Hodgkin lymphoma, also called Hodgkin’s disease, is one category of lymphoma, a cancer of the lymph system. Lymphoma begins when cells in the lymph system change and grow uncontrollably, which may form a tumor.
The lymph 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 lymph system carries lymph, a colorless fluid containing lymphocytes (white blood cells). Lymphocytes 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 sites in the lymph system. Lymph nodes are found in clusters in the abdomen, groin, pelvis, underarms, and neck. Other parts of the lymph system include the spleen, which makes lymphocytes and filters blood; the thymus, an organ under the breastbone; and the tonsils, located in the throat.
Hodgkin lymphoma most commonly affects lymph nodes, usually beginning in the neck or the area between the lungs and behind the breastbone. It can also begin in groups of lymph nodes under the arms, in the groin, or in the abdomen or pelvis.
If Hodgkin lymphoma spreads, involvement of the spleen, liver, bone marrow, and bone is fairly common. Spread to other parts of the body can also occur, but it is unusual.
This section covers Hodgkin lymphoma in adults. For more information on childhood Hodgkin lymphoma, please visit Lymphoma, Hodgkin, Childhood Cancer.
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 by how the cells in a tissue sample look under a microscope and whether the cells contain abnormal patterns of certain 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 cases of CHL in the United States and Western Europe are associated with the Epstein-Barr virus (EBV, the virus that causes infectious mononucleosis, also known as "mono").
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 all cases). 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.
Lymphocyte rich classic Hodgkin lymphoma. This type of lymphoma accounts for about 6% of all cases of CHL. It is more common in men and usually involves areas other than the chest area (mediastinum). The tissue contains many normal lymphocytes in addition to Reed-Sternberg cells.
Mixed cellularity Hodgkin lymphoma. This type of lymphoma occurs in older adults and more 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 accounts for only about 1% of all cases. It most frequently appears in older people, people with the human immunodeficiency virus (HIV), and people in nonindustrial countries. The lymph node contains almost all Reed-Sternberg cells.
Nodular lymphocyte predominant Hodgkin lymphoma. Nodular lymphocyte predominant Hodgkin lymphoma makes up about 5% of all cases of Hodgkin lymphoma. It is not a part of the CHL group, but is more similar at the protein and genetic level to non-Hodgkin B-cell lymphoma. It is most common in younger patients, often found in the neck lymph nodes. There are more B cells involved than in CHL, and Reed-Sternberg cells are infrequent or absent.
Statistics
In 2009, an estimated 8,510 people (4,640 men and 3,870 women) in the United States will be diagnosed with Hodgkin lymphoma. It is estimated that 1,290 deaths (800 men and 490 women) from this disease will occur this year. Hodgkin lymphoma affects both children and adults. It is most common in two age groups: ages 15 to 40 (ages 25 to 30 are most common) and after 55.
The one-year relative survival rate (the percentage of people who survive at least one year after the cancer is detected, excluding those who die from other diseases) of people with Hodgkin lymphoma is 92%. The five-year and ten-year relative survival rates are 85% and 81%, respectively.
Cancer survival statistics should be interpreted with caution. These estimates are based on data from thousands of cases of this type of cancer in the United States, but the actual risk for a particular individual may differ. It is not possible to tell a person how long he or she will live with Hodgkin lymphoma. Because survival statistics are often measured in multi-year intervals, they may not represent advances made in the treatment or diagnosis of this cancer.
Statistics adapted from the American Cancer Society’s publication, Cancer Facts & Figures 2009.
Find out more about basic cancer terms used in this section.
Last Updated: September 23, 2008
