Signs and Symptoms of Hodgkin Lymphoma
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Medically reviewed by Archana Sharma, DO, FAAP
Hodgkin lymphoma is a kind of cancer, one that starts in the cells of the lymphatic system. This is a system that helps move fluid through the body and expose it to immune cells to fight off infection. It is one of the two main types of lymphoma (along with “non-Hodgkin lymphoma”).
Usually, the first symptom of Hodgkin lymphoma is an enlarged but painless lymph node. You might notice this as an unusual lump in your neck or other part of your body.
Some people with Hodgkin lymphoma also have additional symptoms. The most common of these are fever, night sweats, and weight loss, and additional symptoms can happen in advanced disease. However, some people with Hodgkin lymphoma don’t notice any symptoms at all, especially early on.
Hodgkin lymphoma is often curable. But for the best outlook, it’s important to get your symptoms evaluated as quickly as possible.
Enlarged Lymph Node
Usually a health professional can’t feel your lymph nodes, part of your body’s immune system, even though they are there. A lymph node might be enlarged due to Hodgkin lymphoma or some other medical conditions, making it easier to feel.
Enlarged lymph nodes, also called lymphadenopathy, is the most common symptom of Hodgkin lymphoma. You might notice one or more unexplained lumps in your neck, under your arm, around your collarbone, or in your groin.
Usually, an enlarged lymph node from Hodgkin lymphoma isn’t painful to the touch. Some people notice that it feels painful when they drink alcohol. Sometimes the lump becomes bigger over time, and you might notice new lumps appearing near it.
But Hodgkin lymphoma isn’t the most common reason for a swollen lymph node. Infection is a much more common cause, especially in children.
“B” Symptoms
About 40% of people with Hodgkin lymphoma get what are called “B symptoms.” This refers to a designation that scientists have historically used to classify Hodgkin lymphoma. The B symptoms are:
Unexplained high fever (may be intermittent)
Drenching night sweats
Unplanned weight loss (often greater than 10% of body weight)
Other medical problems can cause these symptoms. However, when they occur along with an enlarged lymph node, there’s a strong possibility of some kind of lymphoma. Evaluating for B symptoms is also important, because people with such symptoms may need a different treatment approach from people who don’t have them.
The presence of B symptoms may also mean that a person will have more difficulty fighting the disease overall.
Other General Symptoms
Hodgkin lymphoma can cause other symptoms as well. Some of these might include:
Loss of appetite
Symptoms by Stage
Hodgkin lymphoma is divided into stages based on how much the cancer has spread.
Stages I and II
In stage I disease, the lymphoma has only affected a single site. In stage II disease, the lymphoma has spread a bit more, but it generally hasn’t left the lymphatic system. Any of the symptoms discussed above can affect people with stage I or stage II disease.
Related: 9 Lymphoma Warning Signs To Watch For
Stage III and Stage IV
In stage III, the cancer has spread a bit more. It still hasn’t left the lymphatic system but is more likely to have affected the spleen (another part of the lymphatic system) as well.
B symptoms are more common in people with stage III or stage IV disease compared to those who have earlier stages. People with stage III or stage IV disease are also more likely to have symptoms from an enlarged spleen, such as early fullness after eating.
In stage IV, the cancer might have spread to the liver, bone, lungs, or brain, which can cause additional symptoms. Depending on the areas of spread, it might lead to symptoms like:
Bone or back pain
Shortness of breath, chest pain, or cough from lung involvement
Seizures, headache, muscle weakness, or memory problems from brain involvement (rare)
Jaundice (yellowed skin and whites of the eyes) from liver involvement (rare)
But not everyone with stage IV disease gets all these symptoms.
Symptoms by Hodgkin Lymphoma Subtype
Symptoms of Hodgkin lymphoma tend to vary a little based on the kind of subtype you have.
About 5% to 10% of people have what is called nodular lymphocyte predominant Hodgkin lymphoma (NLPHL). These people tend to have a long-standing single enlarged lymph node without additional symptoms, and they tend not to get an aggressive form of the disease.
Most people have what is called classical Hodgkin lymphoma (CHL), which can be further broken down into different subtypes. These subtypes are:
Nodular sclerosis CHL (NSCHL): More likely to affect lymph nodes in the lungs, which might cause symptoms like shortness of breath
Mixed cellularity CHL (MCCHL): Less likely to cause lung symptoms, but B symptoms are common
Lymphocyte-rich CHL (LRCHL): Tends to have long-standing single enlarged lymph node without additional symptoms
Lymphocyte-depleted CHL (LDCHL): B symptoms are common, often with bone involvement
When to See a Healthcare Provider
If you have what you suspect is an enlarged lymph node, make an appointment with a healthcare provider right away. It’s even more important to do this if you have an enlarged node that isn’t tender or painful, and if you haven’t recently had an infection.
If you have any additional symptoms, especially fever, night sweats, or weight loss, it’s especially critical that you see a health care professional as soon as possible. Tell them you have concerns about lymphoma when you call, to make sure you can get scheduled promptly.
A Quick Review
Hodgkin lymphoma is a type of lymphoma, a kind of cancer. It can cause enlarged lymph nodes which you might feel as a painless lump in the skin under your neck, arm, or collarbone.
Hodgkin lymphoma can also cause symptoms such as fever, night sweats, and weight loss, although many people don’t have these symptoms. Advanced disease can also cause symptoms due to cancer spread, such as shortness of breath.
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