Overview

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 (cervical lymph nodes) or the area between the lungs and behind the breastbone (mediastinal lymph nodes). Because there is lymph tissue in many parts of the body, Hodgkin lymphoma can start in any of the lymph nodes. If the cancer spreads outside the lymphatic system, Hodgkin lymphoma most often involves the lungs, bones, bone marrow, and liver.

Types of Hodgkin lymphoma

There are four types of Hodgkin lymphoma. These are often treated in a similar manner, although research is emerging that will lead to new treatment approaches for some types.

Nodular sclerosis Hodgkin disease (NSHD). This is the most common type of Hodgkin lymphoma in the United States and other developed countries. It is most common in girls. Tumors are often very bulky, begin in the neck, chest, or abdomen, and may spread to the lungs.

Mixed cellularity Hodgkin disease (MCHD). This type is more common in people who have had the Epstein-Barr virus (the virus that causes mononucleosis) and is more common in boys. It is also the most common type of Hodgkin lymphoma seen in those with human immunodeficiency virus (HIV), the virus that causes acquired immune deficiency syndrome (AIDS). It usually begins in the lymph nodes in the abdomen or in the spleen.

Lymphocyte predominant Hodgkin disease (LPHD). In this type, cells under the microscope resemble normal lymphocytes. It usually begins in the lymph nodes of the underarm, neck, and groin, and less commonly involves the lymph nodes in the chest. In young children, LPHD is much more common in boys; in fact, the boy-to-girl ratio is approximately 10:1.

Lymphocyte depleted Hodgkin disease (LDHD). This is a very rare, aggressive type. It appears in the lymph nodes of the abdomen or pelvis, usually skipping the lymph nodes in the neck or underarms. LDHD is very uncommon in children.

Age and Hodgkin lymphoma

There are three different forms of Hodgkin lymphoma:

• A childhood form (in children 14 years or younger)
  
  
• A young adult form (in people 15 to 34 years old)
  
  
• An older adult form (in people 55 to 74 years old)

Hodgkin lymphoma is rare in children younger than five years old in the United States. Hodgkin disease most often occurs in people between 15 and 40 years old and after age 55.

This section covers Hodgkin lymphoma in children and adolescents. For more information on adult Hodgkin lymphoma, please read the Cancer.Net Guide to Lymphoma, Hodgkin.

Statistics

Hodgkin lymphoma accounts for 3.6% of all cancers in children from birth to age 14 in the United States, but it is the most common cancer in people ages 15 to 19. The five-year relative survival rate (the percentage of people who survive at least five years after the cancer is detected, excluding those who die from other diseases) for children with Hodgkin lymphoma is 96%.

Cancer survival statistics should be interpreted with caution. These estimates are based on data from thousands of cases of this type of cancer, 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 childhood Hodgkin lymphoma. Because the survival statistics are measured in five-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 and Figures 2009.

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