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What is Hodgkin Lymphoma: Causes, Symptoms & Stages

By Dr. Rayaz Ahmed in Cancer Care / Oncology , Bone Marrow Transplant

Feb 23 , 2026

Hodgkin lymphoma (HL) is a cancer that develops in the lymphatic system and plays an important role in protecting the body against infections and disease. It is characterised by the presence of abnormal Reed–Sternberg cells in lymph node tissue. One of the distinguishing features of Hodgkin lymphoma is its predictable pattern of spread and its high curability, especially when diagnosed early.

Interestingly, the symptoms of Hodgkin lymphoma can closely mimic tuberculosis, which often leads to delayed diagnosis. However, it is important to note that Hodgkin lymphoma is not contagious.

This condition primarily occurs in adolescents and young adults, with another increase in cases observed among older adults, although it can develop at any stage of life.

What Causes Hodgkin Lymphoma?

The exact cause of Hodgkin lymphoma remains unknown. However, several factors are known to be associated with an increased risk.

Risk Factors Include

Viral infections, particularly the Epstein–Barr virus (EBV)
Family history of Hodgkin lymphoma
Weakened immune system
Environmental exposures such as pollution and certain chemicals

Unlike many other cancers, Hodgkin lymphoma does not have a significant association with lifestyle habits like smoking or drinking alcohol.

Key Features of Hodgkin Lymphoma

Origin: Develops in lymph nodes and lymphatic tissues, commonly in the neck, armpits, groin, or chest
Cell Type: Classic Hodgkin lymphoma is defined by Reed–Sternberg cells
Subtypes: Includes classical HL and the rarer nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL)
Spread Pattern: Typically spreads in an orderly manner from one lymph node group to adjacent regions before involving other organs

Common Symptoms

Not all patients experience every symptom. The most common signs include:

Painless swelling of lymph nodes in the neck, armpit, or groin
Persistent fatigue
Fever and night sweats (known as B symptoms)
Unexplained weight loss
Persistent itching
Shortness of breath or cough, especially if the chest is involved

Because these symptoms overlap with infections like tuberculosis, proper evaluation is crucial.

How Is Hodgkin Lymphoma Diagnosed?

Diagnosis involves a combination of clinical evaluation and investigations, including:

Detailed medical history and physical examination
Blood tests
Imaging studies such as CT scan, PET-CT, or MRI
Lymph node biopsy, which confirms the diagnosis by identifying Reed–Sternberg cells
Staging workup to determine disease extent

Staging of Hodgkin Lymphoma

Stage I: Involvement of a single lymph node region or one extranodal site
Stage II: Two or more lymph node regions on the same side of the diaphragm
Stage III: Lymph node involvement on both sides of the diaphragm
Stage IV: Widespread disease involving organs outside the lymphatic system

Treatment Options

Hodgkin lymphoma is one of the most curable cancers, even in advanced stages.

Common Treatment Approaches

Chemotherapy, most commonly the ABVD regimen
Radiation therapy, often combined with chemotherapy in selected cases
Immunotherapy and targeted therapy, such as Nivolumab, Pembrolizumab, or Brentuximab, especially in advanced or high-risk disease, often in combination with chemotherapy

Relapsed or Refractory Disease

In patients whose disease returns or does not respond to initial treatment, autologous bone marrow (stem cell) transplantation can cure 50–60% of cases.

Conclusion

With timely diagnosis and modern treatment strategies, Hodgkin lymphoma has an excellent prognosis. Awareness of symptoms, early medical consultation, and access to specialised cancer care can make a life-saving difference.

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