clinical features

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The majority of patients present with painless lymphadenopathy (most commonly cervical or supraclavicular).

  • mediastinal masses (present in around 80% of patients) is more common in nodular sclerosing HL and are sometimes discovered after routine chest radiography,
  • peripheral or sub-diaphragmatic lymphadenopathy is more common in mixed-cellularity classical HL (1,2)

Other systemic symptoms:

  • B symptoms:
    • seen in approximately 25% of patients and includes
      • unexplained fever >38°C
      • drenching night sweats
      • weight loss of >10% over 6 months (1)
  • generalised pruritus
  • chest discomfort with a cough or dyspnoea (2)
  • anaemia
  • immune dysfunction

In advanced disease there may be infiltration of any organ often presenting with hepatosplenomegaly. Other sites for tumour localisation include bone, bone marrow, lung, kidneys.

  • bone marrow involvement is detected in only 5-8% of patients with conventional staging but in up to 18% with PET/CT staging

The Ann Arbor system is used to stage Hodgkin's disease.


Last reviewed 01/2018