Diagnosis & staging
This is information about Hodgkin Lymphoma. For information about Non-Hodgkin Lymphoma, see
Non-Hodgkin Lymphoma.
For information about Skin Lymphomas, including Mycosis fungoides, cutaneous T-cell lymphoma, and Sézary syndrome, see
Skin Lymphoma.
The lymphoid system includes:
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Lymph nodes.
- Lymphatic vessels.
- Lymph fluid.
- Lymph tissue in organs such as the spleen, thymus, and bone marrow.
The lymph nodes are small organs in many places in your body. They are mostly in your chest, neck, armpit, groin and near the blood vessels of your intestines. Lymphatic vessels carry lymph fluid between your lymph nodes and throughout your body.
This cancer may be called Hodgkin, Hodgkins, Hodgkin's, or Hodgkin Disease. It is named after Dr. Thomas Hodgkin, who first described lymphoma in the 1830s.
Hodgkin lymphoma is considered "aggressive". This means that it will spread and grow, so you need treatment. Treatment works very well for most people.
Hodgkin lymphoma is not very common. It makes up 10-14% (10-14 out of 100) of all lymphomas.
Most symptoms of Hodgkin lymphoma are also common in other, less serious illnesses. It is always important to have symptoms checked by your doctor or nurse practitioner.
Hodgkin lymphoma symptoms can include:
- Painless, enlarged lymph nodes in your neck, groin or armpit.
- Fatigue (extreme tiredness).
- Shortness of breath.
- Itchiness on the trunk (chest and stomach area) of your body.
- Unusual back or abdominal pain.
- Abdominal swelling.
The following are known as "B" symptoms. These symptoms will affect the staging of the disease and what treatment you have:
- A fever that will not go away and has an unknown cause.
- Unexplained night sweats. These can be so severe that you need to change your bed sheets.
- Unexplained weight loss of more than 10% of your body weight in the last 6 months.
If you have any signs or symptoms that you are worried about, please talk to your family doctor or nurse practitioner.
Tests that may help diagnose Hodgkin lymphoma include:
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Physical exam: close attention to lymph nodes, spleen, liver and pain in bones.
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Blood and urine (pee) tests
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Chest X-ray
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CT (computed tomography) scan: scans of chest, abdomen and/or pelvis to look for signs of cancer in those organs and nearby lymph nodes.
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Biopsy: a surgeon will remove the lymph node(s) or tissue with cancer. A specialist doctor (pathologist) will look at the cells under a microscope. Hodgkin lymphoma has a unique looking cell called a "Reed-Sternberg cell".
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Other scans of bones or organs, such as the liver and spleen.
Hodgkin lymphoma is usually predictable and spreads to nearby lymph nodes.
For more information on tests used to diagnose cancer, see
BC Cancer Library screening and diagnosis pathfinder
Lymphomas are called B-cell or T-cell lymphoma, depending on the type of lymphocyte that has the cancer.
- B-cell lymphocytes come from the bone marrow. 90% (90 out of 100) of lymphomas are B-cell.
- T-cell lymphocytes come from the thymus, a gland in the central part of your chest. T-cell lymphomas are less common and have a greater chance of recurring (coming back).
Hodgkin lymphoma usually starts in a B-cell lymphocyte.
Abnormal or cancerous lymphocytes (T-cell or B-cell) may:
- Stay in the lymph nodes.
- Form solid tumours.
- Rarely, like leukemia, circulate in the blood.
Hodgkin lymphoma is considered "aggressive". This means that it will spread and grow, so you need treatment. Treatment works very well for most people.
Classical Hodgkin lymphoma (this includes four of the five types)
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Nodular sclerosis: About 75% (75 out of 100) of cases. More common in females than males [See note below, Statistics]. Less common in people over the age of 50.
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Lymphocyte-rich: Rare.
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Mixed cellularity: About 20% (20 out of 100) of cases.
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Lymphocyte depletion: Rare.
Nodular lymphocyte predominance: Rare.
Staging describes the cancer. Staging is based on how much cancer is in your body, where it was first diagnosed, if the cancer has spread and where it has spread to.
The stage of the cancer can help your health care team plan your treatment. It can also tell them how your cancer might respond to treatment and the chance that your cancer may come back (recurrence).
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Stage 1: Cancer is only in one lymph node area.
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Stage 2: Cancer is in two or more lymph node areas on the same side (above or below) of your diaphragm. The diaphragm is a thin muscle below your lungs and separates your chest from your abdomen.
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Stage 3: Cancer is in lymph node areas on both sides of your diaphragm.
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Stage 4: Cancer has spread outside of the lymphatic system, into other organs or tissues.
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A: you have no symptoms from the "B" list [see signs and symptoms above]
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B: you have symptoms from the "B" list.
For more information about staging, see About Cancer.
Note: Available statistics do not have information about the inclusion of transgender and gender diverse participants. It is unknown how these statistics apply to transgender and gender diverse people. Patients are advised to speak with their primary care provider or specialists about their individual considerations and recommendations.
