Hodgkin lymphoma, also called Hodgkin’s disease, is one category of lymphoma, a cancer of the lymphatic system. Lymphoma begins when cells in the lymphatic system change and grow uncontrollably, which may form a tumor or spread to other parts of the body.

About the lymphatic system

The lymphatic system is made up of thin tubes that branch out to all parts of the body. Its job is to fight infection and disease. The lymphatic system carries lymph, a colorless fluid containing lymphocytes (a type of white blood cell). Lymphocytes are part of our immune system and help fight germs in the body. B-lymphocytes (also called B cells) make antibodies to fight bacteria, and T-lymphocytes (also called T cells) kill viruses and foreign cells and trigger the B cells to make antibodies.

Groups of bean-shaped organs called lymph nodes are located throughout the body at different areas in the lymphatic system. Lymph nodes are found in clusters in the abdomen, groin, pelvis, underarms, and neck. Other parts of the lymphatic system include the spleen, which makes lymphocytes and filters the blood; the thymus, an organ under the breastbone; and the tonsils, which are located in the throat.

Hodgkin lymphoma most commonly affects lymph nodes in the neck or the area between the lungs and behind the breastbone. It can also begin in groups of lymph nodes under an arm, in the groin, or in the abdomen or pelvis.

If Hodgkin lymphoma spreads, it may spread to the spleen, liver, bone marrow, or bone. Spread to other parts of the body can also occur, but it is unusual.

This section covers Hodgkin lymphoma in adults. Learn more about childhood Hodgkin lymphoma or non-Hodgkin lymphoma in adults.

Types of Hodgkin lymphoma

There are different types of Hodgkin lymphoma. It is important to know the type, as this may affect the choice of treatment. Doctors determine the type of Hodgkin lymphoma based on how the cells in a tissue sample look under a microscope and whether the cells contain certain abnormal proteins.

The American Joint Committee on Cancer (AJCC) recognizes these major categories of Hodgkin lymphoma:

Classical Hodgkin lymphoma. Classical Hodgkin lymphoma (CHL) is diagnosed when characteristic Reed-Sternberg cells are found. About 20% to 25% of people with CHL in the United States and Western Europe have also had an infection with the Epstein-Barr virus (EBV, the virus that causes infectious mononucleosis, also known as "mono"). However, the role of EBV in the development of Hodgkin lymphoma is not yet clear.

The following list describes the different CHL subtypes.

• Nodular sclerosis Hodgkin lymphoma. Nodular sclerosis Hodgkin lymphoma is the most common form of CHL; up to 80% of people with CHL have this form. It is most common in young adults, especially women. In addition to Reed-Sternberg cells, there are bands of connective tissue in the lymph node. This type of lymphoma often involves the lymph nodes in the mediastinum (chest).

• Lymphocyte-rich classical Hodgkin lymphoma. About 6% of people with CHL have this form. It is more common in men and usually involves areas other than the mediastinum. The tissue contains many normal lymphocytes, in addition to Reed-Sternberg cells.

• Mixed cellularity Hodgkin lymphoma. This subtype of lymphoma occurs in older adults and, commonly, in the abdomen. It carries many different cell types, including large numbers of Reed-Sternberg cells.

• Lymphocyte-depleted Hodgkin lymphoma. Lymphocyte-depleted Hodgkin lymphoma is the least common subtype of CHL, and about 1% of people with CHL have this form. It is most common in older adults, people with the human immunodeficiency virus (HIV, the virus that causes autoimmune deficiency syndrome or AIDS), and people in nonindustrial countries. The lymph node contains almost all Reed-Sternberg cells. 

There is another type of Hodgkin lymphoma that is not a part of the CHL group; rather, it is more similar at the protein and genetic level to B-cell non-Hodgkin lymphoma.

Nodular lymphocyte-predominant Hodgkin lymphoma. About 5% of people with Hodgkin lymphoma have nodular lymphocyte-predominant Hodgkin lymphoma. It is most common in younger patients, and is often found in the neck lymph nodes. Nodular lymphocyte predominant Hodgkin lymphoma is often treated differently than CHL. Patients with this type of lymphoma tend to have a very good prognosis (chance of recovery). Sometimes, nodular lymphocyte predominant Hodgkin lymphoma will turn into an aggressive type of non-Hodgkin lymphoma called diffuse large B-cell lymphoma.

Find out more about basic cancer terms used in this section.

Looking for More of an Overview?

If you would like additional introductory information, explore the following items on Cancer.Net:

• Cancer.Net Patient Education Video: View a short video led by an ASCO expert in this type of cancer that provides basic information and areas of research.

• Cancer.Net En Español: Read about Hodgkin lymphoma in Spanish. Infórmase sobre linfoma de Hodgkin en español.

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