Hodgkin lymphoma

What it is

Hodgkin lymphoma is 10-20% of lymphoma; non-Hodgkin lymphoma is 80-90%. Hodgkin lymphoma divides into classical HL, which contains Reed-Sternberg cells, and nodular lymphocyte predominant HL (NLPHL), which contains the popcorn cell.

How it presents

Both Hodgkin and non-Hodgkin lymphoma may present with constitutional (B) signs and symptoms: low-grade fever, night sweats and weight loss.

The pattern of nodal disease is what separates them. Hodgkin lymphoma is localized to a single group of nodes and spreads contiguously; non-Hodgkin lymphoma involves multiple lymph nodes, extranodal involvement is common, and spread is noncontiguous.

The distribution is bimodal, in young adulthood and over 55 years, and it is more common in men except for the nodular sclerosing type. It is associated with EBV, while non-Hodgkin lymphoma may be associated with HIV and autoimmune diseases.

Enlarged, painless, rubbery lymph nodes are the finding that says lymphoma. The B-symptoms are drenching night sweats, fevers and 10% weight loss, and they carry a poor prognosis along with age over 40, a raised ESR and LDH, and a large mediastinal nodal mass.