Hodgkin lymphoma

Classical Hodgkin lymphoma accounts for approximately 95 percent of all Hodgkin lymphoma. While different sub-types of classical Hodgkin lymphoma exist, treatment for classical Hodgkin lymphoma is usually the same for all sub-types and is based on the stage of disease.

Nodular lymphocyte-predominant Hodgkin lymphoma accounts for about five percent of all Hodgkin lymphoma. People diagnosed with nodular lymphocyte predominant Hodgkin lymphoma can go into a remission with treatment although this disease tends to grow back over time. Sometimes people with this disease do not need to undergo treatment, even when the disease is present.

The following tests and diagnostic procedures may be used to diagnose Hodgkin lymphoma:

• A physical exam and full medical history evaluation
• A complete blood count (CBC) that will examine the number of red blood cells and platelets, and the number and type of white blood cells. The CBC will also examine other portions of the blood.
• Blood chemistry studies
• A lymph node biopsy, which will remove part, or the entire lymph node
• Imaging studies such as PET scans, CT scans, chest X-rays and MRI studies

Hodgkin lymphoma has four different stages as classified by the Modified Ann Arbor Staging System:

• Stage I. Single lymph node region or organ involved with disease.
• Stage II. Two or more lymph node regions involved on the same side of the diaphragm (the muscle that controls breathing and that separates the chest from the abdomen).
• Stage III. Lymph node regions involved on both sides of the diaphragm.
• Stage IV. Significant involvement of an organ that is not considered part of the lymphatic system (like the lung or liver) or any organ involvement along with lymph node involvement.
• Additional designations:
  • “B”: Unexplained fevers, chills, drenching night sweats, weight loss or fatigue
  • “E”: Non-lymph node disease that fits into a single area of radiation therapy
  • “X”: Bulky (large) mass, frequently in the mediastinum (chest)

Typically, stage I or II Hodgkin lymphoma is considered “early” stage and stage III or IV is considered “advanced” stage. Within early stage, patients with low-risk features are considered “favorable” and patients not meeting criteria for low-risk disease are considered “unfavorable”.