023   -  5 min read


A type of blood cancer that arises from lymphocytes is Hodgkin's lymphoma. In this article, we had given a detailed narration about the types, signs and symptoms, causes, stages, investigations, and treatment options of Hodgkin's lymphoma.

Hodgkin’s Disease (Hodgkin’s Lymphoma) - Types, Symptoms, Causes, Stages, and Treatment


Hodgkin’s disease (HD), now known as Hodgkin’s lymphoma or Hodgkin lymphoma, is a type of blood cancer that originates in the lymphatic system. The lymphatic system removes waste and fights off infection in the body. This cancer originates in the white blood cells (lymphocytes), which are the cells that protect the body against infections. In HD, lymphocytes grow abnormally in the lymphatic system and spread beyond it. In advanced cases, the body is not able to fight off infections effectively.

HD can affect people of any age, but it is commonly seen in people between 20 and 40 years and those older than 55 years. Hodgkin’s lymphoma is one of the two types of lymphomas, the other being non-Hodgkin’s lymphoma, which is more common.

What Are the Types of Hodgkin’s Disease?

There are two types of Hodgkin’s disease based on the cells involved. They are:

  1. Classical Hodgkin’s lymphoma - this is the more common type. In this type, large cancer cells called Reed-Sternberg cells can be seen in the lymph nodes. The subtypes include:

    1. Nodular sclerosing Hodgkin lymphoma (NSHL).

    2. Mixed-cellularity Hodgkin lymphoma (MCHL).

    3. Lymphocyte-rich classical Hodgkin lymphoma (LRHL).

    4. Lymphocyte-depleted Hodgkin lymphoma (LDHL

2. Nodular lymphocytic-predominant Hodgkin’s lymphoma (NLPHL) - this is the rarer type. Here, large cells, called popcorn cells, are seen in the lymph nodes. The prognosis is better if it is diagnosed early.

HD is believed to be caused by DNA mutations and infection with EBV (Epstein-Bar virus), but the exact cause is still not known. With the recent advances in the treatment of Hodgkin's disease, more patients suffering from this cancer are making a full recovery.

What Are the Signs and Symptoms of Hodgkin’s Disease?

Swollen or enlarged lymph nodes are the most common sign of Hodgkin’s disease. This swelling results in a lump under the skin, which is usually painless. The lymph nodes in the neck, armpit, and groin can get enlarged. The other symptoms of this cancer are:

If you have any of these symptoms, consult a doctor immediately.

What Causes Hodgkin’s Disease?

As doctors do not the exact cause of this disease, the following are believed to play a role:

  1. Epstein-Barr virus (EBV) infection - EBV is said to cause Hodgkin’s disease, which is the same virus responsible for infectious mononucleosis (mono).

  2. Genetics - you are at a high risk of getting this cancer if one of your parents or your identical twin or same-sex sibling has it.

  3. Age - it is commonly diagnosed in people between 20 and 40 years of age and older adults above 55 years.

  4. Sex - males are more susceptible than females.

How Does a Doctor Diagnose Hodgkin’s Disease?

The doctor will take a complete personal, family, and medical history. Then the doctor will check for swollen lymph nodes in your neck, groin, and armpit, and see if your spleen or liver is enlarged. Then based on your symptoms and history, if the doctor suspects Hodgkin’s disease, he or she will suggest you get the following tests done:

  1. Blood tests - CBC (complete blood count) is done to see the levels of white and red blood cells and platelets.

  2. Imaging tests - X-ray, CT, and positron emission tomography are used to look for signs of Hodgkin's lymphoma.

  3. Immunophenotyping - to detect the type of lymphoma cells.

  4. Lymph node biopsy - an enlarged lymph node is removed for testing. The lymph node is then tested for the presence of abnormal cells called Reed-Sternberg cells or popcorn cells.

  5. Bone marrow biopsy - a sample of the bone marrow is taken for testing. Here, a needle is inserted into the hipbone and a sample of the bone marrow is aspirated.

What Are the Stages of Hodgkin’s Disease?

After the diagnosis of HD is made, the doctor will then stage cancer. The following are the stages of HD:

  1. Stage 1 - Early stage - cancer cells are present in one lymph node or a single area of an organ.

  2. Stage 2 - Locally advanced disease - cancer cells are present in two lymph nodes on a single side of the diaphragm (the muscle under your lungs) or cancer cells found in one lymph node and a nearby organ.

  3. Stage 3 - Advanced disease - cancer cells are found in lymph nodes present both above and below the diaphragm or cancer cells seen in one lymph node and an organ on opposite sides of the diaphragm.

  4. Stage 4 - Widespread disease - cancer cells found outside the lymph nodes and has spread to other parts, such as liver, bone marrow, etc.

What Are the Treatment Options for Hodgkin’s Disease?

