Hodgkin's Lymphoma Facts
Most often Hodgkin’s disease starts in the lymph nodes in the upper part of the body, in the chest, neck, or under the arms.
Lymph nodes are small, bean-shaped organs that store white blood cells that fight infections. You have lymph nodes in your neck, underarms, and groin, and also deeper inside the body in the chest, abdomen, and pelvis. The lymphatic system also includes the bone marrow, spleen, and thymus.
The first symptom of Hodgkin’s lymphoma may be fatigue or enlarged lymph nodes.
Hodgkin’s disease can spread through the lymphatic vessels (the narrow vessels that connect the lymph nodes and other organs) to other nearby lymph nodes. If the disease progresses further, it can spread outside the lymph nodes to the lungs, liver, or bone marrow.
Risk factors
The causes of Hodgkin’s are unknown. However, doctors and researchers have found some risk factors that are associated with Hodgkin’s disease. These risk factors include age and sex. The disease is more common in men than in women, and more common in people aged 15 to 35 and over the age of 50.
Another proposed risk factor is family history and linkage with certain HLA antigens. The brothers and sisters of people with Hodgkin’s disease have a higher risk of developing the disease.
It is important to realize, however, that most people with these risk factors do not develop Hodgkin’s, and many people who do get the disease had none of the known risk factors.
Symptoms
The symptoms of lymphoma can be caused by other non-cancer conditions. So it's important to see a doctor if you have symptoms that concern you, such as:
Diagnosis
Your doctor will do a physical exam first to look for signs of lymphoma. The doctor will also ask about your health history.
If the doctor thinks that you may have lymphoma, the doctor will probably perform a biopsy next to confirm the diagnosis. To perform a biopsy, a doctor removes a small sample of tissue to examine under a microscope. This may mean removing part or all of a lymph node or some tissue by surgery.
Another method is to take a sample of fluid or tissue using a needle, called needle biopsy or fine needle aspiration. This type of biopsy may be done to check the bone marrow or the fluid around the lungs (pleural fluid) or in the membrane around the abdominal organs (peritoneal fluid).
Your doctor may also want you to have imaging studies, such as a chest X-ray, computed tomography (CT) scan or PET scan, to see pictures of the inside of your body. This allows the doctor to look for enlarged lymph nodes, tumors or areas of cancer activity.
Doctors may do further tests to detect whether the cancer has spread around the lymph system or to other areas. This helps your doctor determine the stage of your cancer, which will be important when it's time to make decisions about your treatment. You may need these or other tests:
Staging refers to the way doctors classify lymphoma based on where it is in the body. People who have lymphoma are considered to be at one of these stages:
Lymph nodes are small, bean-shaped organs that store white blood cells that fight infections. You have lymph nodes in your neck, underarms, and groin, and also deeper inside the body in the chest, abdomen, and pelvis. The lymphatic system also includes the bone marrow, spleen, and thymus.
The first symptom of Hodgkin’s lymphoma may be fatigue or enlarged lymph nodes.
Hodgkin’s disease can spread through the lymphatic vessels (the narrow vessels that connect the lymph nodes and other organs) to other nearby lymph nodes. If the disease progresses further, it can spread outside the lymph nodes to the lungs, liver, or bone marrow.
Risk factors
The causes of Hodgkin’s are unknown. However, doctors and researchers have found some risk factors that are associated with Hodgkin’s disease. These risk factors include age and sex. The disease is more common in men than in women, and more common in people aged 15 to 35 and over the age of 50.
Another proposed risk factor is family history and linkage with certain HLA antigens. The brothers and sisters of people with Hodgkin’s disease have a higher risk of developing the disease.
It is important to realize, however, that most people with these risk factors do not develop Hodgkin’s, and many people who do get the disease had none of the known risk factors.
Symptoms
The symptoms of lymphoma can be caused by other non-cancer conditions. So it's important to see a doctor if you have symptoms that concern you, such as:
- Painless swollen lymph nodes in the neck, underarm, groin, chest or abdomen
- Unexplained fever, weight loss or night sweats, sometimes called B symptoms
- Ongoing fatigue
- Itchy skin
- Red bumps on the skin, in the case of non-Hodgkin lymphoma
- Swelling in the face, neck or upper chest, caused by lymphoma pressing on the major vein that drains blood from these areas
- Feeling of fullness in the abdomen from an enlarged liver, spleen or lymph nodes
- Abdominal problems, such as nausea, vomiting and indigestion
Diagnosis
Your doctor will do a physical exam first to look for signs of lymphoma. The doctor will also ask about your health history.
If the doctor thinks that you may have lymphoma, the doctor will probably perform a biopsy next to confirm the diagnosis. To perform a biopsy, a doctor removes a small sample of tissue to examine under a microscope. This may mean removing part or all of a lymph node or some tissue by surgery.
Another method is to take a sample of fluid or tissue using a needle, called needle biopsy or fine needle aspiration. This type of biopsy may be done to check the bone marrow or the fluid around the lungs (pleural fluid) or in the membrane around the abdominal organs (peritoneal fluid).
Your doctor may also want you to have imaging studies, such as a chest X-ray, computed tomography (CT) scan or PET scan, to see pictures of the inside of your body. This allows the doctor to look for enlarged lymph nodes, tumors or areas of cancer activity.
Doctors may do further tests to detect whether the cancer has spread around the lymph system or to other areas. This helps your doctor determine the stage of your cancer, which will be important when it's time to make decisions about your treatment. You may need these or other tests:
- Complete blood count, or CBC: to determine how many cells of each type are circulating in the blood stream
- Blood chemistry analysis: to look for chemicals in the blood that indicate disease in certain organs or tissues
- Lumbar puncture, or spinal tap: to remove cerebrospinal fluid (CFS) from the spinal column and check it for cancer cells; used in non-Hodgkin lymphoma only
- Bone marrow test: to see if the lymphoma has spread to the bone marrow
Staging refers to the way doctors classify lymphoma based on where it is in the body. People who have lymphoma are considered to be at one of these stages:
- Stage I: This stage applies to those who have lymphoma in only one lymph node area or one organ.
- Stage II: This stage applies to those who have lymphoma in two or three lymph node areas near each other, such as all in the neck and chest.
- Stage III: This stage applies to those who have lymphoma in several lymph node areas in the neck, chest and abdomen.
- Stage IV: This stage applies to those who have widespread lymphoma in their lymph nodes and other organs, such as lungs and liver.
- Doctors may add a letter after your stage to describe more about your disease.
- In Hodgkin lymphoma, doctors use the letters A and B to describe whether you have symptoms:
- A (such as 'stage IA) means you do not have symptoms.
- B (such as 'stage IB) means you have the B symptoms fever, weight loss or night sweats.