This information should not be used to self-diagnose, or be used in place of a qualified physician’s care.

• Patients with Hodgkin lymphomas are treated by members of the BC Cancer Agency’s Lymphoma Tumour Group.
• For healthcare professional information on treating this cancer, please see our Cancer Management Guidelines: Hodgkin Lymphoma.
• The name of this cancer may be spelled Hodgkin, Hodgkins, or Hodgkin’s; it is also called Hodgkin Disease. Dr. Thomas Hodgkin first described lymphoma in the 1830s. 
• Lymphomas are cancers that arise from lymphocytes, white blood cells that circulate primarily through the lymphoid system. The lymphoid system is part of the immune system, which protects against infection.
• The lymphoid system consists of: lymph nodes, lymphatic vessels, lymph fluid and lymph tissue in other organs such as the spleen, thymus, bone marrow.
• The lymph nodes are small organs occurring in many places in the body, particularly in the chest, neck, armpit, groin and amongst the blood vessels of the intestines. Lymphatic vessels are a network to carry lymph fluid between the nodes and through the body.
• Lymphomas are called B-cell or T-cell lymphoma depending on the type of lymphocyte that has become cancerous. Hodgkin lymphoma usually starts with a B-cell lymphocyte. 
• Abnormal or cancerous lymphocytes (T-cell or B-cell) may:
• stay in the lymph nodes, or
• form solid tumours in the body, or
• rarely, like leukemia, circulate in the blood
• Hodgkin lymphoma is recognized under the microscope by a distinct looking cancer cell called the “Reed-Sternberg cell.”

What causes it and who gets it?
Listed below are some of the known risk factors for this cancer. Not all of the risk factors below may cause this cancer, but they may be contributing factors.

• The cause of Hodgkin lymphoma is not yet known.
• Both men and women are diagnosed with Hodgkin lymphoma and it can occur at any age, more commonly in adults aged 15 - 35, or over 50, but there is no increased risk with aging in general.
• Some researchers suspect a problem in the body's immune (infection-fighting) system plus response to an external stimulant, such as a virus. Hodgkin lymphoma is more common in countries where people get fewer common childhood infections, and it is less common in developing countries, where adults have survived many exposures to disease.
• Infection with the Epstein-Barr virus can increase risk.
• An unusual diagnosis in blood cells, called PTGC (Progressive Transformation of Germinal Centres), has been associated with Hodgkin lymphoma.
• Having someone in the immediate family (parents, brothers, or sisters) with Hodgkin Lymphoma may mean a higher risk, but no gene has been identified.
• Some additional factors seem to increase risk, but probably do not cause Hodgkin lymphoma: previous stem-cell transplant, immunodeficiency, auto-immune diseases such as rheumatoid arthritis, tobacco use, and infectious mononucleosis.
• Lymphomas (all kinds together) are the seventh most common cause of cancer deaths and the fifth most common cancer diagnosed in men or women. Hodgkin lymphoma occurs in 10-14% of all lymphomas. It is not very common.
• Statistics
• B.C.
• Canada - Listed as Hodgkin's disease (M-9650-M-9667), far down on this table.
• Hodgkin lymphoma occurs in fewer than 3 out of every 100,000 Canadians.

Can I help to prevent it?

• There is no effective prevention known for Hodgkin lymphoma.

Screening for this cancer

• Most symptoms of Hodgkin lymphoma are also common in other, less serious disorders. They are more often caused by something else, and not likely a sign of lymphoma.  However, it is always important to have symptoms checked by a healthcare professional.
• Symptoms include:
• Painless enlarged lymph nodes in neck, groin or armpit
• Fatigue
• Shortness of breath
• Itchiness on the trunk of the body
• Unusual back or abdominal pain
• Abdominal swelling
• The following symptoms are called "B symptoms," and affect the staging and treatment of Hodgkin lymphoma.
• Persistent fever whose cause is unknown
• Unexplained night sweats, sometimes so severe the bedclothes have to be changed
• Unexplained weight loss
• Lymph nodes can be swollen in a particular part of the body, such as chest, abdomen, throat, or groin and cause additional symptoms in that area.

Diagnosis
This is a list of some or all of the tests used to diagnose this type of cancer.

Types

• Hodgkin lymphoma is one kind of lymphoma. It has been classified by several systems, using different names.
• There are five different types of Hodgkin lymphoma, based on the exact kind of cell seen under a microscope. Treatments are similar for all five types.
• Classification according to the World Health Organization (WHO):
• Classical Hodgkin lymphoma (this lymphoma includes four of the five types):
• Nodular sclerosis – about 75% of Hodgkin cases; more common in women than men; less common in people over the age of 50
• Lymphocyte-rich – rare
• Mixed cellularity – about 20% of cases
• Lymphocyte depletion – rare
• Nodular lymphocyte predominance – rare, and different than the four “classical” types.

• Careful diagnostic and staging procedures will identify the pattern of spread.