Hodgkin lymphoma (Hodgkin's disease)

Key features and pathology

Microscopically, affected tissue shows Reed–Sternberg cells (or variants), often expressing surface markers that help pathologists distinguish Hodgkin lymphoma from other lymphoid malignancies. The surrounding immune cell infiltrate—T cells, eosinophils and macrophages—gives Hodgkin lymphoma a distinctive appearance that can resemble an inflammatory reaction as well as a malignancy. One clinically important subtype, nodular lymphocyte‑predominant Hodgkin lymphoma, is biologically and clinically distinct from classic forms.

Subtypes and classification

Hodgkin lymphoma is divided into classic forms and nodular lymphocyte‑predominant disease. Classic Hodgkin lymphoma has several histologic patterns that influence presentation and management. Subtypes include nodular sclerosis, mixed cellularity, lymphocyte‑rich and lymphocyte‑depleted patterns. Each subtype has characteristic features and tends to affect certain age groups differently.

Signs, symptoms and diagnosis

Early signs commonly include a painless swollen lymph node in the neck, armpit or groin. Constitutional symptoms—often called B symptoms—can include unexplained weight loss, drenching night sweats and persistent fever. It can also cause itching, fatigue and enlargement of the spleen. Diagnosis relies on excisional lymph node biopsy to demonstrate diagnostic cells and on imaging and laboratory tests to determine disease extent.

Typical diagnostic steps

• Clinical examination and history of symptoms.
• Excisional lymph node biopsy with histology and immunophenotyping.
• Cross‑sectional imaging (CT, PET) to stage the disease.
• Blood tests and, when needed, bone marrow assessment.

Treatment and prognosis

Treatment depends on stage, subtype and patient factors. Early-stage disease is frequently curable with a combination of chemotherapy and localized radiotherapy. More advanced or recurrent disease may require systemic chemotherapy, targeted agents, immunotherapy, or autologous/allogeneic stem cell transplantation. Overall, many patients achieve long-term remission; survival and outcomes have improved substantially with modern therapies, though long-term follow-up is important to monitor late effects of treatment.

History, epidemiology and notable distinctions

Hodgkin lymphoma was first described in the 19th century by physician Thomas Hodgkin. Its incidence and age distribution differ from non‑Hodgkin lymphomas: it often affects younger adults and has a distinctive bimodal age pattern in some populations. A key clinical distinction is that Hodgkin lymphoma is defined by Reed–Sternberg cells and typically follows a predictable pattern of spread from one group of nodes to the next, whereas non‑Hodgkin lymphomas are a diverse group with varied behavior.

For further reading and patient resources, consult specialist oncology summaries and institutional guidelines. Accurate diagnosis by a hematopathologist and staging by an experienced team are essential to choose appropriate therapy and follow‑up.

More on the lymphatic system | What is lymphoma? | Thomas Hodgkin | Lymph node anatomy | Fever and cancer | Spleen function