Your treatment plan will depend on the type and stage of Hodgkin’s lymphoma, and overall health. The treatment options include:

1) Chemotherapy - here, drugs are used to kill abnormal cancer cells. These drugs travel through the bloodstream and reach all areas of the body. It is often combined with radiation therapy to treat people with early-stage lymphoma. Chemotherapy drugs are either administered orally or can be injected into the vein. The side effects include hair loss, nausea, and fertility problems.

2) Radiation therapy - this treatment uses high-energy X-rays and protons to destroy cancer cells. This is often used after chemotherapy. During therapy, the patient lies flat on the table and a large arm of a machine moves around the affected body part. The rays are projected towards the affected lymph nodes. The common side effects are skin redness, hair loss, heart disease, stroke, infertility, etc.

3) Bone marrow transplant - otherwise called stem cell transplant. Here, cancer affected bone marrow is replaced with healthy bone marrow. Once the bone marrow is removed and stem cells are frozen to use later, high-dose chemotherapy and radiotherapy are used to destroy cancerous cells. Then the stem cells are injected back in the body through the veins.

4) Immunotherapy - these drugs focus on specific vulnerabilities in the cancer cells. They activate your immune system to kill abnormal lymphocytes. This treatment option is used if other treatments have not been effective or if cancer recurs.

The average five-year survival rate for people diagnosed with HD is 86 % and the 10-year survival rate is 80 %. The survival rates may vary depending on the stage of cancer and the patient’s age. For more information on Hodgkin’s disease, consult an oncologist online!

Frequently Asked Questions


What Causes Hodgkin's Disease?

In Hodgkin’s disease, there is a mutation of the B-lymphocytes (a type of white blood cell), leading to continuous growth and multiplication. Though unclear, the causative factors may be a viral infection due to the Epstein-Barr virus.


What Are the Early Symptoms of Hodgkin's Lymphoma?

Hodgkin’s lymphoma initially presents with persistent swollen single or multiple lymph nodes, painless visible bumps under the skin in the regions of the armpit, groin, and neck that increase in size and number with time. Other symptoms include night sweats, fever, unintentional weight loss, appetite loss, itchiness, and fatigue.


How Does the Body Get Affected by Hodgkin's Disease?

Hodgkin’s disease affects any part of the lymphatic system, which is the body’s cleanser and provides protection against infection. The B-lymphocytes of the lymphatic system lose their infection-fighting property and hence increases the risk of contracting an infection.


From Where Does Hodgkin's Disease Start?

Hodgkin’s lymphoma starts in the lymphocytes, especially B-lymphocytes, which are a type of white blood cells. These can affect any part of the lymphatic system. Frequently the lymph nodes of the armpits, chest, neck, groin, and abdomen swell due to rapidly increasing B-cells.


Is Hodgkin's Disease Treatable?

Hodgkin’s disease is treatable with excellent success rates though the health status and cancer stage determine the success rates.


Is Hodgkin Lymphoma Dangerous?

All cancers are dangerous, but high cure rates, survival rates, and a very treatable form of Hodgkin’s lymphoma make it less serious (if diagnosed and treated early) than certain aggressive cancers.


Can You Have Hodgkin's Lymphoma Without Any Symptoms?

An individual may be having Hodgkin’s lymphoma and be asymptomatic unless and until detected accidentally after a routine investigation test or done for another illness.


Can Stress Trigger Hodgkin's Lymphoma?

Although there is no evidence or studies supporting stress as a causative factor or trigger of developing Hodgkin’s lymphoma, it may negatively impact the mindset of an individual and cause a lack of self-care and motivation in the treatment pathway.


Does Hodgkin's Lymphoma Spread Promptly?

Hodgkin’s lymphoma is a promptly spreading aggressive cancer of the lymphatic system. But it is easy and high curable rates make them relatively less deadly.


Which Is Worse Between Non-Hodgkin’s and Hodgkin’s Lymphoma?

In accordance with the high survival rates and easy treatability, Hodgkin’s lymphoma is less worse than non-Hodgkin’s lymphoma. Both lymphomas are rare, but non-Hodgkin’s lymphoma is relatively common and aggressive than Hodgkin’s lymphoma due to a relatively less percentage of survival rates.


Who Are Predisposed to Non-Hodgkin's Lymphoma?

Risk factors for Hodgkin’s lymphoma include Epstein-Barr viral infection, family history, weak immune system, younger adults, elderly, and autoimmune conditions like Sjogren syndrome, rheumatoid arthritis, celiac disease, etc.


How Long Does It Take to Treat Hodgkin's Lymphoma?

Based on the cancer stage, type, spread, and age or health condition of the patient, the treatment duration may range up to six months (early stages) or even longer (advanced stages). Treatment options include chemotherapy, radiotherapy, or a combination of both with additional steroids.

Article Resources

Last reviewed at:
06 Jul 2023  -  5 min read




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